Clinical networks covering four condition-areas will be centrally-funded and hosted by the NHS Commissioning Board, it confirmed today.
They will be known as strategic clinical networks and cover cardiovascular disease (including heart, stroke, renal and diabetes); cancer; maternity and children; and mental health.
At present each network, which is based on a region or a local area, is run by its own specific support team. However, under the new system each will be supported by a unified support team, shared with the other networks in each of the commissioning board’s 12 local area teams.
They will be expected to be run according to a single operating model, and are expected to have fewer staff. Those running the networks – who are currently mainly employed by primary care trusts – will instead work for LATs.
NHS medical director Sir Bruce Keogh said retaining clinical networks after the commissioning transition would “avoid throwing the baby out with the bathwater” in the reforms.
He said: “We are keen to preserve things which we know have worked and worked well. There is a feeling networks have been instrumental in helping to improve care.”
The announcement today does not include details of funding for running the networks.
However, the board confirmed to HSJ its budget for networks and clinical senates - with which they will share support teams - would be about £42m annually. Currently networks are allocated about £80m, and the change is being seen as a cut by some working in them. However, the board has decided that around £30m of this is spent on functions such as the National Cancer Action Team and NHS Diabetes, which will transfer into the board’s own service transformation directorate.
Therefore the board believes its new £42m funding total will be “slightly more” than what is currently spent on networks.
A senior NHS clinical source said that, although not directly run by networks, the improvement functions they fund are closely related to their work.
Sir Bruce said moving those functions from networks to the board’s improvement division was the right decision. It would introduce a “systematic approach to change and improvement” and “standardise change methodology and broaden its reach”, he said.
But he said it was important for networks and the board’s clinical leadership to establish “how we build a useful working relationship with the people who are doing transformation”.
The four networks will sit under three of the board’s clinical domain directorates. Cardiovascular and cancer will be under domain one (led by Sir Mike Richards); mental health under domain two (led by Martin McShane); and maternity and children under domain three, related to short episodes of care (for which no lead has yet been appointed).
The domain leads will use them to drive improvement in outcomes, the board said.
The future of nationally-supported clinical networks and funding has been unclear since the government’s reforms were announced.
Other types of clinical networks will have to be formed and supported by commissioners and providers independently.