Like many in the kidney community, and indeed the other clinical communities that have developed managed clinical networks over the last decade or so, I was pleased to read Sir David Nicholson’s, Chief Executive of the NHS and Chief Executive designate of the NHS Commissioning Board, latest letter on managing the transition in which he endorses the role of clinical networks in driving up quality of care.
Sir David said “as part of the broader engagement work, I have asked Sir Bruce Keogh, the NHS Medical Director and the National Clinical Directors to begin longer term work to strengthen our multiprofessional clinical networks and to engage with the networks to understand how best to improve outcomes for patients. There is a central role for networks in the new system as the place where clinicians from different sectors come together to improve the quality of care across integrated pathways. So I want to put these networks at the heart of our efforts to renew and strengthen engagement”.
One of the key challenges now facing networks is to demonstrate their role in improving the integration and coordination of care. Seeing people in the right place, at the right time, by the right professionals with the right information – for both patients and healthcare practitioners, remains as important as ever. Where the provision or commissioning of services is fractured there are considerable risks to patient safety, inefficiency in resource utilisation and too often a dip in quality.
By bringing all the interested parties including patients, to the table networks can facilitate the ways of working needed to deliver coordinated care, measure quality across boundaries of care and potentially support choice and competition.
These days the journals, health service magazines and even the general media are full of claim and counter claim about the “NHS reforms”. The “natural pause” announced by the Secretary of State does allow time to listen, reflect and improve the recommendations in the health and social care bill. Kidney care organisations need to be involved in those debates. But it is possible to get deflected from the day job by all the change and uncertainty and forget that there are a lot of certainties facing the NHS – the financial situation, the aging population, the increasing demands of our public, the central role primary care has always played and will continue to play in our system and the fact that, although kidney disease is changing, it’s also increasing year on year.
If you could only read one thing about the NHS in these turbulent times I would recommend Sir David’s letters on transition “Equity and excellence : liberating the NHS – managing the transition”. They are the epitome of the writing tenets I was taught at school – accuracy, brevity and clarity. Sir David says in taking decisions this year you need only ask yourself 2 questions:
· Will it improve the care for your patients?
· Will it improve value for taxpayers?
If the answer to both is “yes” then it’s the right thing to do.