Research Projects

Delivering health care through managed clinical networks (MCNs): lessons from the North

Researchers

Huw Davies, SDHI
Bruce Guthrie, Tayside Centre for General Practice, University of Dundee
Rosemary Rushmer, SDHI
Isabel Walter, SDHI

Background

Increasingly, health care is being delivered through networks that aim to cut across NHS organisational and professional boundaries. Such 'managed clinical networks' have been encouraged and in some cases mandated by policy makers. They are believed to promote the coordination of care and integration of services, and to lead to improved clinical outcomes, better patient experience, greater equity and enhanced cost effectiveness. However, it is not yet clear what forms of network are most likely to be successful; how they should be set up and managed; or even whether they will actually deliver anticipated benefits.

Aims of the study and methods of working

The overall aim of the project is to generate deeper understandings of the origins, processes and impacts of managed clinical networks, with a view to supporting policy design and implementation. The research will focus on an in-depth examination of four contrasting managed clinical networks for diabetes and heart disease care in two Scottish Health Boards, and includes both networks with strong voluntary roots and 'mandated' networks created in response to policy diktat.

Initial interviews with key policy makers and individuals involved in networks will elicit 'theories in use' on what makes an effective network. Case studies of each network will test these emergent theories, drawing on documentary, interview, patient tracker and longitudinal data. In addition, a national survey of other networks will clarify the extent to which local patterns identified in the case studies are replicated more widely. Finally, workshops, consultation and a modified Delphi process undertaken with experts on network policy and implementation will be used to 'reality test' the findings from the research. By sharing data and experiences with concurrent projects being carried out in England, the study will allow lessons to be drawn for the whole of the UK.

Funding

The study is funded by the NHS SDO (Service Delivery and Organisation) R&D Programme. It is one of three empirical projects looking at the management and effectiveness of professional and clinical networks within the SDO's Studying Healthcare Organisations Programme.