Constitution and Terms of Reference for the Western Isles Neurology Managed Clinical Network 2012 1
Background The concept of Managed Clinical Networks (MCNs) was first set out in the report of the Scottish Acute Services Review, published in June 1998. The Executive s continuing commitment to the concept was made clear in the recent CEL Managed Clinical Networks: Supporting Delivering the Healthcare Quality Strategy (July 2012), which highlighted the potential for MCNs to improve services for those suffering from chronic conditions. In particular Managed Clinical Networks are now central to existing strategies in areas such as diabetes and cancer management and have an established role in the overall approach to the management of long-term conditions. In addition to offering a framework for clinical service delivery, the principles underpinning MCN s, initially expressed in Strengthening the Role of Managed Clinical Networks HDL (2007), and reiterated in this recent CEL, also support other key objectives such as multi-disciplinary working, patient involvement, quality assurance, audit and the effective use of resources. As summarised within the document, the MCN concept continues to be relevant in the context of improving quality and service provision for people with Long Term Conditions. The recent Long Term Conditions Collaborative document Improving Care Pathways (April, 2010) highlights the excellent progress being made by MCN s and highlights that MCN s are integral to achieving the 3 Quality Ambitions and epitomise the ethos of cooperation and collaboration. 2
1. Purpose of the NHS Western Isles Neurology MCN To maintain a strategic overview of NHS planning in relation to Neurology Services, and to ensure that these planning processes are linked to robust operational arrangements The MCN will look to improve the prevention, diagnosis, treatment and care of patients with Neurological Conditions in terms of quality, access and coordination of services. The MCN will focus on five specific Neurological conditions Epilepsy, Headache, Motor Neuron Disease, Multiple Sclerosis and Parkinsons and when it is appropriate to do so, will extend its interest to include other neurological conditions affecting adults and young people. The MCN will link with other services and projects which are involved with population groups most vulnerable to neurological conditions such as people with Learning Disabilities and ensure that planning takes account of people with special needs. 2. Values and Principles NHS Western Isles Neurology MCN adheres to the following values and principles. Service provision for people living with neurological conditions should be high quality, person-centred and based on the principle of equality: Person-centred: People living with a neurological condition should be treated as individuals and given reasonable choice in the provision of their health and social care. People with a neurological condition must be at the centre of their care and must be enabled to have their views, needs and experiences recognised by their service provider. 3
Equity: All people with a neurological condition should equally receive the best standards of care and access to care, irrespective of who they are, where they live, where they access services, and what complications they may have. The Neurology MCN has identified the following as being fundamental to its development: Information and Education: All people with a neurological condition and all members of the multi-disciplinary team who care for them should be provided with up-to-date, consistent and on-going information and education appropriate to their personal and/or professional needs. Access: All people across the Western Isles with a neurological condition should have access to integrated services that meet their individual needs. Standards and Quality Assurance: All people with a neurological condition should have access to a high standard of personal-centred care, assured through regular and performance management arrangements. Communication and Coordination: Systems should be developed which ensure a high level of communication and coordination of neurological care between professionals across statutory and non-statutory health and social care services, to ensure seamless access within different parts of the system for all patients. Signposting will be available across the Western Isles and all staff should have access to these patient referral and clinical pathways. Resource: Services for people living with a neurological condition should be coordinated to ensure the most effective use of resources involved in provision of their care. NHS Western Isles Neurology MCN aims to deliver high quality, integrated and equitable neurological care. 4
Managed Care Networks seek to promote effective collaboration across professional and organisational boundaries and to facilitate health professionals to work in partnership with patients to ensure the best use of resources, facilities, knowledge and experience and thereby improve the patient s experience and promote improvement in quality of life. The MCN will operate in line with the standards set out by the Healthcare Improvement Scotland (HIS). The Neurology MCN will be proactive in capturing service users/carers views and this will be audited through needs assessments which will take place on a regular basis and reviewed as and when required. 3. Objectives of NHS Western Isles Neurology MCN The provision of current, accurate information for patients and carers Prompt diagnosis and access to treatment Person centred care and choice Integrated service provision Rehabilitation Self Management Provision of palliative care Safe and effective use of medicines Appropriate specialist intervention Staff education and training Best use of technology Neurological Care Pathways 5
4. Proposed Structure The MCN will be composed of representatives from all sectors involved in planning the delivery of neurology services across the Western Isles area. The membership may be altered or amended from time to time and can be extended to involve others in short-life working groups when required. The Committee membership of each MCN shall comprise: Chair Person Clinical Lead Nursing representation AHP Representation as appropriate (Radiology, Dietetics, Physiotherapy, Occupational Therapy, Speech and Language Therapy) Comhairle Nan Eilean Siar Social services (as appropriate) Pharmacist (as appropriate) Strategic Planning Service Users MCN Coordinator Primary care Operational Managers Each department working in the delivery of neurological services is required to appoint a representative. Each representative, or their nominated deputy, shall attend the MCN meetings. 6
Neurology service partners are required to agree and establish local mechanisms to deliver the Neurology agenda and to develop local responses and services. Agreement is required by all partners and their representatives to constructively participate in the network and function in accordance with the agreed processes and evidence base. There will be patient / carer representation on the MCN with links to established patient/carer engagement systems. The MCN shall appoint a Clinical Lead, a Chairperson and a Vice- Chairperson. 5. Neurology MCN Role and Remit Proposed remit and responsibilities The MCN is a planning structure with responsibility for prioritising and making recommendations to the Board for future service developments and the planned spend of any development funding. The Neurology MCN will focus on the development and implementation of the Neurology Services 3 Year Strategy and Action Plan. It will ensure that this Action Plan is developed in line with National Standards and Guidelines. It will provide evidence based guidance to local services to identify and address issues within local services through performance information, 7
patient experience and perspectives from across the NHS and relevant partners in social care and the voluntary /independent sector. The MCN will remain focused on equity, efficiency and effectiveness as well as development. 6. Responsibilities Members have a responsibility to consider the corporate local and national agenda in the deliberations of advice given by the MCN. Members will have a responsibility to communicate effectively between the MCN, relevant professions and their organisation and will be expected to have delegated authority on behalf of their respective organisation and be able to commit to the decision-making of the Neurology MCN. 7. Meetings The MCN will meet six weekly and meeting dates will be distributed in advance at the beginning of the calendar year to ensure adequate time for diary planning. 8. Proposed Decision Making Process Where the MCN is making formal decisions: Each representative will have one vote All votes equal weighting Decisions will be based on a simple majority Should an impasse be reached the MCN chair will have the casting vote. The partnership quorum will be FIVE voting members. 8
9. Proposed Governance Arrangements The NHS Western Isles Board relationship to the Neurology MCN will be provided through the Board s Executive Lead for Neurology. The MCN Manager and Clinical Lead, along with the Board s Executive Lead for Neurology will be responsible for working with the MCN to deliver the action plans. The MCN will develop a 3 year Neurological Services Strategy. The MCN will prepare an annual report and work plan to develop and deliver service improvements with best value to be routinely considered. The MCN will submit an annual report to the Corporate Management Team. The MCN will be required to adhere to evidence based, treatment guidelines, quality assurance procedures, including audit and patients and carer involvement in governance. 10. Communication and Reporting Procedures The Neurology MCN is accountable to NHS Western Isles through the Corporate Management Team. The MCN will provide as required updates on the progress of the Neurology MCN s annual work plan to the Executive Lead for communication to the NHS Board Corporate Management Team. The Neurology MCN has a clear commitment to disseminate information to patients, staff and the wider public. This will be achieved as follows: 9
The MCN will disseminate information to members and constituent services. Best practice guidelines will be developed and shared; A web site will be developed and proactively managed and promoted; An annual report will be written and will be made widely available; MCN Manager will undertake a regular commitment to attend workshops meetings and give presentations to interested groups. Press releases and the use of external media will be coordinated through the Communication Manager. 11. Change of Constitution Changes to the constitution can only be made at a meeting of the MCN, having given members at least four weeks notice of the proposed change(s). The change must be agreed by a majority vote of the full membership 12. Connection to the wider NHS Western Isles Long Term Conditions Agenda The Neurology MCN will be an integral part of the planning process. The challenge will be to maintain the strength of being clinically focused whilst playing an effective part in generating whole system change within the wider planning process. 10
There is potential for participation in whole system planning events where groups of MCNs which have commonality, for example those relating to Long Term Conditions. 11