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A nascent network in North East and North Cumbria ICS

Tuesday, June 2, 2020

The NHS England Long Term Plan restated the importance of Respiratory Clinical Networks in delivering its ambitious aims and COVID-19 has shown just how much networks can speed up the response of the health service. Since the launch of the Long Term Plan, a number of regions have either resurrected previous networks that had been disbanded, often due to lack of funding, or are setting up new ones.

Claire Adams is the Primary care Clinical Lead of a nascent Respiratory Network in North East and North Cumbria. Here, she tells us about their story so far.

It all started with Long Term Plan (LTP) for us, it was the first time in a long time that respiratory was getting some recognition, nationally. I have worked in this field for around 15 years now, and until then we had to fight very hard for space and funding in any national plan. Lung disease has been the Cinderella disease for quite some time. The plan didn’t just bring respiratory disease high up on the national agenda, it also brought clinical networks back to the fore.

After the LTP was published, NHS Rightcare approached myself and Dr Graham Burns (Royal Victoria Infirmary, Newcastle), asking us to focus on the Earlier and More Accurate Diagnosis aspect of the plan for the region, and to come up with a blueprint for an improved service that could be applied across North East and North Cumbria. In our case, that meant looking at providing a recommendation for a spirometry model.

When we set to work, we noticed a lot of variation in how spirometry was used across the region, particularly in primary care. It was clear that a more standardised approach was needed to make better diagnoses and we presented these results to the whole North region at the end of the process.

We saw value in forming a clinical network here, as a way to get a full range of views from across our (vast) region on what would be consistently deliverable in the different areas of the North East and North Cumbria given the large number of trusts and CCGs covered. The network would also serve as a forum for people to share innovations in their patch.

The Northern England Clinical Networks, in the meantime, had made funding available and begun recruitment for a primary care and a secondary care lead for a new respiratory clinical network to support delivery of the LTP in the region. I applied to the Primary Care post, and was successful. Next I started to put my idea into practice, I am firmly convinced that to deliver the ambition of the plan, we need a well developed respiratory clinical network to connect all parts of the region and all the professions linked to respiratory disease.

We are now slowly building the actual network and continue to seek the right people to join. I have had quite a few conversations with a number of GPs, consultants, physiotherapists, nurse specialists, pharmacists and others. We need a clinical network, but it’s essential that the people who join want it to happen. We need strong engagement from the clinical community for it to have a meaningful role.

In the meantime, even in incomplete form, the network was able to progress with some of the aspirations of the LTP. Based on the initial work we had done, a model for delivering spirometry across the region was presented to many stakeholders at a ‘North of England’ NHSE meeting. However, as we were working implementation of this plan, the pandemic spread to the UK. Before we can roll it out, it needs to be revised to take COVID into account now.

So it’s ongoing work but the hope is that we will bring together a lot of people with the desire to make this work in order that the network can foster a culture of partnership and collaboration, support integrated care, improve the quality of respiratory care, and promote equity of healthcare in respiratory disease.

It is heartening to see that there is central NHS support for networks at the moment and I hope that there is a will, centrally, to continue to support these initiatives for the long term. Clinical Networks need time to establish and are not a single-issue tool. If appropriately staffed and funded they can transform the way care is provided in their regions for the better, we have seen a great example in the London Respiratory Network, to name one.