Catalysing collaboration in healthcare: Laying the foundations for network success
Healthcare networks are challenging to implement and sustain. Differences in strategic priorities, operational challenges, and ways of working across member organisations can mean they struggle to deliver real value.
But they’re vital to keeping the pace with the changing needs and demands of society. And with the opportunities that technology offers – healthcare networks are extremely rewarding for staff and patients if they’re designed and managed well. For example, without a networking approach to COVID-19, the NHS wouldn’t have had the teams and technology to support the development and roll-out vaccines in record time.
Network opportunities are amplified in capital-intensive services like pathology and imaging where embedding networking is a core component of delivering the NHS Long Term Plan. This is due to the potential benefits from economies of scale in mitigating acute workforce shortages and ageing equipment. Now that several networks are beginning to see some tangible benefits, they’re evolving from loose informal arrangements into formalised collaborations. The intention is to secure new benefits including sharing a workforce, harmonising pathways, and removing unwarranted variation in patient care, experience, and outcomes.
Whether the formalisation of the network model is achieved through joint clinical or operational governance, the creation of a host trust, or the set-up of a Joint Venture, the transition should be carefully designed to deliver optimal value. We’ve seen this in the development of network models such as Acute Provider Collaboratives and Elective Care Hubs. With that in mind, there are three focus areas to consider when building the foundations of a successful healthcare network.
1. Keep governance simple
The bigger the network, the more important it is to keep your operating model simple. People may already view networks with uncertainty. Creating uncomplicated structures and governance minimises the risk of misalignment, reduces change fatigue across the workforce, and increases the pace of benefits.
People make or break networks when they lead, deliver, and experience working in them every day. It’s important to create a new structure that builds trust from the outset and recognises the value of working as a partnership. In our experience, the initial focus should be on getting the network operating quickly rather than overcomplicating the governance – with a clear route to reviewing the effectiveness of the governance at a fixed point in time as relationships and outputs evolve. Develop a phased plan that concentrates on delivering quick wins for all involved, to energise the team and wider network stakeholders. This will encourage confidence, leading to increased commitment and investment which, in turn, will enhance the network's ability to achieve longer-term strategic goals.
2. Measure success as a collective
Nothing slows a network’s progress more than a lack of data. Without an easily accessible single version of the truth, networks will struggle to articulate the benefits achieved and drive collaborative behaviours. Investing time to overcome any data governance hurdles and creating automatic data feeds from each participating organisation is crucial early on. The longer data governance complications endure, the more difficult it is to achieve universal buy-in to access and share the data needed to become an effective network.
Data sets need to be harmonised, well understood, and reported through key performance indicators which directly correlate to the aims of the network. Taking time to co-design and define these aims (whether it be standardising clinical pathways, sharing capacity to meet demand or collaborating to implement AI technologies) within written agreements between the participating organisations will ensure networks can focus on delivering value rather than collecting and debating what the data means.
3. Plan for differences of opinion
Working across organisational boundaries brings different strategic priorities and drivers for change. Unique ways of working and culture can mean that collaborative endeavours struggle to deliver value. Typically, organisations working together look to mitigate difference by establishing a clearly defined vision, setting out drivers for change, aligning critical success factors, and agreeing principles for partnership working. And whilst these are important steps, they won’t prevent arrangements from faltering where, for example, decisions need to be made which could detrimentally impact individual organisations for the greater good of the network.
Designing the right operating and governance model is crucial. So is ensuring that all organisations participating in the network understand what the model means for them.
Organisations should be clear on:
- Core commitments such as data sharing, resources, and financial contributions
- Delegated authority, including Standing Financial Instructions, reporting requirements, liability, risk sharing, control of operations, and clinical governance
- The process for making collective decisions, including membership, voting rights, and dispute resolution procedures
- The process to hold participating organisations to account, including the procedures followed for inactive participation or failure to act upon collectively agreed decisions.
Clearly articulating and agreeing on commitments and processes across the network will avoid delays in implementing partnership agreement. It will also save time, money, and resource in the future as strategic aims evolve during the collaboration.
Working beyond traditional organisational boundaries will enable healthcare services to become optimised for patients and the workforce alike. But networking isn’t easy. Taking the right steps by making the governance simple, measuring success as a network, and planning for differences in opinion before embarking on collaborative working will ensure that networks see benefits quickly whilst retaining agility and adding value for years to come.