MCNs

1
Learning Disabilities Managed Care Network South
East Scotland

• MCNs
• Getting There?
• Friday 14th May 2004

2
Why Are We Developing?(The Drivers)

• New environment of partnership and sharing
• Joint Future Agenda
• Rise of the Private Hospital
• Entrapped patients in State Hospital
• MCN Framework

• Difficulties in recruitment for specialist staff
• Increasing specialisation and loss of
  flexibility in services as they contracted
• Economics of providing high cost low volume
  services
• New problems e.g. Autistic spectrum disorder

3
MCN Principles - How We Hope to Meet Them

• Quality assurance.
• Education and training.
• Audit integral to practice.
• CPD, training opportunities, skills enhancement,
  appraisal etc.
• Improved value for money.

• Clear management.
• Defined structure and connections.
• Provide clinical and service improvements.
• Use of evidence based practice.
• Multi disciplinary input.
• Total commitment to practice according to
  evidence base.

4
Potential Services Structure
CHPs?
Specialist Regional resources
MCN
4
CLDTs and local specialist provision
3
Joint Futures
2
1
Primary care etc
0
5
Potential Tiers
Tier 2/3 CLDTs Clinical Psychology Consultant
Psychiatry Specialist input Social Work
Liaison Local Area Co-ordiantors
Tier 3/4 Acute Assessment Treatment
facilities Specialist Teams - locally based but
co-ordinated across area
Tier 0/1 GP Practices Health Visitors Residential/
Day Care staff Teachers
6
The Development Structure

• Hosted by Forth Valley PCT
• Multi-agency and multi-disciplinary
• Representation from four health areas.
• Local Authority representation in all areas and
  from all areas
• Aim to take a whole systems approach which will
  produce a responsive service.

7
Project Approach

• Formal Framework - all published and approved
• Formal Groups - Regular meetings with notes
• Formal PID - approved and published
• Informal approach - today is an example
• Communications vital - communication strategy
• Partnership Working - over all spectrums

8
Is there a Need?
If it aint broke dont mend it! Weve
eventually settled People are just looking
after their own Agenda Its just another
management fad
Everything is perfect the way it is!
9
The Network

• NOT
• The Network is not about structures
• the effectiveness of a network is inversely
  proportional to its formality (Nancy Foy)

10
The Network

• A set of relationships between individuals and
  organisations working together to achieve a
  common goal
• Need to formalise without imposing bureaucracy
• Need to Achieve the shared objectives
• Architect facilitate emergence and overall
  design
• Lead Operator connect various individuals and
  pieces
• Caretakerenable monitoring, helping, engaging
  learning
• Engage and encourage the debate

Me!
11
What We Are Doing?

• Financial Group
• Specialist professional groups
• Quality and clinical effectiveness
• Political Agenda (CHPs/Joint Futures
• political Agenda (Councils)
• Gaining awareness/involvement

12
Whats Been Good?

• Fully supported initiative
• Everyone is keen to support
• We are in the right place at the right time
• Able to meet wide range of service providers
• People are willing to share good practice
• Plenty of feedback (good and bad)

13
Whats Been Less Good!

• Huge change agenda in progress
• People have huge workloads at the moment
• A small amount of suspicion(!)
• Reluctance still to share the bad times across
  boundaries
• Bringing together different perceptions
• Evidence gathering!!!
• Challenge of moving the agenda out of health
  professionals

14
Challenges

• Engaging all
• Making it something useful for all
• Influencing
• Nagging (without being obvious)
• Realisation - it is everyones Network
• Ticking the boxes (without seeming to!)
• Taking the direction forward

15
What Next

• Engaging Users and Carers
• Engaging Local Authorities
• Engaging Care Providers
• Ticking the boxes
• Making it a Network that is of value - or it
  wont be a Network

16

• And finallywe know we cant always get it right

but at least we are on the journey
17
Contact?
Christine Livie Project Administrator LD
MCN Trust HQ Forth Valley PCT Old Denny
Road Larbert Telephone [phone] e mail
christine.livie_at_fvpc.scot. nhs.uk
Beth Wilson Network Development Manager LD
MCN Trust HQ Forth Valley PCT Old Denny
Road Larbert Telephone [phone] mobile
07769 912 800 e mail beth.wilson_at_fvpc.scot.nhs.uk

Web page www.show.scot.nhs.uk/ldmcn