Networks - a briefing paper for the Health Foundation - Centre for ...

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GovernanceUnambiguous,clearly definedauthority toregulate members(but strength ofhierarchy isvariable); Relativelystraightforward toperformancemanageA ‘professional’modelFinancial andClinicalaccountability is theresponsibility ofparticipantmembers andremains separateRobustarrangementsneeded fordifferent types ofclinical nets.Good whenseeking fewerstructuralsolutions.Little authority toregulatemembers; selforganising;membersregulate throughpeer pressure./Hard toperformancemanagePlural forms ofgoverningEnclave andindividualistic networksare often self-governingentities with limitedformalised accountability.Horizontal /non-existentManagement structureProfessional integrityand inculcation, andarranging forimprovisation andexperimentation.Self-governing.Accountable tomembers forimpactDemocraticWhy theywork whenthey doMandated networkwhich works whenmutually agreedobjectives andpriorities areshared whichconnect directlywith that of otheragents. Retainssignificantlegitimacy withmany clinicians.Used to develophub and spokemodels of care.Innovative, flexibleand adaptable tochanginghealthcare contextsbased on principlesof effectivepartnershipworking.Work well whenall parties engageincludingclinicians, otherhealthcareprofessionals andpatients/users/carers etc. convergearound apathway.Work well whensupported by anevidence baseNew ideas andways of doingthings may notcommenceimmediately, butspread via socialnets.Rapid access tolatest intelligence.Socialmovements canbe created withinshort space oftime so are veryresponsive.High Trust neededto succeed7They develop novel waysof working, and newsolutionsGood at ProfessionalDevelopmentGood at developinglegitimacy andauthenticity.Good at information &knowledge sharing;Succeed whenparticipants commitselves to ownership ofthe networks goals, inconjunction with activefacilitation by anonaligned party/agencyMembers share apassion and committo frequentinteractions.Where there iscommitment todeveloping expertise,and working togetherto solve problemsWork when havingclear impact anddemocraticengagement makesthe best of allparties.
Why theyfailIf it struggles toachieve support(&commitment)from the networksmembers.If it hampersprofessionalmember’sautonomy topractice.When there areproblems reachingobjectiveagreement.When there are suboptimal outcomes;Over-regulation;meagreproductivity;inability to createsufficient capital;high transactioncosts; congestionvia bureaucraticprocedures; staticdesignated rulesand roles; low(front-line serviceprovider) morale;gateway barriers tohigher authority.Limited success insolving theproblems ofcapacity andfragmentation.Complex decisionmaking process forimplementing newstructures andinnovation-basedservices.Tensions betweeninterests andprioritiesWhen they don’tmake agreementsbetween membersthat are binding.Need to negaterisk of littledictators ormonopolies orperhaps conflictof interest.Social capital notalways a publicgood.Institutionalisationand becomesmainstreamPart of theproblemGovernment andsocieties’incapability ofperceiving groupsas self-organisednetworksBreakdown in trust;if multi-agencycoordinating groupscannot agree aboutits desired results.Where specific andunique publicmandates are notalignedLow motivation viafatigue; rifts anddivisions.Unstable entities withweak negotiation powersand reliant on agentswho may be unable toprop up effective powerLow productivity via moreemphasis on distributionbased values rather thanproductive based values.isolation from largestakeholder groups.Breakdown of trustbetween agents (peopleand orgs)Community is acontested conceptWhy CoPs fail(Roberts, 2006)Neglects power;doesn’t acknowledgepre-existing socialcodes;.Dissolve ifmembers do notachieve the impactthey intended.Overly concernedfor democracy getsin the way ofaction.Too blinked on theirown remit and notconnected to widercontext.What ittakes toOver-regulationmay result inNascent solutions/need to be properlyProfessionalcredibility;High level ofsocial media, andHuge effort to run.Challenging to maintainenergy and participationChallenging tomaintain energy andCommitment todemocratic process8
Page 1 and 2: Centre for Innovation in Health Man
Page 3 and 4: 2.4 Agency Networks, Policy Network
Page 5 and 6: ‘Networks can take many forms to
Page 7: of the parts.based uponintegrity.Ho
Page 11 and 12: Table 2: Examples of NetworksManage
Page 13 and 14: 1.1.3 The scoping methodologyA brai
Page 15 and 16: pathways, managed clinical networks
Page 17 and 18: in terms of a shared vision, common
Page 19 and 20: Rangachari (Rangachari, 2008) took
Page 21 and 22: Turrini et al (2009) also raise fou
Page 23 and 24: Trying things out: just taking some
Page 25 and 26: Success is attributed/dependant on
Page 27 and 28: 2.2 Developmental NetworksCharacter
Page 29 and 30: transaction costs. Also: ‘...the
Page 31 and 32: The authors acknowledge that the mo
Page 33 and 34: Research has explored regional clus
Page 35 and 36: Networks are essentially a form of
Page 37 and 38: significant social bonds and joint
Page 39 and 40: 3 Network Evaluation and Future of
Page 41 and 42: contractual relationships; the arra
Page 43 and 44: to meet the legal and policy based
Page 45 and 46: Sectors Networks (PSNs) are underst
Page 47 and 48: coordinated manner, unconstrained b
Page 49 and 50: Research has shown that there is no
Page 51 and 52: perhaps are used as a way to avoid
Page 53 and 54: attempted to determine (section 1.2
Page 55 and 56: Leadership, 2, 147-163.BOURDIEU, P.
Page 57 and 58: DOUGHERTY, T. W., CHEUNG, Y. H. & F
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other social media are reshaping he
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NHS SCOTLAND. 2010. Review of nine
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mental patients in a Manhattan SRO
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AppendixPrinciples of engagement (M
Page 67 and 68:
NHS Networks: The document (NHS NET
Page 69 and 70:
iPrinciples of engagement (MENDIZAB
Page 71 and 72:
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