Category: Advancing Modules

The table below shows each of the 14 NHS Boards in Scotland and how they are performing against the current top 10 priorities from the Better Heart Disease and Stroke Care Action Plan agreed by the National MCN Managers group and endorsed by the National Advisory Committee for Stroke at the Scottish Government.

The priorities may change over time as progress is made. Some examples of priorities are given in the additional information box.

The different colours denote each Board’s progress with the priority (see colour key under the table and an example of how these are defined for one of the priorities on the next page.)

The National Advisory Committee for Stroke (NACS) set out a plan to deliver key actions from the BHD&SC Action Plan.

MCN Managers in each Health Board will lead delivery of the key actions.

Ten priority areas have been agreed by the National MCN Managers Group (and endorsed by NACS) and performance against these key performance indicators are monitored by the National Action Plan Co-ordinator and Stroke MCNs across Scotland.

Priority areas are reviewed during visits to the NHS Boards by the National Action Plan Coordinator.

Local Action Plans to improve performance in individual Board areas are agreed locally by Stroke MCNs.

Better Heart Disease and Stroke Care Action Plan (2009) (BHD&SC Action Plan)

This action plan reflects the direction set out in Better Health Better Care: Action Plan in the way it seeks to respond to a series of challenges:

• Listening to what people with, or at risk of heart disease or who have had a stroke tell us about the kind of services they want
• Responding to developments in the evidence base, as reflected in the suite of SIGN Guidelines on CHD and cardiovascular disease (CVD) published in February 2007, and revised stroke guideline published in December 2008
• Introducing a new focus on prevention of ill health through anticipatory care approaches
• Reducing health inequalities across Scotland
• Meeting the needs of increasing numbers of older people and
• Responding to changes in our workforce

The Healthcare Quality Strategy sets out the Scottish Government’s intention to build on the collaborative, cross-disciplinary working exemplified by MCNs, as a well established approach to supporting and delivering high-quality healthcare. The Chief Executive Letter (CEL) 29 (July 2012) also notes that networks are ideally suited to delivering service redesign, quality improvement, strategy and planning across pathways working across boundaries of departments, teams, units, sectors, agencies and Boards.

MCNs improve quality and efficiency of services to patients through consensus and collaboration, by enabling clinicians, patients and service managers to work together across boundaries to deliver safe, effective and person-centred care.

MCNs are also involved in:

• Helping NHS Boards to achieve national outcomes that can be measured by the national indicators and HEAT targets.
• Linking data outputs to the standards of delivery of clinical care.
• Delivering on priority actions from the Better Heart Disease and Stroke Care Action Plan [.pdf]
• Linking all of the above to locally developed action plans focussing on improvement in the delivery of stroke care in their local area.

Further general information on MCNs can be found at:

• Chest, Heart & Stroke Scotland

Scottish Government communications regarding Managed Clinical Networks

• Promoting the development of Managed Clinical Networks in NHS Scotland (2002)[.pdf]
• Strengthening the role of Managed Clinical Networks (2007) [.pdf]
• Managed Clinical Networks: Supporting and delivering the healthcare quality strategy (2012) [.pdf]

Managed Clinical Networks (MCNs) have been forming in every health board in Scotland since 1998. They are made up of a network of people whose shared interest is in one particular area of health. MCNs membership usually comprises healthcare professionals, patients and carers, health managers, colleagues from social care and voluntary organisations, e.g. CHSS or the Stroke Association.

Their role is to work together to:

• make recommendations about what local healthcare services are required
• make the best use of resources available to provide these
• ensure that standards of care are equal to those provided elsewhere in Scotland

Key areas of work for MCNs include:

• Patient involvement
• Social care
• Service planning
• Quality assurance programmes
• Clinical governance
• Funding arrangements
• Workforce arrangements
• Information Technology arrangements
• Evaluation arrangements

Introduction to Quality Improvement

Using the outputs of audit coupled with the evidence from research, guidelines and standards the stroke Managed Clinical Networks (MCNs) should develop an Action Plan to ensure service improvement in relation to the delivery of stroke care.

This is driven by the Healthcare Quality Strategy of NHS Scotland published in 2010.

“By establishing a shared understanding of quality and a commitment to place it at the heart of everything we do, the Quality Strategy represents a unique and important opportunity for all of us to work together to our mutual benefit to make our NHS even better, for now and in the future”

Ref: Scottish Government