Table 1:

Characteristics of a selection of clinical networks that have existed in England*,5,11

Network purposeMembersLeadership structureProcesses
Clinical genetics network (initiated in 2001):
  • To develop national policy on genetics and transition into public health and policy

  • To transition genetics research into practice

  • To support a network in human genetics

  • Largely university based

  • Included a core stakeholder group of 24 people, including clinical scientists, health care providers, patient groups and ethical and legal experts

  • Has a network director, reporting to a supervisory board made up of the Department of Health and Social Care and Department for International Trade, as well as research and hospital trusts

  • Embedded in translational science, the network translates evidence from genetics research into national policy, clinical practice and education for the public and patients

Managed cancer networks (initiated in 2000):
  • To implement national policy and evidence-based cancer guidelines locally

  • To improve patients’ journeys through the health system

  • Each managed cancer network is composed mainly of clinicians, with some patient representation

  • National cancer director (a respected clinical academic)

  • 34 local managed cancer networks, generally led by a chief executive officer, a medical and nursing director and a service improvement lead

  • Organized into multidisciplinary tumour groups reporting to a national network management team

  • Individual tumour groups review service improvements, monitor data on wait times and outcomes and are responsible for joint protocols, guidelines, education and care pathways

Sexual health networks (initiated in 2001):
  • To implement national guidelines on sexual health locally, including improved response to and care for HIV/AIDS

  • To reduce teen pregnancy rates

  • The membership of sexual health networks varied and included members from hospitals, clinicians, voluntary sector, patient representatives from the NHS Sexual and Reproductive Health services, and other professional organizations

  • Sexual health networks were accountable to primary care clinical commissioning groups

  • These networks have organized patient forums to respond to HIV/AIDS in diverse communities, as well as teen pregnancy. To improve HIV care, they are working to roll out standardized care protocols in line with national guidance

  • Note: NHS = National Health Service.

  • * Most of these networks were mandated by national policy, although a few developed organically.

  • Funding sources have been varied. Some original networks, including the clinical genetics network and the sexual health networks, have been defunded or repurposed. Note also that England still has a series of other managed clinical networks in cardiovascular; maternity and children; cancer; and mental health, dementia and neurological conditions (and some other clinical areas) — organized locally, with national integration.