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Introduction

Johanna Moss, executive lead, Moorfields' vanguard programme

The pressures facing acute hospitals, particularly smaller district general hospitals, are often complex. It is increasingly difficult for these organisations to afford to deliver safe and effective care across all clinical specialties and sub-specialties.

Understandably, smaller clinical specialties are rarely a high strategic or operational priority and often lack the benefits of scale in a local setting. In the absence of a critical mass of patient numbers or specialty workforce, provision of care may become clinically or financially unsustainable. These difficulties are often compounded by competition generated by local commissioning arrangements and other providers.

Moorfields’ innovative approach to delivering care across multiple sites has been referenced in various national policies relating to new models of care. NHS England’s report ‘The Five Year Forward View’ highlighted the benefits of our model in helping to sustain local hospital services and enable smaller hospitals to remain viable. The Dalton Review categorised our approach as a contractual arrangement which it described as a service-level chain. Often referred to as “the Moorfields@ model”, our approach has also been cited as an example of franchising or networked care.

We know that many other NHS and commercial organisations have experience of delivering care across multiple sites, both in ophthalmology and other specialties, and have gained a wealth of collective experience. We have asked colleagues dealing with these challenges day after day what it’s like for them, what works and what doesn’t, in the hope that their experience will help others trying to find the answers to some difficult questions.

In this toolkit you will find our collective learning in a single resource that describes what good looks like for networked care. We hope that it will help organisations as they consider the strategic case for adopting a networked model as well as implementing and sustaining it. We would like to thank all those who so generously and openly shared their learning with us and the national new care models team for its support. Without our partners we could not have created this resource.

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The Moorfields team and collaborators