The operating model for any service hosted and delivered at a host site should be clearly defined from the outset and incorporated into staff training. This will include not only processes relevant to the staff delivering the clinical service but also interactions with the specialty provider site and partner site processes and services (such as theatre recovery areas, dispensing pharmacy services, IT support).
Different types of arrangement for specialty provider host networks:
a. service delivery and accountability is wholly outsourced to the specialty provider, or
b. services are delivered by the provider, who is held accountable for performance by the host trust, or
c. service delivery remains with the host trust using the governance framework of the specialty provider.
Regardless which of these, or other options, are in place, the relationship between the two parties will be key.
- The relationship should be managed both formally, via a partnership agreement and informally, via good working relationships.
- It may be useful for provider and/or host to sit on some of each other’s committees.
- A monthly meeting between both parties can ensure compliance with the agreement.
- Good links between the organisations at service level will ensure operational aspects run smoothly and technical issues can be resolved quickly.
- Consider making available staff communications such as newsletters to each other’s organisation to aid understanding.
- Encouraging the provider’s IT team to develop a good working knowledge of the host site and the services operated there will guard against the host site staff perceiving the specialty provider as detached and uninterested in its needs and challenges.
- Consider whether some mandatory training (such as fire training, resuscitation) is best delivered at the host site rather than requiring travel to the centre to allow local variation.
- Information-sharing agreements should be put in place between the organisations. This will be particularly important where systems are integrated and patient details shared. The agreement will need to incorporate the wider NHS’s confidentiality, information governance and security requirements as well as statutory data protection provision.
- There are likely to be differences in the way the operating model works for different sizes and types of site. Variables include different levels of integration and interaction with the host’s systems and whether particular services like surgery are offered, requiring additional systems and procedures.
- Business continuity planning should include liaison between the organisations in the event of a system or infrastructure failure. Shared procedures and/or technical resources that the provider can use in the event of failure of its own systems might be useful.
- Any information that may be held on the host site’s systems should be backed up regularly and recoverable on demand.