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Scaling up networked care


In the first year of the vanguard programme we identified the critical success factors for when and how a single specialty networked care model might be developed. The learning from that work is shared in the first four categories of the toolkit.

The definition of single specialty networked care used for the toolkit is one provider delivering a single specialty across multiple sites.

In 2017/18 we widened our research to consider the critical success factors when scaling up networked care. ‘Scaling up single speciality networked care: a strategic overview’ was published in March 2018 and we share some of the learning from that research in this new toolkit subcategory.

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The NHS needs healthcare delivery models that can adapt as the landscape changes and add value to local health and care systems. A number of recurring themes emerged during our research, some of which are more limiting to network growth and others more enabling.

Single specialty networked care is already delivered by a number of providers and has long been recognised as a sustainability solution for services where critical mass does not support local provision or recruitment to specialist roles is problematic.

Given the move towards locally integrated health care systems (ICSs) the research indicated greater appetite and opportunities for numeric expansion.

There are many ways in which single specialty networked care can be delivered as previously evidenced in the toolkit – no one size fits all.
This table shows the generic characteristics of some of the models which we refer to in this section:

scaling up summary table


In this section of the toolkit we share our findings from semi-structured interviews with more than 35 strategic decision makers across the NHS (providers, commissioners and regulators), other sectors and from a desktop literature review.

Our research has focused on the benefits and challenges to scaling up networked care numerically and geographically.
Our definitions of these terms are:

  • Numerical expansion – extending a network’s sites within a single STP.
  • Geographical expansion – refers to an increase in networked sites across multiple STPs.

We identified a number of conditions which need to be in place in order to facilitate successful expansion of networked care. These become more critical the further the network sites are situated from each other:

  • A shared understanding of the benefits of single specialty networked care to the wider NHS and to systems locally.
  • Active support for networked care as a model for service sustainability.
  • Aligned priorities between networked care providers, commissioners and other system partners.
  • Rigorous standardisation for network assurance and oversight.
  • Accurate data and performance indicators to evidence the changes before and after a site is added to the network.
  • Collaborative working to ensure that networked services represent best value for patients and other system partners.