The first group we spoke to were clinical and managerial representatives from more than 18 healthcare organisations about what they saw as critical to a successful network.

• Excellent staff who are able to work well at a distance but who know when to escalate.
• Organisational buy-in: a clear, strategic narrative on the purpose of your network is required and may need to change as your network evolves.
• Professional buy-in: do your consultants believe in your network model and do they support each individual venture?
• Choice of partner: be clear on the terms of your relationship
  and align your understanding of what a successful partnership will look like.
• An understanding of the health needs of the population you are seeking to serve and the expectations of those who commission/purchase care.
• The importance of reputation: identify red lines to protect your brand.
• A well thought-out management structure with clear lines of responsibility, communication, reporting and escalation.
• Standardised processes with tightly controlled variation to ensure consistent quality.
• Excellent links between sites and the centre to spread learning.
• A central learning and development team who move between sites.
• A values-based culture, embodied by strong leadership.
• Clear agreements with host sites.
• Excellent remote connections and systems.

We thought it was also important to know what assurance trust boards would need that a networked care model was delivering the required improvements. To understand this, we commissioned 25 board level executive interviews.

Their observations included:

• standardisation across the network is key but hard to deliver consistently.
• balancing network standardisation and local flexibility to support innovation is challenging.
• collating data across the network in a meaningful way is important but complex.
• there is a complexity of relationships with multiple commissioners and host organisations.

In non-networked hospitals executives would expect to see evidence of:

• the maintenance or improvement of clinical quality.
• good patient experience.
• transparent clinical governance.
• service standardisation.
• a better range of services.

Existing networked care provider executives said their regular assurance processes looked for evidence of:

• direct support of the trust’s strategy/objectives.
• the right experience and care for patients.
• greater organisational resilience, for example contributing to overheads and the bottom line, increased skill base, increased catchment and market, increased influence and reputation.