Networks may seem like over used terms and often sound like management speak or NHS jargon. The term itself conjures up visions of networking which seems the preserve of management consultants, handing out business cards. A friend of mine who worked in management consulting often spoke of collecting business cards in order to build a network which often helped score points for the annual bonus round, this seems like a far away world from NHS
dentistry.
Could networking be the future of dentistry? Could there be different networks that could all overlap and be interconnected that may make it easier for patients to access services and for commissioners and providers to drive up quality? Within dentistry, there has already been some attempt to form networks following on from the models used in other parts of healthcare. These were often called managed clinical networks and took different names. However they varied in their structure and their function as some were very much more managed whilst others were closer to being independent networks with management support.
In England, primary care trusts often had oral health advisory groups or dental networks, occasionally even a hybrid of the two. Many of these groups formed following the creation of the 2006 NHS dental contract and subsequent legislation which placed certain duties on PCT in respect of health promotion, needs assessmentand consulting with the profession in the development of services. However, even these groups were often heavily dominated by PCT officers and acute and community providers, they weren’t usually the preserve of most GDPs.
The changes in the English NHS in April 2013 created the mandate for local professional networks. There has been some momentum towards providing frameworks to establish these networks as well as training for aspiring members. It was initially thought that the local area teams of the NHS Commissioning Board would be provided with funding for these networks but it remains to be seen whether this will be commensurate with the time involved in mobilising and implementing such initiatives. In some areas these networks are being chaired by former PCT advisors and consultants and in other areas they seem to have actively gone out to recruit new members and an independent chair.
The difficulty with any network is whether it has any purpose and if it really has any real influence. Dentistry already benefits from a number of lobbying groups and negotiating committees in the form of the local dental committees and the British Dental Association as the representative of the professional. Some LPNs around the country seem to have a PCT like committee structure and it remains questionable whether they will be able to differentiate themselves enough to effect change, some are even being established with executive members, core members and ordinary members. It would have been hoped that networks were forums with equal members that could come together to work on specific issues of common interest, rather than lapsing into old health service committees with hierarchies.
In my view, local professional networks may offer nothing more than their predecessor oral health advisory groups unless they can differentiate themselves sufficiently and offer members equality in representative status. They need to be given the freedom to select their own chair from their membership who can facilitate the network with independence. However, whether or not LPNs will actually make any policy change remains to be seen, especially given that NHS England appear to be moving ever closer towards single operating models. I really hope that LPNs can be creative enough to help secure a bonus for the benefit of patients; otherwise they may simply become reinventions of old PCT committees with new names and some new faces.