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The development of orthodontic managed clinical networks in the united kingdom

From Volume 4, Issue 4, October 2011 | Pages 118-124

Authors

Elizabeth Lammiman

BDS, MSc

Specialist Orthodontic Practitioner, Isle of Wight

Articles by Elizabeth Lammiman

Robert Ireland

BDS, MPhil, MFGDP(UK)

Hon Associate Clinical Professor, Warwick Dentistry, University of Warwick

Articles by Robert Ireland

Richard Cure

BDS, MDS RCS(Eng), FDS RCS(Ed), MOrth RCS(Ed), FFGDP(UK)

Hon Associate Clinical Professor, Warwick Dentistry, University of Warwick

Articles by Richard Cure

Abstract

Managed clinical networks were developed in the UK as an alternative model of healthcare delivery. They are said to focus on the patient journey making best use of available resources, improving access and the quality of care. They are based on a concept pioneered in Scotland and have recently been introduced into dentistry. This paper reviews the historical background and structures of existing UK orthodontic networks.

Clinical Relevance: The recent introduction of managed clinical networks into orthodontics is designed to improve equity of patient access and the quality of care. It is also said to have economic benefits, with services designed to cross geographical, political and National Health Service (NHS) boundaries, providing a way of achieving full coverage of specialist services beyond historical provision based in major population centres. The key principles ensure quality assurance and standardized evidence-based care aiming to improve clinical standards and, ultimately, the allocation of resources.

Article

The government's devolution policy in 1998 created important differences within the UK with respect to NHS policy.1 The resulting divergence led to an experiment in some areas with collaboration replacing competition as a significant policy theory.2 In Scotland ‘professionalism’ led to the development of integrated healthcare models leading to the concept of managed clinical networks (MCNs). The structure is not a set design but is described as a way of working, the ultimate goal being to improve access, quality and appropriateness of treatment and focus on the ‘patient journey’.3 They have been defined as ‘linked groups of health professionals and organizations from primary, secondary and tertiary care working in a co-ordinated manner, unconstrained by existing professional and existing [organizational] boundaries to ensure equitable provision of high quality effective services’.4

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