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Maternity and children's services are one of the four service areas for which Strategic Clinical Networks1 (SCN) have been designated in England. Is this latest introduction to the new commissioning framework good news or something that will hardly impinge on the working lives of most paediatricians? More importantly, will this impact on the health outcomes for babies, children and young people (CYP)? Certainly there is much room for improvement; across the UK there remains huge variation in both health and service quality for children.2–4 Furthermore, a review of health services across Western Europe has recorded that the UK has moved from the average to the worst for ‘all-cause’ mortality rate for children aged 0–14 years. There are many reasons for this statistic, but the authors concluded that some health systems are not keeping up with the changing health needs of children, and that a whole-system approach is required to improve outcomes.5 Consequently, if SCNs provide an opportunity to make the necessary cross-organisational changes to service, then it is beholden on paediatricians to engage.
Background to the development of SCNs
NHS England's (NHS-E) statement of its intentions to host and support SCNs started by observing1 that: “Clinical networks are an NHS success story…networks perform varied and valuable roles…” A recently published book,6 which assesses the development of managed clinical networks to date, concludes that while the record is perhaps rather more mixed, nevertheless, clinical networks “should be given more time to develop and reach their potential”. Networks can make effective use of scarce resources, bridge the cracks between services offered by ‘self-interested’ NHS organisations, and move knowledge around clinical communities more effectively than hierarchy and the market.
1996 was a key year for the idea of networks. A review7 argued that there have always been networks in the NHS but ‘ad hoc’ …