Andrew Papworth1, Lorna Fraser2, Jo Taylor2. 1. Martin House Research Centre, Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD, UK. andrew.papworth@york.ac.uk. 2. Department of Health Sciences, University of York, York, UK.
Abstract
BACKGROUND: Consistent evidence suggests that children's palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children's palliative care MCN, with an aim to identify barriers and enablers of successful implementation. METHODS: Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children's palliative care (September 2019-March 2020). RESULTS: The study explored health professionals' perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN's development was impeded by cross-cutting barriers including limited funding for the MCN and children's palliative care more generally, no shared technology, lack of standards and evidence base for children's palliative care, and shortage of palliative care staff. These barriers impacted on the MCN's ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. CONCLUSIONS: Key features of children's palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network's success.
BACKGROUND: Consistent evidence suggests that children's palliative care is not equitable and managed clinical networks (MCNs) have been recommended as a solution. This study explored the perspectives of health professionals involved in the development of a children's palliative care MCN, with an aim to identify barriers and enablers of successful implementation. METHODS: Thematic analysis of semi-structured interviews and focus groups with 45 healthcare staff with a role in developing the MCN or in the delivery of children's palliative care (September 2019-March 2020). RESULTS: The study explored health professionals' perceptions of the MCN features that had helped to formalise governance processes, establish training and networking opportunities, standardise practice, and improve collaboration between organisations. These include the funded MCN co-ordinator, committed individuals who lead the MCN, and a governance structure that fosters collaboration. However, the MCN's development was impeded by cross-cutting barriers including limited funding for the MCN and children's palliative care more generally, no shared technology, lack of standards and evidence base for children's palliative care, and shortage of palliative care staff. These barriers impacted on the MCN's ability to improve and evaluate palliative care provision and affected member engagement. Competing organisational priorities and differences between NHS and non-NHS members also impeded progress. Training provision was well received, although barriers to access were identified. CONCLUSIONS: Key features of children's palliative care can act as barriers to developing a managed clinical network. Managing expectations and raising awareness, providing accessible and relevant training, and sharing early achievements through ongoing evaluation can help to sustain member engagement, which is crucial to a network's success.
Authors: Caprice Knapp; Lindsey Woodworth; Michael Wright; Julia Downing; Ross Drake; Sue Fowler-Kerry; Richard Hain; Joan Marston Journal: Pediatr Blood Cancer Date: 2011-03-17 Impact factor: 3.167
Authors: Julia Wager; Larissa Alice Kubek; Maria Brenner; Sara Calmanti; Carmel Doyle; Malin Lövgren; Ulrika Kreicbergs; Leontien Kremer; Philippe Le Moine; Guillaume Robert; Meggi Schuiling-Otten; Peter Schröder-Bäck; Eduard Verhagen; Boris Zernikow Journal: BMC Palliat Care Date: 2022-10-17 Impact factor: 3.113