Networks in health care : a comparative study of their management, impact & performance

This project proposes a comparative study of four different professional and clinical network types in health care - cancer care (a clinical service), elderly care (a client group), public health (a functional activity) and the development of new genetics technologies (a basic science) - and to derive empirical and theoretical findings from this comparative work, along with policy recommendations for more effective network management. We seek to identify the characteristics (ie. structures, systems and processes) of the selected network types that are likely to lead to 'success' within their given context and inform wider network development. This proposal builds on previous work by each of the members of the research team (Ferlie & Addicott, 2004, Exworthy et al, 2003, Fitzgerald et al, 2002) on different networks in health care. This study has six objectives: 1. To identify key network characteristics (eg. organisational, managerial or membership), with a view to developing a typology of professional and clinical networks 2. To investigate the differences between more and less managed forms of networks 3. To describe the origin and evolution of different types of network structure and process over time and to examine the context, content and processes of network policies and practices 4. To explore the extent to which new ICTs are contributing to the development of more network based forms of working in health care, 5. To ascertain the factors which contribute to network performance, success factors and high impact within each network type 6. To identify promising lessons for policy and practice around networks in health care, and identify appropriate management styles and skills This qualitative study will use a comparative case study design, selecting cases from each network type across London and the midlands - with a total of eight network cases. Data collection methods thus include: (i) analysis of key local policy documents (ii) a range of semi-structured (that is, loosely guided and topic based interviews) across the various stakeholders identified; (iii) observation at key meetings. Further, we propose to include two consultancy projects, focusing on clinical and user perspectives, to complement the skills and experience of the core research team in organisational and managerial themes. The study will provide an analysis of the performance and impact of the network types within their particular context. The basis for this analysis will be formed partly on previous literature, particularly by the research team, and also through consultation with the project advisors. The six objectives identified above, in conjunction with our intended methodology, are clearly relevant to the SDO call for proposals. Networks have become an increasingly important mode of organising in health care, yet we know little about them. As identified (Ferlie & Addicott, 2004; Goodwin et al, 2004), there is very little independent and rigorous research on the recently established managed clinical networks set up in the UK. Following previous research on managed clinical networks for cancer by members of our own research team, we would seek to extend these findings through comparison with other network types.