Update on transition of the ODN to an ISDN

On behalf of the Greater Manchester Stroke Operational Delivery Network and the Greater Manchester and Eastern Cheshire Strategic Clinical Networks

The NHS Long Term Plan identifies stroke as a clinical priority and sets out an ambitious agenda to transform stroke services in England to  improve patient outcomes and experience. To help support these improvements the plan requires each region to establish an Integrated Stroke Delivery Network (ISDN) to oversee transformation across the whole stroke pathway, from the pre-hospital phase to life after stroke, with prevention also a key focus.

ISDNs will be directly accountable to their Integrated Care Systems (ICS) and Sustainability and Transformation Partnerships (STP) and will include a range of stakeholders such as providers and commissioners of stroke services.  ISDNs will be responsible for designing and implementing optimal stroke pathways and will support the delivery of the NHS’s seven-day standards for stroke care.

Since 2015, local improvement of stroke services has been successfully led by the Greater Manchester Operational Delivery Network (ODN), with the network widely viewed as the exemplar for the new ISDNs. Since its inception, the ODN has overseen a significant programme of work across the care pathway; developed and delivered collaboratively with NHS and other stakeholders. This includes supporting the implementation and ongoing development of the region’s re-organised hospital pathway so that all residents now receive ‘A’ rated stroke care. The network has pioneered the transformation of community neuro-rehabilitation services, with its model reflected in the national service specification.

Other work has included supporting the implementation of a regional thrombectomy service, improving the pre-hospital pathway and developing improved cardiac monitoring of stroke inpatients to prevent further strokes. The network also facilitates a training programme that supports the development of 900 professionals a year, and undertakes significant data analysis of the care pathway to help ensure quality and safety in the region’s stroke care.

The national formation of ISDNs provides a timely opportunity to review the existing ODN and consider how it can transition into a new organisation that will help deliver the stroke programme in the Long Term Plan. The new ISDNs will have a broader remit than the ODN and will be formally integrated in the local health and  social care “system” via accountability to their local ICS/STPs (i.e. the Greater Manchester Health & Social Care Partnership).

There is significant congruence with the ODN’s existing structures/operations and the requirements of an ISDN, and so the process of change will be one of evolution rather than wholesale reform that may risk de-stabilising what is currently being successfully delivered by the network. Key areas for consideration will be: Strengthening the current ODN governance into the new ISDN so it aligns with the Partnership; clinical leadership will need to evolve and existing hosting arrangements also require review. The work programme and infrastructure of the ISDN will also require examination to ensure they support delivery of the Long Term Plan although many of the key elements such as inpatient and community service re-organisation is either complete or well underway.

The Strategic Clinical Network (part of the Partnership) and the ODN are currently developing plans to support transition of the ODN to an ISDN within the designated timelines. To support transition, there will be a network engagement event in late April to outline and discuss proposals to key stakeholders and to agree a way forward (that will require sign off by the Partnership). Further details will be shared shortly.

We are very proud to have led the way in stroke care improvement in Greater Manchester through successful collaborative working, initially led by the Strategic Clinical Network and more latterly the ODN. Our success has been recognised at the highest level in NHS England and has led to the development of other regional networks that will hopefully replicate our achievements across the country.

We hope that you will join us in the next stage of the journey and help ensure that the new Greater Manchester ISDN continues to pioneer improvements in stroke care that has thus far resulted in significant benefits for our stroke survivors and their families.

You can download slides to find out more here.

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