TERMS OF REFERENCE
NORTHERN NEONATAL NETWORK
A Managed Clinical Network for neonatal care
These are the Terms of Reference for the Northern Neonatal Network, a Managed Clinical Network for neonatal care in the North East and North Cumbria.
Background
The Northern Neonatal Network (NNN) is now a Managed Clinical Network (MCN) that builds on the pre-existing informal clinical network arrangements.
The NNN is clinical in focus, as its purpose is to deliver high quality care that produces the best possible outcomes for babies and their families. The Board membership (see Appendix 1) therefore consists of medical and nursing representation from the four regional specialist neonatal intensive care units and the other NHS Trusts. The MCN also includes the North East Specialist Commissioning Group (NESCG) and NHS North East. North Cumbria is part of the network as it also provides services to residents in North Cumbria.
Values and Principles
We are privileged that families entrust the care of their ill or premature babies to us. We strive to earn that trust. We want each year to give better care than we did the year before.
The Network therefore has just one core principle:
To give the highest possible standard of safe, effective care to babies and their families.
Aims of the network
The NNN will:
u Provide a specialist advisory role to the NESCG, commissioners and the wider Chief Executive Community regarding the commissioning, deployment of resources and service development of safe, effective, patient-centred, equitable and sustainable neonatal care (Neonatal Intensive care Units - NICU and beyond)
u Provide assurance of the highest standards of care for babies and their families by monitoring performance across the network, to include activity, quality monitoring, benchmarking and audit
u Ensure that the network is owned by the organisations and professionals that participate in it
u Relate closely to obstetrics, midwifery and paediatrics
u Encourage collaboration and sharing of best practice and learning
u Ensure equitable service provision across the network
u Achieve clinical consensus on care pathways, models of care and standards
u Agree a common clinical governance structure with an improvement process to identify and rectify weak points on the pathway or within the network, so that the best clinical outcomes are achieved
u Collaborate on workforce planning, workforce projections, joint education and training
u Provide information to the public/media and ensure public engagement in the network at all levels
u Publish an annual report
u Provide advice to professionals across the north of England.
Scope
The MCN will consider neonatal care (NICU and Special Care). The network will include the four regional specialist neonatal units and the non-specialised maternity units to ensure co-ordination and integration of services. The Trusts with the four specialist units are:
u City Hospitals Sunderland NHS Foundation Trust
u The Newcastle upon Tyne Hospitals NHS Foundation Trust
u South Tees Hospitals NHS Foundation Trust
u North Tees and Hartlepool NHS Foundation Trust
Trusts with special care facilities only are South Tyneside, Gateshead, Northumbria Healthcare, County Durham & Darlington, North Cumbria University Hospitals (at Carlisle & Whitehaven) and South Tees (on the Friarage Hospital, Northallerton site).
Commissioning/accountability arrangements
The main commissioning relationship for the NNN will be with the NESCG and the network will be accountable to the NESCG and the wider Chief Executive community.
Process
The NNN Board will provide advice based on a clinical consensus to the NESCG or its successor body, and to other commissioners and partner NHS Trusts to ensure consistency and high quality care across the North East and North Cumbria. The Network will agree an annual work plan with NESCG and the wider Chief Executive Community.
The delivery of the network's objectives will be through the NNN management team and the network board (see below).
Implementation and commissioning based on the networks advice will be undertaken by NORSCORE and commissioners.
Organisational structure
The host organisation and budget holder is City Hospitals Sunderland NHS Foundation Trust. This Trust is responsible for the recruitment and management of the network management team and ensures that the network board has clear terms of reference, constitution and governance arrangements.
Terms of Reference of the Network Board
Chair
The board will be chaired by an independent person.
Membership
The members are listed in Appendix 1. The Board seeks to be predominantly composed of clinicians and managers who are authorised to make commitments on behalf of their host organisations to implement decisions made collectively by the network Board.
The managerial representation from each Trust will be nominated by the Chief Executive. Representative doctors and nurses will be those whose designation in relation to neonatal care in their Trust naturally leads to network responsibilities (lead doctor/head of department/clinical director; lead nurse/matron/ward manager).
Others members will be invited to join the Board as appropriate (e.g. paediatric surgery, obstetrics).
Lay people (who may be parents of babies treated within the Network) will be recruited through an open process to a subgroup of the Board, from which the Chair and one other chosen member will be delegated to attend Board meetings.
Substitutes
In order to maintain consistency and facilitate effective decision-making, substitution of board members will not normally be allowed. If a board member is unable to attend a meeting, their views on agenda items will be sought before the meeting and may be presented on their behalf by another member or by the Network officers.
Frequency of meetings
Usually quarterly, with a minimum of three per year.
Subgroups
The Board will convene standing or temporary subgroups as necessary for the achievement of its objectives. A list of these is given in Appendix 3; this list may change from time to time.
Mode of operation
The Board is the forum where the Officers of the Network are tasked to undertake necessary actions, and where they are held to account for their work. It is the place where representatives from all the partner Trusts can meet to agree policy and strategy.
Implementation of Board decisions
It is the responsibility of Board members to ensure that matters to which they have agreed at the Board are implemented in their own organisations.
Links to other groups
u Regional Maternity Survey Office
u Maternity and Newborn Clinical Innovation Team (NHS North East)
u BLISS
u Adjacent neonatal networks (Yorkshire, North West, Scotland)
u British Association for Perinatal Medicine
u Neonatal Nurses Association
Appendix 1 Northern Neonatal Network Board Membership January 2011
Board Designation / Name / OrganisationChair / Deborah Jenkins / Independent
Chief Executive Sponsor (Host organisation) / Ken Bremner / City Hospitals Sunderland NHS Foundation Trust
Lay members
Member 1 / Lisa Salkeld / Independent
Member 2 / Vicki Lynn / Independent
Network Officers
Network Manager / Martyn Boyd / Network
Data Manager / Mark Green / Network
Clinical Lead / Dr Steve Byrne / Network
Nurse Lead / Lynne Paterson / Network
Nurse Educators / Eileen Swinton
Sasha Smith / Network
Audit Lead / Dr Martin Ward-Platt / Network
Consultant Neonatologist (NICU) leads
Newcastle / Dr Alan Fenton / The Newcastle upon Tyne Hospitals NHS Foundation Trust
Sunderland / Dr Lorna Gillespie / City Hospitals Sunderland NHS Foundation Trust
North Tees / Dr Chidambara Harikumar / North Tees and Hartlepool NHS Foundation Trust
James Cook, Middlesbrough / Dr Jonathan Wyllie / South Tees Hospitals NHS FT
Senior Neonatal (NICU) Nurse Leads
Newcastle / Yve Collingwood / The Newcastle upon Tyne Hospitals NHS Foundation Trust
Sunderland / Pamela Jack / City Hospitals Sunderland NHS Foundation Trust
North Tees / Barbara Harrison / North Tees and Hartlepool NHS Foundation Trust
James Cook, Middlesbrough / Jane Hall / South Tees Hospitals NHS FT
Management (NICU) Leads
Newcastle / Chris Wilkinson / The Newcastle upon Tyne Hospitals NHS Foundation Trust
Sunderland / Fiona Kay / City Hospitals Sunderland NHS Foundation Trust
North Tees / Dr. Jagat Jani / North Tees and Hartlepool NHS Foundation Trust
James Cook, Middlesbrough / Alwyne Turnbull / South Tees Hospitals NHS Foundation Trust
Other NHS Trusts (1 clinician/nurse and 1 manager)
County Durham and Darlington / Dr. Moorthy Subramania / County Durham and Darlington NHS Foundation Trust
Ann Bowes
Gateshead / Dr Dennis Bosman / Gateshead Health NHS Foundation Trust
Gill Wiggham
Northumbria / Joan Oliver / Northumbria Healthcare NHS Foundation Trust
Nicky Moon
South Tyneside / Lilian Malcolm / South Tyneside NHS Foundation Trust
Derek Curry
North Cumbria / Sue Whyte-Earl / North Cumbria University Hospitals NHS Trust
Stephanie Preston
Specialist Commissioner / Peter Dixon / NORSCORE
SHA Neonatal lead / Sam Cramond / NHS North East
Other members
Ambulance / Paul Fell / North East Ambulance Service NHS Trust
Paediatric Surgery / Mrs. Anne Lawson / The Newcastle upon Tyne Hospitals NHS Foundation Trust
Obstetrician / Dr. Phillipa Marsden/
Dr Helen Simpson / County Durham & Darlington NHS Foundation Trust
South Tees Hospital FT
Appendix 2 The NNN management team (officers of the network)
Network Manager
Network Administrator/data manager
Network Educators (two persons, one whole time equivalent)
Clinical Lead
Nursing Lead
Audit lead
Appendix 3 Board Subgroups & their terms of reference
The Board will define the terms of reference for any subgroup. Any suggested changes to the terms of reference must be endorsed by the Board. Subgroups may be standing or time and task-limited temporary working groups. Subgroups of any kind need not be chaired by a member of the Board, but there must be a defined means of reporting back to the Board through a group member who is also a Board member.
Transport sub-group
Status: Standing sub-group
Remit:
u To monitor transfer activity across the network
u To develop quality markers for this activity
u To report to the Board on transport performance with respect to the quality markers
u To review from time to time the configuration and staffing of transfer services in the network.
Chair: Dr Alan Fenton
In-utero Transfer at the borderline of viability
Status: Temporary working group
Remit: To work with obstetric colleagues to develop a coherent, network wide approach to the management of women in danger or need of delivery at the extreme of neonatal viability.
Chair: Dr Jonathan Wyllie
Lay and Parent sub-group
Status: Standing sub-group
Remit:
u To consider aspects of the parent and family experience in relation to neonatal care across the network
u To undertake specific work from a parental perspective at the request of the Network Board
u To provide up to two persons from the group to participate in Board meetings and to represent the sub-group at the Board; this will normally be the Chair and one other.
Chair: To be appointed/elected from within the subgroup
Recruitment of lay and parent members: The existence of this sub-group will be made known to the public and to parents through the Network website and in publicity material (fliers, posters etc) available on the special care and intensive care neonatal units. Applications to join may be made at any time. As this is a standing committee for the Board, rather than a support group for parents, application to join the group will be made by letter or email to the Network Manager, and a formal process of selection will be undertaken. It is hoped that both parents and others with an interest will come forward to join this group.
Sub-group size: The sub-group will initially be limited to 12 persons.
Research sub-group
Status: Standing sub-group
Remit:
u To consider Network participation in research projects generated outside the Network and make recommendations to the Board in relation to Network participation in such projects
u To keep a record of neonatal research projects taking place within the Network, or led by a unit in the Network, and to publicise this work using the Network website
u To link the Clinical Research Networks and Universities covered by the Network to the NNN itself
u To report to the Board on research activity.
Chair: To be elected by the subgroup
Audit sub-group
Status: Standing sub-group
Network audit is the central task of the RMSO, which already has a standing steering group (the perinatal morbidity and mortality steering group, PMMS). This group will have the task of supervising routine and specific audits of process and outcome for the Network, including the maternity component and the Northern Baby Outcome Survey (NorBOS). It will normally have an independent chair, and will report to the Board through the Audit lead.
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