Network Models

MODELS / EXAMPLES of how different networks have organised themselves

The aim of these summaries is that they will complement the NAN Guide and support other networks to see how structures and processes have been effective in developing and maintaining a network and demonstrate some of the challenges associated with them. We have received summaries from Canada, United States and United Kingdom and await others.


Bone and Joint Canada

Country: Canada

NAN Coordinator: Rhona McGlasson, Executive Director

Contact Information: Rhona



National Steering Committee that is lead by Co chairs that represent clinicians and researchers. The Steering Committee is comprised of individuals who are involved with system level projects to improve the care for individuals who present with musculoskeletal conditions. Individual projects are lead by National Directors including:
• Hip and knee replacement
• Osteoarthritis
• Hip Fracture
• Spine
• Young Investigators


BJC has no formal membership structure. For each project undertaken there is a process to identify the organizations and individuals who are important for the success of the project and a partnership arrangement is agreed to as appropriate.

Strategic Priorities/Objectives:

Canada consists of 10 provinces and 3 territories. Although it has a national publicly funded health care system the operations is under the control of each individual provinces or territory with standards of care varying between each. As such BJC has a mandate for the promotion of system based best practices and facilitates knowledge translation at a local, provincial and national level to improve access and evidence based care for individual presenting with MSK conditions.

Operating Processes (how you work together to deliver your strategic objectives):

BJC works on a project basis applying for funding to support each individual project. Over the last 10 years funding has been obtained from the federal agency (Health Canada), provincial funding agencies as well as industry partners. The National Steering Committee identify the trends and opportunities within health care across Canada and the National Directors work with the Executive Director to apply for funding and implement the project.

Primary Activities/Accomplishments in the past 5 years:

In Denmark, a program called GLA:D® (Good Life with osteoArthritis in Denmark) has successfully helped individuals with hip and knee OA to reduce their symptoms and increase their levels of function and physical activity. It’s a 6-week program that includes 2 education sessions and 12 neuromuscular exercise sessions, which focus on stability and control of the knee and hip joints. Working with the researchers from Denmark, Bone and Joint Canada (BJC) has brought the program to Canada under the title “GLA:DCanada™” and is undertaking an initiative to implement the program across the country.

Hip and Knee replacement
In 2006 BJC developed a toolkit for the best practices management of hip and knee replacement, which, in the subsequent years was implemented in the 10 provinces across the country resulting in an increase in access to surgery and a reduction in wait lists. In 2015 BJC developed recommendations on the system design to ensure appropriate candidates were being offered hip and knee replacement surgery. This report was released in December 2015 and is being used to guide program design in the provinces.

Hip Fracture
The management of hip fracture is complex and requires a comprehensive program to facilitate access to surgery within 48 hours and access to post operative best practice care including rehabilitation. BJC developed a toolkit on best practices that has been implemented in the 10 provinces. BJC is currently working towards a standard data measurement system to track and report performance across the country.

Young Investigators Initiative
BJC works with the Bone and Joint Initiative US to host the Young Investigators. The Young Investigators Initiative is a grant mentoring and career development program that aims to increase musculoskeletal research by increasing the pipeline of clinician and basic scientists. The program has engaged 339 participants of which 180 participants (50%) have obtained grant funding totalling more than $210 million for 846 new musculoskeletal research studies (May 2016).

Low Back Pain
The management of low back pain is complex and there is significant research being undertaken to identify the system approach required to ensure patients’ access the care they need to prevent the development of chronic low back pain. BJC developed a framework for a system design, which was launched in 2015.


Prepared by: Rhona McGlasson
Date: June 7, 2016


ARMA (Arthritis & Musculoskeletal Alliance UK)

Country: UK

NAN Coordinator: Sue Brown (CEO)

Contact Information:;




We have a Board of Trustees consisting of 9 Trustees elected by our member organisations and up to 4 co-opted Trustees, including a Treasurer, which meets quarterly. We have an Annual Generral Meeting open to all members.

We have a staff body consisting of one FT CEO, one FT Admin Manager and one PT Public Affairs & Comms Officer. We are supported by a freelance Web Manager and an Accountant.

Our office is in the building of one of our members, the British Society for Rheumatology, in central London.


We have roughly 40 member organisations from across the spectrum of MSK conditions, roughly equally divided between professional and patient-led (and research) charities.

Strategic Priorities/Objectives:

This is our Strategic Plan 2016-2018:

Operating Processes (how you work together to deliver your strategic objectives):

We have quarterly meetings of our member CEOs and bimonthly meetings (every 2 months) of our member policy and comms leads, which discuss shared priorities and activities at different levels of detail and delivery.

There is also a steering group for our key project, the MSK clinical networks project in England, which meets roughly every 3 months.

We have a monthly newsletter which all members ocntirbute to, and we are active on Twitter.

Primary Activities/Accomplishments in the past 5 years:

See “Benefits of ARMA” document (as of January 2016)

Our MSK clinical networks project, and particularly the MSK Knowledge Network, is a key focus involving all our key members as well as key stakeholders across the NHS in England. We held a very successful seminar in January.

We are also actively working with Public Health England on evidence and messaging around prevention and public health issues including MSK health & work and physical activity.

We are currently “mapping” our members’ activities and policies to produced shared narratives in key policy areas.


Prepared by: Federico Moscogiuri
Date: 6 May 2016


United States Bone and Joint Initiative (USBJI)

Country : USA

NAN Coordinator : Toby King, Executive Director

Contact Information:, or



We are governed by a Board of Directors made up of representatives from our member organizations. An Executive Committee of the board is comprised of the President, President-Elect or Immediate Past President, Vice-President, Secretary and Treasurer..

We have a staff consisting of the Executive Director, Society Coordinator and two part-time Program Coordinators.

Our office is located in Rosemont (Chicago), Illinois, near O’Hare International Airport.


We have roughly 50 member organizations from across the spectrum of MSK conditions.

Strategic Priorities/Objectives:

Our Mission is to advocate and promote multidisciplinary, coordinated, and patient-centered care to improve the prevention, diagnosis, and treatment of musculoskeletal conditions. Our Strategic Plan and Goals can be accessed at

Operating Processes (how you work together to deliver your strategic objectives):

The Board which meets quarterly sets the strategic direction of the organization, approve an annual budget and operating plan. The Executive Committee meets monthly to review progress and handle decisions between Board meetings.

Every program is led by an Advisory or Steering Committee, on which one member serves as a Board liaison. Each committee is comprised of a chair and representatives of member organizations with an interest in the program area.

Regular notices and a newsletter are sent out to members and their members who have in one way or another become engaged in the activities of the USBJI or to be kept abreast of activities.

Primary Activities/Accomplishments in the past 5 years:

BMUS Canada

The Burden of Musculoskeletal Diseases in the United States: Prevalence, Societal and Economic Cost (BMUS)
This publication presents comprehensive and independently validated data to support raising the profile of musculoskeletal health, and to make the case for the value of scientific research, innovation and access to specialist care. This publication is used by decision-makers, legislators and other policy-makers, granting organizations, Federal and State agencies, provider/payer formularies, employers (wellness in the workplace), the press, researchers, educators, healthcare professionals, patients and industry/suppliers. BMUS covers all major musculoskeletal conditions and is available online (

Young Investigators Initiative

Young Investigators Initiative
The Young Investigators Initiative is a grant mentoring and career development program that aims to increase musculoskeletal research by increasing the pipeline of clinician and basic scientists. The program has engaged 339 participants of which 180 participants (50%) have obtained grant funding totaling more than $210 million for 846 new musculoskeletal research studies (May 2016).

To better enable clinical research in the musculoskeletal diseases performed by young investigators to keep pace with the increasing burden of these diseases in the U.S. the USBJI offers this multi-disciplinary program consisting of workshops and mentoring to provide early-career clinical investigators an opportunity to work with experienced researchers to assist them in securing funding. This program is open to promising junior faculty or senior fellows or post-doctoral researchers who have been nominated by their department or division chairs. It is open to senior fellows or residents who are doing research and have a faculty appointment in place or confirmed. Workshops take place in the Spring and in the Fall. The unique aspect of this program is the opportunity for attendees to maintain a relationship with a mentor until their application is funded and to benefit from multi-disciplinary collaborations.

Chronic Osteoarthritis Management Initiative (COAMI)

This inter-disciplinary initiative is working on a new model of care in the management of osteoarthritis on the basis of advances on the pathogenesis and treatment of this highly prevalent musculoskeletal disease. COAMI, which is focused on the clinical encounter and the role of various healthcare professionals in a coordinated care program, includes representatives from more than 25 leading professional societies, including various medical and surgical subspecialties as well as others health care providers. Work to develop the new model is organized under three areas: care pathway/delivery; shared decision-making tools; physical activity. Systematic Reviews of Guidelines and of Outcomes Measures have been published. The work addresses the impact of OA on various ethnic populations.

Project 100/1000

Too many graduating medical students do not have the knowledge and skills required to properly diagnose and treat patients with musculoskeletal diseases. In collaboration with the Association of American Medical Colleges and the National Board of Medical Examiners, among other organizations, Project 100 works to increase formalized instruction in musculoskeletal medicine in medical schools. In 2002, less than 50% of medical schools offered this formalized instruction; by 2010, instruction was offered in 80% of medical schools. This likely will result also in greater interest in a career in the musculoskeletal specialties. The Project 100/1000 team is currently building a Community of Musculoskeletal Educators, to share expertise and resources. Around 300 educators are enlisted (May 2016). Interested faculty can register at

Public/Patient Education Programs

Experts in ArthritisFit to a T
USBJI Public/Patient Education programs focus on prevention, treatment and rehabilitation of musculoskeletal conditions, in partnership with national and local healthcare professional, patient, and public organizations committed to improving musculoskeletal health. In 2015 115 sessions were held of Fit to a T (bone health & osteoporosis), Experts in Arthritis, and PB&J (for adolescents). A total of more than 900 sessions have been held, nationwide, offered to more than 30,000 patients and the public. The ready-to-use slide sets and handout materials are available to members at no charge.


Prepared by: Toby King
Date: May 19, 2016