IT Solutions to Support Prevalence, Case Finding, Diagnosis & Care Planning in Dementia

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1 IT Solutions to Support Prevalence, Case Finding, Diagnosis & Care Planning in Dementia "High Quality Care for All, Now and for Future Generations"

2 Dementia Diagnosis - Why is it important Dr Sara Humphrey GP North Street,Keighley GP with a Special Interest in Older People-BTHFT Clinical Specialty Lead Older People & Stroke Airedale, Bradford District &City CCGs GP Advisor Yorkshire & Humber Dementia SCN Honorary Visiting Research Fellow Bradford University School of Dementia Studies 28/9/17

3 Why is a diagnosis important?

4 Patients and their Carers want it! It was a huge relief right thank goodness now we ve got a diagnosis, now I know what I m dealing with and I ll cope with it It s an illness, it s a terminal illness as well you know, nobody gets better from it, and it isn t treated like that with the NHS is it, unfortunately if it was cancer it would be different, you know Absolutely instead of being really really aggravated you become empathic on diagnosis Source: Dementia in Leeds Evaluation Project, 2013

5 Transforming toxic uncertainty into empowered understanding

6 Why is Dementia important to the NHS,LAs & CCGs?

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10 Total Estimated savings 86 million Nationally on just 4 conditions

11 So is it important for the NHS and LA We spend 23 Billion a year as a society and we can spend this money more effectively rather than on expensive crisis interventions Crisis presentations Care Home Admission ( or delay them) Reduce Emergency Admissions and readmissions to Hospital Reduce hospital Length of Stay Spend the money saved on more meaningful support

12 Why has it been so topical for the last 5 years?

13 Prime Minister s challenge on dementia 2012 & 2020 Set the bar to achieve a national ambition of 67% of patients with Dementia receiving a diagnosis

14 Dementia Diagnosis Rates Diagnosis rate shown is number of patients on QOF dementia registers as a percentage of estimated dementia prevalence (for ages 65+ only) % = national ambition Date of Register

15 What makes a difference?

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17 IT Solutions to Support Prevalence, Case Finding, Diagnosis & Care Planning in Dementia?

18 Yorks & Humber Clinical Networks Dementia Technical Solution DQT toolkit At Risk of Dementia Toolkit -for targeted screening assessments DiADeM Suite of Clinical templates to support GP Care Planning & aspects of care of patients living with Dementia These resources can be used by individual practices or by CCGs to look at the needs of the CCG population.

19 Alternatively, users can send an to or ring and request membership. Units will then receive an unassigned task titled Organisation Group Membership. System Administrators can easily action this task via a right click on the appropriate task.

20 Dementia Quality Toolkit (DQT) Updated DQT Access them HERE Automated system search which is easily uploaded by the practice Looks for codes that suggests the patient has dementia but there has been a missed opportunity to code it Available across Yorks & Humber for GP practices using SystmOne and EMIS Web Technical guidance Frequently Asked Questions

21 How to use the reports The **WORK TO DO** reports will contain a list of patients who may have a missed dementia diagnosis. If GPs wish to review patients then you can use the read code Ongoing Review (Xalpj) and this will remove the patients from the **WORK TO DO** reports. These patients marked with an ongoing review (awaiting/confirming diagnosis) will remain on the **MASTER LIST** until they have dementia diagnosis added to their record.

22 NEW At Risk Toolkit to support case finding At-risk patients are: Aged >60 with CVD, stroke, peripheral vascular disease or DM Aged> 40 with Down s syndrome; Aged >50 with learning disabilities; long-term neurological conditions which have a known neurodegenerative element, for example, Parkinson s disease. Living in a care home Previous Delirium Female > 90 yrs old MCI diagnosed > 12months ago

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24 Diagnosing Advanced Dementia Mandate in a Care Home setting DiADeM -App -Paper -Templates

25 What is DiADeM? DiADeM is a tool for diagnosing of advanced dementia in people who live in care homes. o 70-80% of care home residents will have dementia o Supports primary care clinicians to make a diagnosis o Reduces the need to attend formal clinics o Increases the likelihood of receiving good post diagnosis care

26 DiADeM Diagnosing Advanced Dementia Mandate (for care home settings) Link to website

27 DiADeM Reports

28 How to Access DiADeM

29 DiADeM Website

30 DeAR-GP Link to website DeAR GP, developed by the Health Innovation Network and supported by Alzheimer s Society, is a simple paper based case-finding tool which has been designed for use by care workers to identify people who are showing signs of dementia. DeAR GP acts as a communication between care workers and health professionals

31 Updated Resources Gateway

32 Making a Diagnosis of Dementia Using all the codes used to monitor primary care referrals

33 Updated QOF Templates Using a joint code set across frailty & dementia national templates

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38 New Resources from the CN

39 Pt & Professional Outputs

40 Care Planning Outputs To share with Professionals

41 Care Planning Outputs For People Living with Dementia and their Carers

42 Team Contacts Colin Sloane, Quality Improvement Lead Sara Humphrey, GP advisor Emma Blamire, IT Support at Airedale NHS Trust