Professor Alistair Burns National Clinical Director for Dementia and Mental Health in Older People, NHS England/NHS improvement

Transcription

1 Humber Teaching NHS Foundation Trust Research Conference 2018 The challenges and opportunities of dementia Professor Alistair Burns National Clinical Director for Dementia and Mental Health in Older People, NHS England/NHS improvement Humbernhsft Caring, Learning and Growing

2 Dementia rarely travels alone 80% of people with dementia have another long term condition Diabetes: twice the risk of dementia Cardiovascular disease: increased risk of dementia (a third) 30 times more likely to develop delirium Delirium: increased risk of developing dementia 100,000 people with dementia have sight loss Deafness a risk factor for cognitive impairment Parkinson s disease: 80% cognitive impairment after ten years Down syndrome and learning disability associated

3 Preventing well Diagnosing well Supporting well Living well Dying well

4

5 Current issues Diagnosis/post diagnostic support Antipsychotics The Long Guide The Dementia Care Pathway: Full Implementation guidance Dementia Care Planning - Nationally agreed set of codes STP Initiative Dementia: Advance Care Planning

6 NHS England: Dementia update NHS MANDATE 2018/19 Overall 2020 goals: Deliver the actions as outlined in the Challenge on Dementia 2020 Implementation Plan (see Annex) deliverables: Maintain a minimum of two thirds diagnosis rates for people with dementia. Implement and embed the dementia pathway, set out in the Implementation Guide and resource pack for dementia care, and improve the quality of postdiagnosis treatment and support. NHS PLANNING GUIDANCE 2018/19 Maintain the dementia diagnosis rate of two thirds of prevalence and improve post diagnostic care. 6

7 Dementia diagnosis What we ve done: Achieved and maintained national ambition Inclusion in CCG Improvement & Assessment Framework Reduced number of CCGs more than 10 percentage points below ambition Provided intensive support to CCGs most in need Ethnicity data What we re doing now: Continue to address diagnosis rates at sub-national level Monitoring referral to treatment time Mental Health Services Dataset 7

8 Dementia diagnosis rates 8

9 Post-diagnostic support What we ve done: Care plan in CCG IAF Published good care planning guidance Published advanced care planning sign-posting document Publishing monthly anti-psychotics prescribing data What we re doing now: Operationalising the good care planning guidance template Dementia commissioning Knowhow STP pilot Experience measure 9

10 National Audit of antipsychotics in dementia 2012

11 Anti-psychotic prescribing NHS Digital published the latest collection of anti-psychotic dementia data in January 2018 Part of existing Dementia Data Extract Split by CCG and STP Dec 17 Name Below 5% Between 5% & 15% Above 15% Regions 4 STPs 44 CCGs

12 Clinical context: Anti-psychotic prescribing 12

13 Implementation Guide 13 The Implementation guide and resource pack for dementia care Align with published mental health standards (EIP / Liaison Psychiatry) that provide greater detail The Dementia Care Pathway - Full Implementation Guidance

14 Dementia Care Planning Following the publication of the Dementia: Good Care Planning guide, a task and finish group has been established in order to support incorporation of the dementia good care planning template in GP IT systems. 14

15 STP/ICSs initiative Working with 3 STPs to take part in project Bring together a range of measures with potential to reduce: unnecessary admissions length of stay Person centred meaningful care Targeting care homes and individual residents within those homes for bespoke 15

16 Dementia: Advance Care Planning (ACP) AIM: Resource to support the offer of an ACP in all care settings INPUT: NHS orgs, GP Dementia Leads/ CCGs, Trusts, Experts by experience, hospices, charities THEMES: What good would look like; Faith / Religion and the ACP process; Liberty protection / DoLS and ACP 16

17 Dementia Research in Humber Long history of involvement in national dementia studies One of first trusts in Yorkshire and Humber to promote and recruit from Join Dementia Research Trust Patient Research Ambassador, Wendy Mitchell, is living with dementia Trust volunteer of the year 2017 Link in with local vol orgs e.g. Alzheimer s Society, Butterflies Often number one: first to open, first national recruit, first to hit target, highest recruiting Humbernhsft Caring, Learning and Growing

18 Dementia Research in Humber Humber community involved in trialling many new interventions DESCANT memory aids in early stage dementia Caregiverspro interactive website, including social networking Promoting Independence in Dementia (PRIDE) one to one sessions Journeying through Dementia (JtD) group sessions Valuing Active Life In Dementia (VALID) occupational therapy intervention Individualised Cognitive Stimulation Therapy (icst) one to one manualised intervention Challenge Demcare elearning and decision support tool Remcare group reminiscence..to name but a few Humbernhsft Caring, Learning and Growing

19

20 Perceptions