End of Life Care for Dementia in Central and Eastern Cheshire: a new innovative, facilitative, service development model

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1 End of Life Care for Dementia in Central and Eastern Cheshire: a new innovative, facilitative, service development model Jacqueline Crowther PhD Research Associate/Dementia EoL Practice Development Team Evaluator University of Liverpool Cheshire & Merseyside Strategic Clinical Network event Warrington October 2014

2 Outline Background to team Dementia demographics for area Gaps identified Proposed team configuration Role/function of new team Evaluation

3 Population based service evaluation: Central and Eastern Cheshire July July 2013 Funding: People s Health Trust, Dementia UK Host: St. Luke s Cheshire Hospice, Winsford Included: Two DGH s and allied health professionals within these Domiciliary Care District Nurses 8 Care Homes Family Carers 3 rd Sector and voluntary organisations Hospices (2) Methods: Interviews Questionnaires Background

4 Dementia Population and Annual Estimated Deaths across Central Eastern Cheshire Total Population: 457,08 Population 65+ = 82,955 Estimated Dementia Population: 6,199 Annual deaths: 4,430 Deaths 75+ = 3,015 South Cheshire CCG Total population: 173,175 18% of population 65+ Dementia n= 2,009 Community n= 1,397 Residential n= 612 Mild n= 1,107 Mod. n= 654 Adv. n= % Eastern Cheshire CCG Total population: 200,951 20% of population 65+ Dementia n= 3,132 Community n= 1,925 Residential n= 1,207 Mild n=1,718 Mod. n=1,018 Adv. n= % Vale Royal CCG Total population: 99,761 16% of population 65+ Dementia n=1,058 Community n= 736 Residential n= 322 Mild n= 583 Mod. n= 344 Adv. n=131 12% Total with Advanced Dementia n=774 37% across all CCGs Annual Deaths 2011/12 n = 828 Source: Alzheimer s Society Alzheimer s Map (2012) National End of Life Care Intelligence Network (accessed 2013) Marie Curie Cancer Care Atlas (accessed 2013)

5 Gaps identified Gaps in workforce re: end of life care and dementia knowledge, skills, information and confidence. Family support and planning for death. Support for care homes, DGH s and Primary Care re: palliative and end of life care for people with dementia. Co-ordination and awareness of services and initiatives. Communication and collaboration between providers. Out of hours advice on issues pertaining to EoL and dementia. No dementia specialist service identified within either of the DGH s or across the geographical area.

6 Proposed new Team Dementia End of Life Practice Development Team Funding/duration WTE: Team Leader/Strategic/Organisational lead WTE: Educational Lead WTE: Nurse (?Admiral Nurse) 0.5 WTE Speech and Language Therapist 0.5 WTE Administrator 0.5 WTE Analyst/Evaluator

7 Role and functions of New Team Development and upskilling of generalist workforce Increase partnerships and collaborations with shared goal Embedded within the new End of Life Partnership in Cheshire Will not case manage/carry caseloads: facilitative/enabling function Work alongside/support families, Health and Social Care colleagues in both Primary and Secondary Care, voluntary, 3 rd sector and care homes Explore Out of Hours requirements in order to support good EoL care Signposting, advice and information giving

8 Link with current specialist palliative and end of life care teams i.e. Macmillan supporting development and joint working Supplement and support developments in end of life care for other dementia services available i..e. Parkinson s Disease, Learning Disability, Cheshire Wirral Partnership. Act in specialist, advisory capacity for them as and when required Co-ordinate and support standardisation of service provision at end of life for people with dementia where possible Systems analysis in relation to EoL care in dementia locally

9 Explore service configuration and provision elsewhere globally and nationally Central point of contact for advice and training in EoL care in dementia in different caring contexts Contribute to ongoing review and evaluation of local dementia population need Help achieve local and national targets and CQUINS, contribute to development of dementia specific ones in future

10 Evaluation Undertaken by University of Liverpool Specific framework developed Data collected over two years: quantitative/qualitative Ongoing analysis Results reported at year one and end year two Will inform future of team and developments required

11 In conclusion Commitment Communication Competence Compassion Care Courage Contact: