Mental Health Collaborative. Dementia Summary of Activity. April 2010

Transcription

1 Mental Health Collaborative Dementia Summary of Activity April 2010 The following extracts provide either one example of a Board s dementia improvement activity or a brief summary of a Board s current and planned activities in dementia; further details are available from their local programme manager or identified lead. The aim of these summaries is to support collaboration between Boards by enabling you to identify who else is working on something of interest to you and then make contact to share ideas. NHS Ayrshire and Arran Information sent to GP s on their current position against Eurodem prevalence. We have also updated dementia diagnosis data in secondary care and half of our care homes. All this information has been sent to general practice using an agreed format. Exploratory meetings have taken place with staff within selected GP practices and Care Homes to identify any specific issues around communicating and sharing information relating to confirmed and potential diagnosis. From this a process map will be developed over time illustrating identified good practice arrangements. Process mapping exercise underway to refine and improve admin processes within Older Peoples services. Focus groups have been held with service users and carers in each of the three Locality areas Further details are available from anne.gerard@aapct.scot.nhs.uk NHS Borders Primary care dementia guideline has been developed and tested using PDSA with one practice with positive feedback. Now engaged with a second practice. More rapid spread will take place in the next 4 months to all practices. When engaging with practices the following will be delivered: ο Primary care dementia guideline and algorithm ο Face to face delivery of training in the guideline to each practice. ο Options for regular liaison with Mental Health for Older Adults Team (Specialist Service) ο Offer of support to compare primary care and specialist care dementia data. ο Offer support around care home engagement, identification of people with dementia and future processes. Acute Hospital project presently being scoped. Planning to use DCAQ within Mental Health for Older Adults Team. Reconfigured a Day Service (one day per week) as a pilot to provide an information and support service for people post-diagnosis. Further details are available from Pauline.Burns@borders.scot.nhs.uk 1

2 NHS Dumfries and Galloway An information pack including individual practice data has been sent to all practices accompanied by a letter from the Medical Director regarding dementia registers. Undertaking series of practice visits to explore actual v predicted prevalence. Where diagnosis needs confirmation by consultant, arrangements discussed regarding this. Programme of Care homes visits underway. Lists generated of people with a dementia diagnosis or suspected dementia, and these aligned with CMHT and memory clinic info. Five End of Life care workshops have been facilitated in partnership with Alzheimer s Scotland, and multidisciplinary staff from has positively received these across the region. Follow up sessions are planned for May/June. A survey is underway in Stewartry to establish GPs and service users opinions around the current memory clinic review process. A training plan is in place to deliver training to staff across the region on appropriate interventions for challenging behaviour. This is being piloted in Annandale locality An audit is being carried out on the use of antipsychotic medication for people with dementia, with a focus on care homes. A draft proposal has been developed by one of the consultant psychiatrists to carry out a care homes study on dementia. Further details are available from linda.mckechnie@nhs.net NHS Fife Undertaking programme of practice visits. Info pack sent out to all practices comparing actual v predicted prevalence and methods used to increase numbers. Initial figures show a 6% increase in register figures between March to December 2009 Mapping some patient journeys of people in acute care to feed into pilot within medical assessment unit of assessing for cognition all over 65s Working with a local authority residential home to improve the care pathway for people with suspected dementia. The aim is to clarify the process for diagnosing dementia so that staff are clear on what may or may not be dementia, and how they can best articulate their observations to the most relevant clinician. Planning a GP Teaching event on Dementia during Protected learning time supported by the Collaborative Further details are available from mikekelly@nhs.net NHS Forth Valley A post-diagnostic information checklist has been developed for patients and carers. A patient and carer experience questionnaire of the information received will be evaluated quarterly. A Post Diagnostic Support Group has commenced in two CHP areas. This group is for people with Dementia. It is co facilitated by CMHTE and Alzheimer s Scotland. Patient and carer experience evaluation is ongoing. Eurodem data has been broken down by CHP and GP practice and has been distributed to all practices and local CMHTEs. From this trajectories have been 2

3 calculated for meeting the dementia Eurodem targets for NHS Forth Valley. Process mapping of the dementia pathway is complete. Advanced Care Plans for people with dementia, this work has commenced in care homes, and supported by care home liaison staff. Care Home Screening Project, this commenced in April 2010 in one CHP area, this project will screen all patients in care homes with memory impairment, if people have dementia they will be referred onto secondary care for appropriate care and treatment, and will be added to the Dementia register. Further details are available from / NHS Grampian We have used the Dementia calculator to work out expected prevalence of dementia for each GP Practice and compared this to the practice QOF registers for Dementia. Currently targeting top 20 practices. Sending out info on secondary care cases. Work currently being undertaken on the PIMS Data to add ICP diagnosis on all the open referrals. Clinical Lead delivers educational work with RCGP speaking about dementia care on GP courses: One course with 20 GPs held on 3 Feb 2010 and another one arranged for end of April 2010 (in Orkney). Further details are available from william.cowling@nhs.net NHS Greater Glasgow and Clyde Agreement has been reached on the inclusion of patients from the Nursing Homes Practice on the Dementia Register, and NHS GG&C has now achieved the target. Now engaging with key stakeholders regarding how we improve follow-up for the people on the registers. A Local Enhanced Services agreement was set up with GPs in some of the CHPs/ CHCPs in NHSGG&C in order to further develop dementia diagsnois, including screening for dementia in the over 75 age group and setting up a treatment/care plan for those identified through screening. Continuing to use focus group approach to improve management of people with dementia. 12 Helpful Hints leaflets on communicating with someone who has dementia are to go into staff payslips at the end of May. We are developing a standard information pack to be made available on diagnosis. Following the success of the production of the play Changed Days, which aimed to raise awareness about dementia, a DVD is being made to allow a wider audience to view it. Further details are available from jill.carson@nhs.net 3

4 NHS Highland We have agreed a protocol for providing a memory clinic service in NHS Highland, and aim to establish a peripatetic service that offers the agreed key functions. This will be tested on one area using PDSA, and subsequent roll-out across Highland. We have also created and sent out an information pack to practice managers, that includes QoF comparison data, READ codes and affiliated ICD-10 codes, ideas for reconciling registers, and example literature for patients and carers. Further details are available from lynda.forrest@nhs.net / ruth.mantle@nhs.net NHS Lanarkshire Developed a trajectory for each Locality and all GPs within the Locality using the Dementia Target calculator. We then compared the actual numbers on the GPs registers with that of the trajectory to determine 2 registers/localities most requiring improvement. We then collated a list of all people diagnosed with dementia from PiMS and the CMHT caseloads to cross reference with the GP registers. Results have had a positive impact on increasing the GPs registers within those 2 Localities. Early stages of developing a Dementia awareness and training programme for all staff in Lanarkshire. We plan to write up the approach and have each Service Manager/ Clinical Governance apply the same process within their Locality. A standardised covering letter is being developed to aid the GPs and practice mangers to ensure those people who have been diagnosed with Dementia by the CMHTs are recorded on the GPs Dementia Registers Further details are available from Gail.Notman@lanarkshire.scot.nhs.uk NHS Lothian Feedback information to General Practices regarding the gap between the number on the dementia register and the predicted prevalence. Develop, pilot and audit information packs for patients / carers as part of the dementia ICP, for use in specialist services. Pilot a system for 6-monthly reviews in secondary care as part of the Dementia ICP. Planning a Protected Learning Time event on dementia for GPs and relevant primary care staff on 26 May Circulation of a guide to assist in managing dementia and a booklet with advice for carers on managing people with dementia to all GPs in Lothian MHC Clinical Lead is meeting with lead GPs to discuss improving dementia care in primary care, including the primary care role in the dementia ICP Further details are available from Kerrie.Buhagiar@nhslothian.scot.nhs.uk 4

5 NHS Orkney We have used the Mental Health Collaborative (Dementia) toolkit to identify a range of issues where service improvement activity can be targeted. These include: ο Develop a fit for purpose database for the memory team database has been developed and is currently being tested using PDSA methodology. Develop information form for the Memory Team information form has been developed and is currently being tested using PDSA methodology Further details are available from john.trainor@nhs.net NHS Shetland Compared actual v predicted levels of prevalence for each practice. Information has been gathered from Social Care colleagues regarding people they are working with who either have or are suspected of having a diagnosis of dementia. Conducting an audit of READ code use within 1 practice. Working in partnership with Stirling Dementia Services Development Centre to deliver various levels of training throughout Shetland. A process mapping exercise has been carried out to identify current diagnosis pathway. Visioning exercise being held on 31 st March 2010 to develop ICP. Further details are available from alan.murdoch@nhs.net / elai@nhs.net NHS Tayside Establishing a Secondary care dementia register in Psychiatry of Old Age (POA) in one CHP area. This register will be tested prior to roll out. SMR00 data is to be collected by POA community teams in one CHP area. Following agreement with organisations random audits of case notes to check compliance rates to be carried out. A target of all Practice Pharmacists to cross-check anti-cholinesterase medications against QOF registers for omissions. Dr Michelle Watt corresponding with CHPs with regard to the need for this action in relation to the target. Monthly register levels are being assessed against predicted prevalence using the dementia calculator. Develop a patient experience question set with NHS Grampian and the 3rd sector to support the New Tayside Measure Agreement from 3rd sector and Carer and Patient representatives required. Further details are available from lesleyannebrown@nhs.net 5

6 NHS Western Isles Completed an audit of waiting times from referral to first seen to identify a baseline prior to the implementation of an electronic pathway from referral to diagnosis. Pathway being tested using PDSA. Common read codes and their equivalent ICD 10 code have been issued to each GP practice to assist in accurate coding. ICD 10 codes are now included in all correspondence to GPs to further assist accurate coding in primary care. An audit has been completed Feb 10 to monitor compliance. The Lead clinician is visiting targeted practices to assist with searches and coding issues relating to dementia. Dementia awareness day held in Southern Isles to educate school children regarding the early signs and symptoms of dementia. Further sessions to be held in Lewis and Harris. Our future actions will be to validate QOF registers against those known to the community mental health team as having a diagnosis of dementia. Further details are available from anne.hutchison2@nhs.net / kbrightwell@nhs.net 6