Frailty Conference Midlands and East Improving Care for People with Frailty

Frailty Conference Midlands and East Improving Care for People with Frailty Contents Context 2 Purpose of the region wide event 2 Pre-event activity 2-3 Delegate pre work 3 Viewing stands 4 Agenda 5-6 Workshop Sessions 7 Speaker Biographies 8-12 Event Evaluation form 13-15 Directions to Leicester Racecourse 16-17 1

Context What is Frailty? NHS England have defined frailty as a progressive, long term condition characterised by a loss of physical and/or cognitive resilience that means people living with frailty do not bounce back quickly after an acute stressor event such as a physical illness, an accident or other stressful event. Why is Frailty Important The population of England is ageing. By 2040, nearly one in seven people are projected to be over 75. Whilst frailty is associated with age it is not the same: not all older people live with frailty and not all people living with frailty are old. Many of the factors that cause people to age differently are amenable to population-level interventions based on lifestyle choices and exercise. Frailty (rather than age) is effective as a means of identifying people who may be at greater risk of future hospitalisation, care home admission or death. For example, people living with severe frailty have a four times greater one-year hazard ratio for these outcomes. This means population-level frailty identification can help anticipate future health and social care demand. Accelerating population ageing coupled with existing health system pressures means it is important for local areas to take action to provide a more sustainable, wholesystem approach to managing frailty that ensures that we have the rights types of services in the right quantities to meet demand. For example, the number of people aged 65 to 69 has grown by 34% in the last 10 years, with corresponding hospital admissions growing by 57%. Purpose of the region wide event Discuss national strategic plans for older people living with or at risk of developing frailty Identify regional variation and develop good practice with regards to the frail elderly Helping STP areas develop strategic plans for managing the frail elderly population. Explore workforce issues across health and social care Pre-event activity If you are an organisation planning frailty, data and information analysis is a useful tool to help plan and commission services. To get the most out of the day delegates are requested to review the information contained in the Right Care pack which will 2

be available from your local STP or CCG lead. The Get It Right First Time data pack is attached to the email with this pre-event pack. Ideally, delegates are requested to review and reflect on the frailty service data preferably with their local partner agencies and wider colleagues. Consider the questions below using local knowledge as well as the data provided as this will form the basis of group work at the workshop session. Delegate pre work Before the event please: Reflect on the local frailty services Review the attached data and Answer the following questions, as they will form the basis of group work at the workshop session. Describe the services you commission or provide for people with frailty? What can you do to improve frailty in a sustainable way, in both the short and long term? 3

Information for delegates for the day There will be stands on the day from the following organisations: Eastern Academic Health Science Networks East Midlands Academic Health Science Network West Midlands Academic Health Science Network Knowledge and Intelligence Network (Public Health England) Acute Frailty Network Dementia Crisis and Support Team Resources table - please feel free to bring with you any examples of case studies, templates and other information to share with colleagues. Please see below the agenda and biographies of speakers. We look forward to seeing you on the day. 4

Frailty Conference - Midlands and East Tuesday 27 March 2018 Leicester Racecourse, Leicester Road, Oadby, Leicester, LE2 4AL 9.30-15.45 Chair: Dr Mark Sanderson, Deputy Regional Medical Director, NHS England, Midlands and East Time Presenter 09.30 Registration tea and coffee available 09.45 Welcome and Introduction Dr David Levy Regional Medical Director NHS England (Midlands and East) 09.55 Ageing Well National Frailty Approach Dr Martin Vernon National Clinical Director Older People NHS England 10.20 Presenting the regional data Get It Right First Time and Right Care Information Dr Adrian Hopper Geriatric Medicine Lead NHS Improvement Lucy Heath NHS Right Care Delivery Partner Midlands and East Regional team 10.40 Acute Frailty Network (AFN) Professor Simon Conway National Clinical Lead for the AFN, NHS Elect, Professor of Geriatric Medicine, University of Leicester 10.55 Q&A Facilitated by Dr Mark Sanderson (Deputy Medical Director, NHS England, Midlands and East) 11.10 Refreshment break and stand/poster viewing LEARNING FROM LOCAL PROJECTS 11.30 Using an international benchmarking tool as a focus for quality improvement in care homes Dr Adam Gordon Clinical Associate Professor in Medicine of Older People University of Nottingham 11.45 Fire Safety and promoting health and well being Glynn Luznyj Director of Prevent and Protect Staffordshire Fire and Rescue Service 5

12.00 A whole systems approach to frailty in Lincolnshire including EOL and mental health Kim Barr Older Persons Fellow Kings College, London. Clinical Pathway Lead for Frailty, Palliative, End of life care and Respiratory Services 12.15 Large Scale Care Home Improvement Helen Hunt Assistant Patient Safety Programme Manager, West Midlands Patient Safety Collaborative West Midlands Academic Health Science Network 12.45 Dementia Crisis and Support Team Dr Afifa Qazi Consultant Psychiatrist Associate Medical Director North East London NHS Foundation Trust Irene Lewsey Head Of Transformation Thurrock CCG 13.00 Q&A - Facilitated by Dr Dawn Moody (Associate National Clinical Director for Older People and Integrated Person-Centred Care, NHS England) 13.15 Introduction to the afternoon action planning session Dr Dawn Moody 13.20 Lunch, networking and viewing stands 14.10 Workshop Introduction NHS England Action planning by STP footprints Collation of feedback on proforma NHS England (Midlands and East) Regional team AHSN colleagues 3 Breakout rooms split by AHSNs: Proceed to the appropriate breakout room *Please see below workshop breakout room locations 15.00 Feedback from each breakout rooms STP member 15.30 Next steps Regional Lead/AHSN 15.45 Close 6

*Workshop breakout rooms ROOM A ROOM B ROOM C Nelson Suite Nelson Suite (main room) (partition) East Midlands AHSN Eastern AHSN The Kube (main hall) West Midlands AHSN The Black Country Birmingham and Solihull Coventry and Warwickshire Herefordshire and Worcestershire Staffordshire Shropshire and Telford and Wrekin Derbyshire Lincolnshire Nottinghamshire Leicester, Leicestershire and Rutland Northamptonshire Bedford, Luton and Milton Keynes Cambridgeshire and Peterborough Norfolk and Waveney Suffolk and North East Essex Hertfordshire and West Essex Mid and South Essex NHS Dudley CCG NHS Sandwell and West Birmingham CCG NHS Walsall CCG NHS Wolverhampton CCG NHS Birmingham CrossCity CCG NHS Birmingham South and Central CCG NHS Solihull CCG NHS Coventry and Rugby CCG NHS South Warwickshire CCG NHS Warwickshire North CCG NHS Herefordshire CCG NHS Redditch and Bromsgrove CCG NHS South Worcestershire CCG NHS Wyre Forest CCG NHS Cannock Chase CCG NHS East Staffordshire CCG NHS North Staffordshire CCG NHS South East Staffordshire and Seisdon Peninsula CCG NHS Stafford and Surrounds CCG NHS Stoke on Trent CCG NHS Shropshire CCG NHS Telford and Wrekin CCG NHS Erewash CCG NHS Hardwick CCG NHS North Derbyshire CCG NHS Southern Derbyshire CCG NHS Lincolnshire East CCG NHS Lincolnshire West CCG NHS South Lincolnshire CCG NHS South West Lincolnshire CCG NHS Mansfield and Ashfield CCG NHS Newark & Sherwood CCG NHS Nottingham City CCG NHS Nottingham North and East CCG NHS Nottingham West CCG NHS Rushcliffe CCG NHS East Leicestershire and Rutland CCG NHS Leicester City CCG NHS West Leicestershire CCG NHS Corby CCG NHS Nene CCG NHS Cambridgeshire and Peterborough CCG NHS Great Yarmouth and Waveney C NHS North Norfolk CCG NHS West Norfolk CCG NHS Norwich CCG NHS South Norfolk CCG NHS Ipswich and East Suffolk CCG NHS North East Essex CCG NHS West Suffolk CCG NHS Bedfordshire CCG NHS Luton CCG NHS Milton Keynes CCG NHS East and North Hertfordshire CCG NHS Herts Valleys CCG NHS West Essex CCG NHS Basildon and Brentwood CCG NHS Castle Point and Rochford CCG NHS Mid Essex CCG NHS Southend CCG NHS Thurrock CCG 7

Chair, Key Note and Speaker Biographies Dr David Levy, Regional Medical Director, NHS England (Midlands and East) David has 30 years of medical experience, having worked in the past as the President of the British Columbia Cancer Agency and as a Consultant Neurooncologist at Sheffield Teaching Hospitals NHS Foundation Trust. There he developed an innovative, patient-focused, research-orientated, multidisciplinary team. He led three of the Keogh Panel Reviews and a new style CQC visit to a large Trust. He co-led the review of Clinical Senates, Strategic Clinical Networks and AHSNs for NHS England and is the Clinical Lead part leading the implementation of that review. He also is the clinical lead for implementation of 7 day services. Dr Mark Sanderson, Deputy Regional Medical Director, NHS England (Midlands and East) Mark joined the Regional Medical Directorate in August 2017. He is part of the team leading the GP Forward View in the region, and is regional lead for the National Diabetes Prevention Programme. Before joining the region he was a GP in St Ives, Cambridgeshire for 17 years and Assistant Medical Director for NHS England - Midlands and East (East). At the start of his medical career he spent five years in General Medicine and five years in Public Health Medicine. He has experience of being a GP trainer, a NHS England Responsible Officer, and a GMC Performance Assessor. He is Treasurer of the East Anglia Faculty of the Royal College of General Practitioners. Professor Martin Vernon, National Clinical Director for Older People and Person Centred Integrated Care, NHS England Martin qualified in 1988 in Manchester. Following training in the North West he moved to East London to train in Geriatric Medicine where he also acquired an MA in Medical Ethics and Law from King s College. He returned to Manchester in 1999 to take up post as Consultant Geriatrician building community geriatrics services in South Manchester. Martin was Associate Medical Director for NHS Manchester in 2010 and more recently Clinical Champion for frail older people and integrated care In Greater Manchester. He has been the British Geriatrics Society Champion for End of Life Care for 5 years and was a standing member of the NICE Indicators Committee. 8

In 2015 Martin moved to Central Manchester where he is Consultant Geriatrician and Associate Head of Division for Medicine and Community Services. He also holds Honorary Academic Posts at Manchester and Salford Universities and was appointed as Visiting Professor at the University of Chester in 2016. In 2016 Martin was appointed National Clinical Director for Older People and Person Centred Integrated Care at NHS England. In 2017 he became Chair of the NHS England Hospital to Home Programme Board and is working on National Frailty Care with NHS Improvement. Dr Dawn Moody, Associate National Clinical Director for Older People and Integrated Person-Centred Care Dr Dawn Moody is Associate National Clinical Director for Older People and Integrated Person-Centred Care for NHS England. Dawn is a GP with a special interest in the care of older people, with current clinical practice in Derbyshire and Cheshire. In addition to her wide clinical experience in primary care, community care and interface services, she has also worked with commissioners, providers and in education and research in this area. Dawn has an MPhil for research into the measurement of frailty in primary care and holds an MSc in Geriatric Medicine. In addition she is Clinical Director for the Nottinghamshire Frailty Toolkit and Training Programme and Frailty Lead for the West Midlands Primary Care Workforce and Improved Patient Access Plan. Dr Adrian Hopper, Geriatric Medicine Lead, Getting It Right First Time Dr Adrian Hopper is a Geriatrician based at Guy s and St Thomas Trust in London. He has a long standing interest in patient safety and quality of care for older persons in particular falls prevention and decision making for patients with uncertainty about recovery where he developed the AMBER care bundle. He has just started a national role as the speciality lead for Geriatric Medicine for the Getting it Right First time programme. Lucy Heath, NHS RightCare Delivery Partner Lucy started her career in residential mental health working first with people with chronic mental health problems and secondly with mentally disordered offenders. Lucy then moved into project work in the voluntary sector before starting as a researcher in the NHS. Lucy had two research roles. The first was on a project investigating the mental health of Gypsies and Travellers and the second was with the Modernisation Agency investigating why NHS Trusts fail. Following this she started public health training and completed placements in Staffordshire and Wolverhampton. Since qualifying she has worked as a Consultant in Public Health in Wolverhampton City PCT, Staffordshire County Council and Cheshire East Council. 9

Lucy had a varied portfolio including lead roles for CVD, mental health, sexual health, children, health intelligence and healthcare public health. Along the way Lucy has completed a number of degrees: Cognitive Science, Forensic Mental Health, Health Service Research and Public Health. More recently she has completed a number of courses on system leadership and commissioning. Professor Simon Conroy, Professor of Geriatric Medicine, University of Leicester Simon s ambition is to improve outcomes for frail older people by embedding evidence based medicine into clinical practice ( campus to clinic translational research). His research addresses different models of care for frail older people, assessing feasibility as well as clinical and cost-effectiveness. His educational activities take an interdisciplinary perspective on developing and teaching knowledge locally (frailty services), nationally (BGS) and internationally (EUGMS & EAMA). Implementation of research findings into clinical practice is key, and best exemplified by work on the Silver Book and the Acute Frailty Network. More information can be found at: http://www2.le.ac.uk/departments/healthsciences/research/primary/staff/conroy Professor Adam Gordon, Clinical Associate Professor in Medicine of Older People - University of Nottingham, Visiting Professor - City University London & Consultant Geriatrician - Derby Teaching Hospitals NHS Foundation Trust Adam Gordon is Clinical Associate Professor in Medicine of Older People at the University of Nottingham. He has a research interest in care home service delivery and is an investigator on multiple care home studies ranging from randomised controlled trials, to observational cohort, to implementation research studies. He is specialist advisor to the East Midlands Academic Health Sciences Network Patient Safety Collaborative on Care Homes and has played a leading role in that organisation s recent work to benchmark prevalence of care problems in care homes and use these data as the basis of quality improvement discussions with and within the sector Glynn Luznyj - Director or Prevent and Protect, Staffordshire Fire and Rescue Service I have worked for Staffordshire Fire and Rescue Service for 21 years in many roles which include working within the realms of fire protection and community safety. My previous experiences include a number of years working as an operational firefighter, progressing through junior and middle management roles into my current position as a Director. One of my priorities is working at a national level on behalf of the National Fire Chiefs Council with colleagues from the NHS, Public Health and 10

the LGA to expand the role of the of the Fire and Rescue Service to work more collaborative with health organisations. This important work is improving the safety and wellbeing of the citizens whilst also reducing fire risk. Outside of work I enjoy spending time with my family and being involved with a number of sports. Kim Barr RGN, BSc, MSc, Older Person s Fellow Kings College London Kim Barr is the Clinical Pathway lead for Frailty, Palliative and End of life care and Respiratory services for Lincolnshire Community Health Services. She has worked within the NHS for over 35 years and has worked in Lincolnshire since 1994. Before coming to Lincolnshire, she worked in London training at University College Hospital, specialising in Intensive care working in both specialist and management roles. Since working in Lincolnshire she worked in primary care becoming a nurse practitioner developing her skills in chronic disease management and where her interest in palliative care started for non-cancer patients. In 2003 she moved into working in the community working in several roles as a clinical nurse specialist. She has led on several service development programmes such respiratory services to keep patients at home including early assisted discharge, acute respiratory assessment, and home oxygen services. She led on the embedding of complex case managers across Lincolnshire and has worked for the SHA developing a package of education tools and resources to embed the principals of the end of life Strategy (2008). Over the last 10 years has always worked closely with the Lincolnshire palliative care forums and is representative for the NCPC. More recently she worked as a Quality Matron for the community hospitals where she and raised the profile of frailty and the complexity of patients being cared for and started her pathway work. She has worked on quality improvement projects using evidence based best practice tools to identify and how to manage Frailty. In 2016 Kim became one of the first Older Person s Fellow s at Kings College London. Helen Hunt, Assistant Patient Safety Programme Manager, West Midlands Patient Safety Collaborative Helen has worked in the NHS acute care setting for 16 years in various roles. During her tenure, she has undertaken multiple roles, starting with frontline patient-facing positions right up to senior management positions overseeing large departments. These positions have covered a large cross-section of NHS landscape including cancer services, operational management, health informatics and R&D. Helen is a trained as Prince 2 practitioner and has also trained in human factors. She leads and project manages the care homes work for the West Midlands Patient Safety Collaborative and the Learning from Excellence and Appreciative Inquiry work being championed in the West Midlands. 11

Dr Afifa Qazi, M.B.B.S, M.R.C.Psych, Consultant in old age psychiatry and Associate Medical director, North East London NHS Foundation Trust Dr Afifa Qazi is a consultant psychiatrist in old age psychiatry at NELFT. She is the clinical lead for the Dementia Crisis Support team, which is an innovative service providing integrated and holistic care to people with dementia living in the community aimed at avoiding hospital admissions. This service won the prestigious and highly sought after Health Services Journal Award in 2016, in addition to winning the Eastern Academic Health Sciences Network, Health Innovation award for long term conditions management in 2014. Dr Qazi was involved in research in dementia at University College London and has numerous publications in peer reviewed academic journals. She takes an active part in teaching and training at NELFT. Dr Afifa Qazi is renowned in the UK and internationally for her Crisis model for Dementia, a model that supports GPs and care homes and provides rapid response and support to people with dementia in the community which results in greatly reduced hospital admissions and length of hospital stays for people with dementia in mental health and acute hospital beds. Irene Lewsey, Head Of Transformation, Thurrock CCG 12

Midlands and East Regional Frailty Conference Tuesday 27 March 2018, Leicester Racecourse, Leicester Road, Oadby, Leicester, LE2 4AL Event Evaluation Form Thank you for attending the NHS England Midlands and East Region hosted Frailty Conference. We would value your opinions of the conference and any suggestions for improvements. 1 Please rate your overall satisfaction with the event 2 Please rate your overall satisfaction with the format of the event (presentations, top table discussions, break and lunch) 3 Please rate your overall satisfaction with the food and refreshments 4 Please rate your overall satisfaction with the facilities at the venue 5 Please rate your overall satisfaction with the location of the event Very Satisfied Satisfied Dissatisfied Very Dissatisfied Please rate the presentations from the sessions: Subject Excellent Good Ok Poor 1 National Frailty Approach 2 Ageing Well National Frailty Approach Presenting the regional data Get It Right First 3 Time and Right Care Information 4 Acute Frailty Network (AFN) 5 Q & A - Dr Mark Sanderson Using an international benchmarking tool as a 6 focus for quality improvement in care homes 7 Fire safety and promoting health and well being A whole systems approach to frailty in 8 Lincolnshire including EOL and mental health 9 Large Scale Care Home Improvement 10 Dementia Crisis and Support 11 Q & A Dr Dawn Moody 12 Workshop and action planning by STP footprints Please provide us with any other comments on the event structure and content 13

Will you be taking any ideas from this conference to your local health economy? If so, what did you find most useful in this respect? What support would you find useful going forward? 14

Would you be interested in having/attending another Regional Frailty event in the future? What would you like to see covered in future events? Any other comments? Please hand this evaluation form in at the event reception or leave on the table at the end of the day. 15

Directions to Leicester Racecourse By Car Exit Junction 21 of the M1/M69 head eastbound on Soar Valley Way (A563) towards Oadby and Wigston. Follow Soar Valley Way until you reach the A6 and at that point the Racecourse will be on your right hand side. Parking: There will be gate attendants to direct you to The Kube Car Park (no 32 on site plan below) By Train Leicester railway station is approximately 2 miles from the racecourse. Taxi: The taxi rank is located inside the station forecourt. To walk: Exit the railway station head southbound on the A6 (London Road) towards Oadby. By Bus From: Leicester Railway Station To: Oadby Glebe Bus Stop Bus Stop: Stand EE Bus Numbers: Arriva Sapphire 31 and 31A 16

Event Registration Reception and registration will be at The Kube Conference and Events Centre (no. 31) 17