Dementia Friendly Practices in Kent, Surrey and Sussex Caroline Jessel Lead for Clinical Transformation and Outcomes NHS England South (South East)
Context
Dementia Scorecard: crosswalks and metrics Preventing Well Diagnosing Well Supporting Well Living Well Dying Well i Statements I was given information about reducing my personal risk of dementia I was diagnosed in a timely way Those around me and looking after me are supported I feel included and I am treated with dignity and respect I am confident my end of life wishes will be respected NICE Guideline Prevention Diagnosis and assessment Integration Promote independence Palliative care and pain Choice Carers, Respite, NICE Quality BPSD Memory Assessment Care Plan, Information (3) Palliative Care Standard 2010 (1) Liaison NICE Quality Standard 2013 (2) Concerns Discussed Needs Advocates, Housing, Choice, Relationships, Leisure, Community NICE Pathway (1) Services Investigation Information Supporting Carers Intergrated Services Choice, Independence Living, Hospitals Treatments End of Life OECD Risk Reduction Diagnosis Supporting Carers Social Care Co-ordinated Care Safe Communities Environments Technology Health Services Preferred Place of Death Metric(s) Vascular Risk Diagnosis Rate Enhanced Service QOF Reviews John s Campaign Dementia friends PLACE To be developed?place of death (1) Training - common to all areas. (2) Includes wellbeing and choice evaluation (3) BPSD Behavioural and Psychological Symptoms of dementia NICE Guidance on risk reduction imminent
Care planning D E M E N T I A Diagnosis review Effective support for carers Medication review Evaluate risk New symptoms inquiry Treatment of medical conditions Individual issues Advance care planning
Dementia villages
Becoming a Dementia Friendly Practice a new culture which starts with you and me Nicola Decker Clinical Chair for North Hants CCG Dementia Lead for North Hants CCG GP Partner at Oakley & Overton Partnership NICE Fellow 24 November 2015
1. Background 2. Working with the Wessex AHSN 3. The Detail 4. Benefits to patients 5. Benefits to practice 6. The future
Key is. culture and coding
A toolkit to share (ispace) which represents a better way of care and a shift in culture
Identify a Dementia Champion Staff who are skilled and have time to care Partnership working with carers, family and friends and other agencies Assessment and early identification of Dementia Care plans which are person centered Environmen ts that are dementia friendly
Awareness, Reviews, Templates & Care planning Aware Proactive with patients and carers Modified our Emisweb template which then creates the care plan for our patient and their carer
The figures (April 14 to Nov 15) DNACPR (in patients with Dementia) up from 5% to 29% This is me up from 0% to 43% Patient, Carer and Staff experience up 100%
The Wessex AHSN and The Alzheimers society The RCGP Cascading the ideas.making sure best practice is shared
Sharing our story
Benefits to the patients
Benefits to the practice
The surprise element! All our patients / the wider community are just much more aware Set up a Befriending Scheme - Our patients are now involved in befriending patients living with dementia
The Future? Being Dementia Friendly is the basis of being Frailty Friendly and that is surely our next big challenge?
Aims To understand what is meant by a Dementia Friendly Practice To develop a programme to support practices to become more dementia friendly To set this programme in the wider context of dementia friendly communities and good post diagnostic support for dementia across Kent, Surrey and Sussex
Project plan
Exploratory and research phase Creating a project board Building on ispace in Wessex Visits to four practices Developing and refining an assessment template Engaging with CCGs, Alzheimers society, Admiral Nursing etc Play Inside Out of Mind
Mustn t forget prevention Alcohol Learning new language/ musical instrument Social engagement Regular exercise All cardiovascular risk factors
Assessment template
Early conclusions Practices need a straightforward process which is clear, effective and simple to implement. The cultural changes required to become dementia friendly need clinical leadership, engagement of the whole team in discussion and engagement with the local community. If done effectively the process results in less work for the practice and a happier outcome for patients and carers. The process is energising and rewarding for all involved if the engagement is well executed. It is clear that making the practice dementia friendly will support other patient groups too e.g. those with Intellectual disabilities or hearing impairment.
Community engagement
Memory cafe
Next steps January 2015 - December 2015 (Exploration and research phase) Develop proforma; Engage CCGs and practices, also LMCs; Identify funding and capacity. January 2016 - December 2016 Launch pilot covering 20 practices from CCGs across Kent, Surrey and Sussex; Award ceremony in November 2016 to recognise best practice and encourage others. January 2017 - December 2018 Roll out to all practices; Further awards November 2017 and November 2018.
Thank you for listening
Group work 40 minutes What are the barriers to becoming a dementia friendly practice and how can they be overcome? 1. How would you define a dementia friendly practice? 2. What are the barriers for your practice or one in your CCG that will need to be overcome to achieve this 3. Can you suggest ways of overcoming these? Feedback on two solutions each (10 minutes)