draft milton keynes dementia strategy 2014-17
TRANSCRIPT
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ITEM 10a
Draft Milton Keynes Dementia Strategy
2014-17
www.milton-keynes.gov.uk
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BLANK PAGE
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Content
1. Foreword
2. Introduction
3. Strategic Priorities
4. Measuring Success
5. Appendix 1 National Dementia Strategy 17 Objectives
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1. Foreword
Local providers from Health and Social Care have made considerable improvements in dementia care locally to meet a number of the National Dementia Strategy objectives. This includes the development of a local Memory Assessment Service, delivery of peer and carers community support services and the development of a range of specialist housing for people with dementia. The Secretary of State for Health has recently announced that NHS England has set the first-ever national ambition to improve dementia diagnosis rates. The plans aim to see two-thirds of people with dementia identified and given appropriate support by 2015. With the number of people with dementia in Milton Keynes likely to reach 2,300 by 2015 and budgets under increasing pressure, there is a challenge to resource future improvements. As SUCH A financial assessment of the resources required for the delivery of this strategy will need to be considered on an annual basis. Resources are interdependent on other local strategies and the Better Care Fund 1will be allocated to support service development. We shall be securing additional social value in any future service development and fundamental to this is the development of dementia friendly communities.
To achieve high rates of diagnosis and support for everyone in Milton Keynes, we must ensure services continue to improve and increase in capacity. PEOPLE HAVE ALSO TOLD US THAT SOMETIMES THEY DON’T KNOW WHEN TO SEEK HELP, SO GOOD QUALITY ADVICE, INFORMATION AND A CONSISTENT RESPONSE IS CRUCIAL to PROVIDING dementia services. We also want to ensure that people are advised appropriately about how healthier lifestyles can contribute to prevention of dementia in later life. This includes not smoking, a balanced diet, regular physical activity, and moderate alcohol consumption. In addition REDUCING SOCIAL ISOLATION AND MAINTAINING GOOD EMOTIONAL HEALTH can help lower the risk of developing dementia in older people and delay the progression of symptoms2. In line with the National Dementia Strategy this local Dementia Strategy outlines the proposed priorities for improvements across the Dementia Pathway over the next three years AND I am confident that the successes we have achieved so far show that in the next few years we will go even further to help people to live well with dementia. Lyn Scott
(Service Director, Adult Social Care, Milton Keynes Council)
1 http://www.local.gov.uk/health-wellbeing-and-adult-social-care/-/journal_content/56/10180/4096799/ARTICLE
2 Source: http://www.nhs.uk/Conditions/dementia-guide/Pages/dementia-prevention.aspx
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2. Introduction Dementia is predominantly a disorder of later life, with a small percentage of people under the age of 65 with the illness. DEMENTIA IS AN UMBRELLA TERM THAT DESCRIBES A SET OF SYMPTOMS AFFECTING COGNITIVE FUNCTIONING AND MOOD. IT IS CAUSED WHEN THE BRAIN IS DAMAGED BY DISEASES SUCH AS ALZHEIMER’S DISEASE OR A SERIES OF STROKES (VASCULAR DEMENTIA). THE CONDITION IS PROGRESSIVE SO SYMPTOMS GET WORSE OVER TIME. DIFFICULTIES WITH COGNITIVE FUNCTIONING MAY INCLUDE MEMORY LOSS, PROBLEMS WITH THINKING, PROBLEM SOLVING AND LANGUAGE. CHANGES IN MOOD MAY INCLUDE FRUSTRATION, IRRITABILITY, BECOMING WITHDRAWN, ANXIOUS, EASILY UPSET OR UNUSUALLY SAD3. THE TERM MILD COGNITIVE IMPAIRMENT (MCI) IS ALSO USED TO DESCRIBE SIMILAR SYMPTOMS, ALTHOUGH LESS SEVERE THAN DEMENTIA. WHILST MCI MAY BE CAUSED BY DISEASE TO THE BRAIN, IT COULD ALSO BE AS A RESULT OF A CURABLE CONDITION SUCH AS STRESS, ANXIETY, DEPRESSION, PHYSICAL ILLNESS OR A SIDE EFFECT OF MEDICATION. Milton Keynes population is predicted to have a significant rise in the number of older people over coming years, and it is estimated that the total number of people in Milton Keynes WITH dementia (NOT INCLUDING MCI) will increase to 2,300 by 2015 and will continue to rise to 3,250 by 20214. IT IS IMPORTANT TO RECOGNISE THAT MANY MORE PEOPLE THAN THIS WILL BE AFFECTED BY DEMENTIA IN PARTICULAR FAMILY CARERS. Currently the estimated total number of people expected to have dementia in Milton Keynes is significantly higher than the number of people registered with a diagnosis on the GP register. 2012/13 Dementia in Milton Keynes- Predicted vs. Reported numbers at GP practice level5
Total Persons estimated to have dementia (2012/13
Number with dementia registered with practice (as per data March 2013)
Percentage of estimated number diagnosed
Difference Actual-Expected = diagnosis gap
2201 936 43% -1265 = 57%
3 Source: http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=106
4 Source: National Dementia Prevalence Calculator
5 Source: Dementia Prevalence Calculator v2. MKC CCG QOF data 2012/13, IC -ONS
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People with dementia CAN FREQUENTLY HAVE MULTIPLE NEEDS, WHICH MEANS THEY MAY BE significant users of health and social care services. IMPROVING LOCAL DIAGNOSIS RATES WILL ENABLE MORE ACCURATE NEEDS ASSESSMENT, PLANNING AND DELIVERY OF SERVICES. WHILST A DIAGNOSIS OF DEMENTIA OR MCI CAN BE IMPORTANT IN ENABLING PEOPLE TO RECEIVE THE CORRECT TREATMENT AND PLAN FOR THE FUTURE. NOT EVERYONE WILL WANT OR RECEIVE A DIAGNOSIS AND ACCESS TO SUPPORT SERVICES WILL ALWAYS BE DEPENDENT UPON NEED AND NOT JUST DIAGNOSIS. THIS STRATEGY IS INTENDED FOR PEOPLE WITH OR WITHOUT A DIAGNOSIS OF EITHER DEMENTIA OR MILD COGNITIVE IMPAIRMENT AND THEIR CARERS. FROM THIS POINT ON, USE OF THE TERM DEMENTIA IS INTENDED TO REFLECT THIS. The priorities OF THIS STRATEGY are NOT LISTED IN ANY ORDER OF IMPORTANCE. THEY ARE ALL intrinsically linked and as such co-dependent. Furthermore the strategy has taken into account THE range of other local strategies including Milton Keynes Older Peoples, End of Life and Long Term Conditions strategies.
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3. Strategic Priorities for Dementia People with dementia and their carers should experience a seamless journey from diagnosis, through to the end of life and beyond. Throughout this journey the services delivered should be tailored to individuals and enable people to have choice, control and influence over decisions about themselves.
The Milton Keynes Joint Strategic Needs Assessment (2012/13)6 identified the following
areas of improvement for people with dementia and their carers;
Increasing early diagnosis
Increasing support to carers of people with dementia
Improving community support services for people with dementia, to enable people to live at home for as long as possible
Improving the experience of hospital care for people with dementia and their carers
Improving the quality of care in residential care homes for people with dementia
Providing a workforce fit to deliver services to people living with dementia and their carers
The Milton Keynes strategy has been written in response to these identified areas of
improvement.
Strategic Priority
1. RAISE AWARENESS OF DEMENTIA AND ENCOURAGE PEOPLE TO SEEK HELP
What we will do:
INCREASE the public understanding OF factors associated with increased risk and prevention of dementia
Provide support, advice and information to tackle unhealthy and harmful behaviours
Promote accessible physical AND SOCIAL activities for older people
Continue to assess the impact of services which promote physical and mental wellbeing
DEVELOP AND DELIVER A LOCAL DEMENTIA FRIENDS CAMPAIGN
PROVIDE INFORMATION SO THAT PEOPLE CONCERNED ABOUT THEIR MEMORY KNOW HOW TO SEEK HELP
6 Source: http://www.milton-keynes.gov.uk/your-council-and-elections/corporate-core/jsna-dementia
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Strategic Priority
2. Increase early and timely diagnosis What we will do:
Improve public and professional awareness and understanding of dementia.
This includes detailing the benefits of timely diagnosis and care and the availability of community support services
Target information and resources to support early diagnosis and intervention in harder to reach groups and communities
Review the pathway and DEVELOP AGREED clinical guidelines for primary care AND Milton Keynes Hospital Foundation Trust to access specialist services
Ensure SPECIALIST SERVICES CAN PROVIDE; A rapid and competent specialist assessment An accurate, timely diagnosis, sensitively communicated to the
person with dementia and their carer & Evidence based treatment AS INDICATED
Strategic Priority
3. Increase support to carers and relatives of people with dementia What we will do:
Review the pathway to community support services, ensuring one gateway to the service is available
PROVIDE HIGH QUALITY AND CONSISTENT POST DIAGNOSTIC INFORMATION, ADVICE AND GUIDANCE TO PEOPLE AND THEIR CARERS
Increase the number of people with GP shared care arrangements in place
Increase the number of people WITH DEMENTIA accessing community support services, including an increase in Carers’ Assessments
INCREASE THE NUMBER OF CARERS RECEIVING PLANNED BREAKS AND RESPITE FROM THEIR CARING RESPONSIBILITIES
Strategic Priority
4. Improve community support services for people with dementia What we will do:
PROVIDE A RANGE OF GOOD QUALITY SERVICES TO SUPPORT PEOPLE TO LIVE AT HOME FOR AS LONG AS THEY CHOOSE
ENSURE THAT THE PHYSICAL AND SOCIAL CARE NEEDS OF PEOPLE WITH DEMENTIA ARE MET
Further develop the use of assistive technology to support people to maintain independence
Further develop high quality personal care and support services with staff who are experienced, SKILLED and well trained
PROVIDE a range of day services and day opportunities for people with dementia to reduce isolation, encourage independence and wellbeing
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Provide a range of suitable services for people WITH EARLY ONSET dementia
Understand the current and LIKELY future demand for specialist out of area placements and explore the need for INVESTMENT AND THE COMMISSIONING OF specialist local provision for people with more complex and challenging needs
Develop a range of innovative housing and support options for people with dementia
Support people to share and record how they would like to be cared for as and when their condition deteriorates
Strategic Priority
5. Improve the experience of hospital services for people with dementia and their carers
What we will do:
SUPPORT HOSPITAL AND SPECIALIST COMMUNITY SERVICES TO; o Work together on planned admissions and urgent care for people
diagnosed with dementia o Continue to review and develop the discharge pathway for people with
identified memory issues o ENSURE CARERS ARE INVOLVED IN CARE DECISIONS AND
RECEIVE RELEVANT ADVICE AND INFORMATION o Continue to review, develop and deliver training that reflects local need o REVIEW AND IMPROVE the hospital environment for people with
dementia o Develop appropriate Intermediate Care AND REABLMENT OPTIONS
FOR PEOPLE WITH DEMENTIA WHO HAVE HAD A PERIOD OF ILL HEALTH
o Continue to SUPPORT THE DEVELOPMENT OF SPECIALIST INPATIENT SERVICES
Strategic Priority
6. Improve the quality of care in care homes and domiciliary care for people with dementia
What we will do:
ENSURE THAT PEOPLE WITH DEMENTIA RECEIVING DOMICILIARY CARE HAVE CARE PLANS WHICH REFLECT AN UNDERSTANDING OF HOW TO MEET THEIR PARTICULAR NEEDS
Ensure care homes and domiciliary care providers have the appropriate skills and resources to provide stimulus and activities for people with dementia
Support care homes to review and improve the environment for people with dementia
Support care homes to improve how they work with specialist in-reach services from community mental health services, GP’s and hospitals
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Review and develop dementia specific quality monitoring indicators for residential care homes and domiciliary care provider contracts
ENSURE THAT SPECIALIST COMMUNITY SERVICES RESPOND APPROPRIATELY TO SUPPORT THE NEEDS OF PEOPLE IN CARE HOMES
Strategic Priority
7. Continue to develop a workforce fit to deliver services to support the care pathway for dementia
What we will do:
Develop a high quality awareness and training structure based on best practice and person- centered care WHICH IS ALSO ACCESSIBLE TO FAMILY CARERS
Ensure consistency of training across health and social care providers
Support the DELIVERY AND ACCESS TO training ACROSS THE HEALTH AND SOCIAL CARE WORKFORCE
Monitor and evaluate the QUALITY AND EFFECTIVENESS of training in Milton Keynes
4. Measuring success
Commissioners will DEVELOP a strategy implementation plan, overseen by a Dementia Strategy Implementation Group. This will outline the SPECIFIC service development that is required in each organisation. WORKING IN partnership the organisations will determine service outcomes to be achieved and will develop mechanisms to measure and monitor the effectiveness of this service delivery. There will be an agreed common approach to deliver the key aims of the strategy in a seamless way and each of the organisations involved will be able to demonstrate that their service development plans are designed to meet the aims of this strategy. This three year strategy and its implementation will be reviewed on an annual basis by the Milton Keynes Health and Wellbeing Board.
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5. Appendix 1 National Dementia Strategy – 17 Objectives
National Dementia Strategy Objective:
1. Raise awareness of dementia and encourage people to seek help
2. Good-quality, early diagnosis, support and treatment for people with dementia and their carers, explained in a sensitive way
3. Good-quality information for people with dementia and their carers
4. Easy access to care, support and advice after diagnosis
5. Develop structured peer support and learning networks
6. Improve community personal support services for people living at home
7. Implement the New Deal for Carers
8. Improve the quality of care for people with dementia in general hospitals
9. Improve intermediate care for people with Dementia
10. Consider how housing support, housing-related services, technology and telecare can help support people with dementia and their carers
11. Improve the quality of care for people with dementia in care homes
12. Improve end of life care for people with dementia
13. An informed and effective workforce for people with dementia
14. A joint commissioning strategy for dementia
15. Improve assessment and regulation of health and care services and of how systems are working
16. Provide a clear picture of research about the causes and possible future treatments of dementia
17. Effective national and regional support for local services to help them develop and carry out the Strategy
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T 01908 25xxxx
W www.milton-keynes.gov.uk
Milton Keynes Council
Joint Commissioning
Civic Offices
1 Saxon Gate East
Central Milton Keynes
MK9 3EJ
Available in audio, large print,
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Tel 01908 25xxxx