transforming the quality of dementia care – consultation on a national dementia strategy presenter...
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Transforming the quality of dementia care – consultation on a National Dementia Strategy
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Policy CommitmentTo develop a national dementia
strategy and implementation plan by October 2008 with the following themes:
• Improving awareness• Early diagnosis and intervention• Improving the quality of care for
people with dementia from diagnosis– General hospital care– Care homes– Intermediate care– Care in people’s own homes
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Strategy Timeline
• August 2007 - Ministerial announcement• October 07 to March 08 - External Reference
Group (ERG) meets • Jan to March 08 – Regional Listening and
engagement events • 18th March 08 - ERG report submitted to
Minister and to DH• 14th April - draft Strategy → internal DH
circulation• Early June - draft Strategy to be published
for consultation until August 08• October 08 - Strategy published
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Key themes of draft Strategy
• Improving awareness
• Early and better diagnosis
• Improved quality of care
• Delivering the Strategy
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Who is the Strategy for?
• People with dementia• Carers• Commissioners• Providers• Local authority corporate functions• Acute health trusts• Regulation and inspection bodies• Workforce and skills training
bodies
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Recommendation 1 – Increased public and professional awareness
of dementia
Public information campaigns at national and local levels making use of the personal narratives of people with dementia and their carers
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Recommendation 2 - An informed and effective workforce for people
with dementiaThose responsible for professional and vocational education ensuring that the core curriculum and training of all those who work with older people and others who may have dementia enables them to work effectively with people with dementia and their carers. Care providers auditing dementia training and competencies. Commissioners including training and competencies in dementia care as part of the specification for services commissioned.
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Consultation questions
• Are these outcomes, recommendations and the suggested means of achieving them the right ones?
• Is there anything that has been missed to help us improve public and professional awareness of dementia?
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Recommendation 3 – Good quality early diagnosis and intervention
for all
Commissioning a specific service to carry out the specific function of early diagnosis and intervention, working in a way that complements existing services
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Recommendation 4 – Good quality information for those with dementia and their carers
Development of a comprehensive package of high quality information, to be given out along following diagnosis and during care as needed. To include information on the nature of the condition, its treatment and support available nationally and locally
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Recommendation 5 – Enabling continuity of support and advice
Development of a dementia care adviser role, not responsible for the provision of services themselves, they could provide a single point of contact for people with dementia and carers, to provide advice and to signpost them to access the care needed
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Consultation questions
• Is there anything that has been missed to help us enable early diagnosis and intervention?
• Do you agree that the diagnosis of dementia should be made by a specialist?
• How open should referral systems to a memory service be? Should people be able to refer themselves, or should they have to go to their GP first?
• How would the dementia care adviser be able to ensure continuity of care?
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Recommendation 6 - Improved quality of care in general hospitals
General hospitals developing an explicit care pathway for the management of people with dementia on their wards, identifying a senior clinician to lead its development and delivery. Complemented by the provision of older people’s mental health liaison teams for general hospitals to provide specialist assessments and expertise
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Recommendation 7 – Improve home care for people with
dementiaCommissioners and providers reviewing the specification of the services they buy to ensure that the home care services that are commissioned are personalised, offer flexible support, and are appropriate to meet the needs of the individual dementia. People with more complex needs are likely to require a specialist home care service
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Recommendation 8 - Improve respite care/short breaks for
people with dementia and their family carers
Respite care/short term breaks that provide valued and enjoyable experiences for people with dementia as well as their family carers; that are flexible and responsive and that can be provided in a variety of settings including the home of the person with dementia
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Recommendation 9 – A Joint commissioning strategy for
dementiaA joint commissioning strategy by local authorities, PCTs and others, based on a Joint Strategic Needs Assessment generating a comprehensive integrated pathway of care to cover the full range of generic and specialist home support services, rehabilitation and intermediate care and residential and nursing care services. It would define the specification for each element of the pathway against which services would be procured and performance managed. It would take account of the allocation of personal budgets for people with dementia and the implications of self directed commissioning
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Recommendation 10 – Intermediate care for people with
dementia
Updating Department of Health guidance on intermediate care to ensure that the needs of people with dementia are properly addressed. PCTs and local authorities reviewing services to ensure that people with dementia have access to re-ablement home care and rehabilitation services, including intermediate care
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Recommendation 11 - Improved dementia care in care homes
Care homes developing a policy for good quality care for people with dementia; the appointment of a senior member of staff to lead the development and delivery of the policy; the policy being monitored and its provision being part of the contacting process. Commissioning specialist mental health in-reach services into care homes as well as enabling in-reach from other professionals such as community pharmacists, community dentists, optometry and geriatricians
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Recommendation 12 – Improved registration and inspection of care
homes
Given that the large majority of people in care homes have dementia, this might be achieved by registration procedures requiring all care homes being able to demonstrate that they can provide good quality care for people with dementia, unless there are specific reasons for exemption
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Consultation questions
• Is there anything that has been missed which would help to ensure high-quality care and support for people with dementia and their families?
• What more could be done in acute care, home care and care homes?
• What could be done to make the personalisation of care agenda (including individual budgets) work for people with dementia and their family carers?
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Recommendation 13 – Clear information on the delivery of the
strategy
National baseline measurement of dementia service content and resources. Subsequently, an independent programme of successive assessment completed on a national basis to deliver information on the growth and activity of services for people with dementia and their carers, comparing services against agreed benchmarks at one, three and five years.
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Recommendation 14 – A clear picture of research evidence and
needs
A strategic review of UK dementia research, conducted or facilitated by the Department of Health, which sets out how research funders, charities and industry can work together to deliver the programme of dementia research needed on prevention, cause, cure and care.
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Recommendation 15 – Effective support of implementation
Central DH support with regional and local implementation
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Consultation questions
• Is there anything that has been missed to help us deliver the National Dementia Strategy?
• What are your priorities for implementation? What can and should be done first?
• What should the timetable for implementation be?
• Does this draft Strategy fully address issues of equality and diversity, and the needs ofparticular groups?
• What can you or your organisation do to help implement these recommendations?
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Links to other current strategies
• Carers Strategy• End of Life Strategy• Our NHS, Our Future• Putting People First• NICE commissioning guide for
memory assessment services• Independent Living Strategy• Darzi Review
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What next?
• Consultation process• Analysis of responses• Redrafting of Strategy, where
responses indicate• Launch of final Strategy –
October • Implementation Plan
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What does this mean for you?
• Thinking of your locality, what will this mean for: -– Commissioners– Providers– Staff– Residents– People with dementia
• Do you know what you already have in your locality?
• Do you know what you need?• What needs to happen in your area to
– Start the process?– Make a difference?
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The challenge for you
• How will you ensure that people with dementia and their carers have a voice in the development & delivery of your services?
• How will you make the cultural shifts required?
• How will you ensure the commitment and investment required?
• Do you have local leadership?• Do you have real local partnerships that work?• How will you know that local
changes/developments have made a difference to people’s lives?
• Are you ready?