Healthwatch: Dementia
Patient / Customer Experience
Briefing to Health and Well-Being Board
Janice Horsman
Chair Healthwatch Westminster
Patient/Customer experience
Evidence collected through ‘enter & view’ visits to hospitals and care home, patient stories,
outreach, Dementia Project Group, Dementia Action Alliance (70+ stories):
Memory Cafés
• ‘…(x) is great; she organises a book club… read book out loud, …royal academy workshop
discuss paintings - once a month’
• ‘(would like to) leave her husband for half or a full day as opposed to a 2 hour slot
Diagnosis
• ‘GPs don’t know where to send people’
• ‘diagnosis took a long time’ GP and hospital
Care and support
• ‘… care not reviewed’ Social care and health
• ‘her husband felt very isolated because early on he refused to pay for anything (self
funders)’ Day services; health
• ‘Pay for ….a private company but they are not specialists and don’t know where to go for
help’ Homecare
• ‘Father was already discharged and was on his way to his flat by ambulance…. when (she)
got to father’s flat…found him lying on the sofa in his vomit in a dazed medicated state.’
Hospital
• ‘(Workers are).. are not trained or experienced enough ‘ Community services, healthcare,
day services, extra care housing, hospital staff, residential care, GPs and practice staff
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Patient/Customer experience
Areas for improvement (to date):
• Confidence in GP ability to effectively screen for dementia
• Regularity of care reviews – GP and social services every
year/15 months?
• Integration of health and care services
• Staff training (inc. GPs, support staff, hospital staff)
• Support for carers
• Respite
• Information on how to access services especially for self
funders
• Inpatient care including discharge planning
• Personal control when choosing services
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Triborough Dementia Strategy
2014 – 2019
Development Summary
Briefing to Health and Well-Being Board
Joint Commissioning
Central London CCG, West London CCG, Hammersmith and Fulham CCG, Triborough LAs
Dementia
Dementia is an umbrella term for symptoms of diseases of the brain that will
affect a third of people over 65
• There are more than 40 different types of dementia illness
• Alzheimer’s Disease accounts for 50%; Vascular related dementia accounts
for 30%
National Dementia Strategy: Living Well with Dementia 2009 recommends:
• Diagnosis - needs to be timely, in specialist services
• Treatment includes suitable dementia medications and personalised activity
to help with health and well-being
• Reduction in the use of mental health medications if these are not needed
• Integrated approach to care in the community – dementia is a progressive
long term condition that requires support to ‘live well’
• Access to information about dementia
• Better Public awareness – Dementia Alliances, Dementia Champions
• The National Dementia Strategy recommends a range of post-diagnostic
provision for health and well-being
Triborough Dementia Strategy Proposal 2014-2019 v3
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Dedicated Dementia care across the Triborough
Dementia Services
• Memory Assessment Services
• Dementia Day Resources including outreach services
• Carers respite services
• Admiral Nursing and other dementia clinical support
• Memory Cafes
• Dementia Advisers/Dementia Outreach workers – support for the
person and their carer
• Cognitive Stimulation therapies such as Mind Gym, Exercise for the
Mind
• Third sector arts and music activities
• Peer support for carers and people with dementia
• Triborough Dementia Service User and Carer Group – Healthwatch
Triborough Dementia Strategy Proposal 2014-2019 v3
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Achievements to date
• Westminster and Kensington and Chelsea MAS
reaccredited as excellent (Royal College of Psychiatry Memory
Service National Accreditation Programme (MSNAP 2014)
• Imperial College Hospital Trust and Chelsea and
Westminster Hospital Foundation Trust appointed
Dementia Nurses (2013) – awareness training
commenced for all staff
• GPs in Westminster and K&C receive training in
dementia from the Memory Services. Training
programme for H&F GPs started 2014
• New monthly Memory Cafe set up in Victoria
Medical Centre, Westminster - September 2013
• Dementia Friends briefings delivered to 20 staff in
Central London CCG (2013) and 12 Triborough
Day Services managers (2014)
• Dementia Guides in Westminster
and K&C republished 2013.
Planned for H&F for end 2014
• Compassion in Care training
delivered to all home care staff in
Westminster in 2011/12 - rolling
out to all homecare and care
home staff across Triborough
(2014)
• Dementia Alliances set up 2013 in
Westminster and K&C; planned for
H&F 2014
• Dementia Resource Centre
commissioned in Westminster
2012 – similar service changes
planned for H&F and K&C 2014
Triborough Dementia Strategy Proposal 2014-2019
v3
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Dementia Trajectory - population
The national prevalence of people with dementia stands at approximately 800,000 in the UK –
this number is expected to rise to 1.7m by 2051. The current and future population of
people with dementia (NDPR) in H&F, K&C and Westminster is shown in the following tables:
H&F 2013/14
The % of
people with
dementia
diagnosed out
of total
expected is
52.7%
H&F Total Expected numbers of people with dementia* Projected
**
(additional average 25 cases per year)
2019
2011
2012
2013
2014
2015
K&C + QPP
2012/13 The %
of people with
dementia
diagnosed out
of total
expected is
51.1%
K&C Total Expected numbers of people with dementia* Projected
**
(additional average 35 cases per annum)
2019
2011
2012
2013
2014
2015
W’stmstr
2012/13 The %
of people with
dementia
diagnosed out
of total
expected is
54.3 %
W’smstr Total Expected numbers of people with dementia* Projected
**
(additional average 25 cases per annum)
2019
2011
2012
2013
2014
2015
1,118
1,542
1,113
1,143
1,578
1,139
1,169
1,613
1,164
1,193
1,647
1,187
1,217
1,680
1,212
1,317
1,820
1,312
*National
Dementia
Prevalence Rate
[NDPR] – NHS
England
Prevalence
calculator
**Projected
Dementia
Prevalence Rate
based on
additional
average cases
per annum
NHS England
has set a
mandate for
local diagnosis
of dementia to
reach 67% of the
total expected by
2015 (Nat. av.
44.6%)
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Triborough Dementia strategic aims
Aim
Determine the current need via Joint Strategic Needs Assessment and review
the dementia care pathway to deliver a Triborough strategy. The strategy will
need to fit with the CCG Collaborative dementia strategy and the Triborough
Customer Journey. Overarching themes include:
1
Determining need – mapping epidemiology and populations
2
Engaging all stakeholders
3
Dementia Pathway design – the Customer Journey
4
Integrated approach to commissioning dementia services
5
Timely diagnosis
6
Integrated action-plan across organisations
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