Dementia - Leading for Improvement

8/7/2019 Dementia - Leading for Improvement

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DementiaLeading for Improvement

Geoff Baines

Associate Director

9 December 2010


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NHS White Paper

Equity and excellence: liberating the NHS,July 2010

Move from centralised top down devolved local

From targets to outcomes

Regional performance management to

local transparency State dependency to Big Society

Importance of GPs, local needs and

accountability


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National Strategy

Living Well with Dementia: A National

Dementia Strategy Feb 2009, 17

objectives 2009, South West Dementia Partnership

developed

Initial priority, peer review of dementia

services in 14 localities May June 2009


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Progress in the South West

over the past 15 months

Work has focused on raising awareness and building capacity but

we need a greater emphasis on delivering improved outcomes

PCT Performance Assessment Framework - ementia, 2010-11

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The National position

June 2010 Operating Framework, dementia

care one of two areas not being given

sufficient local priority

P s and their partners should publishhow they are implementing the NationalDementia Strategy to increase localaccountability for prioritisation.


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National Position cont..

September 2010 DH published Quality

outcomes for people with dementia

four priorities.

good-quality early diagnosis andintervention for all;

improved quality of care in generalhospitals;

living well with dementia in care homes;and

reduced use of antipsychotic medication


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Presc ribing of Acetylchloninesteras e Inhibitors (Drugs for Dementia

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Donepezil Hydrochloride Galantamine Idebenone Memantine Hydrochloride Rivastigmine

arly intervention for all (2)NHS in South West is at the national average for prescribing drugs to delay

symptoms of Alzheimers but there is great variation between PC s


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NAO in 2010 concluded that the NHS in the SWhas the largest diagnosis gap betweencapacity and need of any region

wo key strands Memory clinics:

All P s have established memory clinics but are insufficientcapacity - some have not specified levels of activity

Each locality should have at least one accredited memory

clinics GP education and awareness:

4 GP leads are being recruited

GP training programme with South entral being designed

Early intervention for all (3)


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Patients with a co-morbidity of dementia havelonger lengths of stay, more clinical incidentsand more ward moves than patients with the

same physical health needs In the South West, Alison Moon, hief Nurse at

UHB, has led a project to produce standards oncare in general hospitals that will be available in

January for local self assessment All hospitals are identifying an executive and

clinical lead

Care in general hospitals


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SW Dementia Partnership is developing a

kitemark for care homes to indicate

expertise on caring for people with

dementia

Four councils (BANES, Wilts, Plymouth

and Dorset) and two care home providers

already committed

Care homes


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Antipsychotic Prescribing

his concluded that prescribing

could reduce by 2 3rds which would Reduce preventable deaths (estimated

at 1800 per annum)

Reduce complications (1600 vascularevents, half being serious)

Save money (wider issue of improvedmedication in care homes estimated at4.2m in SW)

Professor Banerjee published a report in 2009 concluding that

there was inappropriate prescribing of antipsychotic drugs

he Minister of State has made a commitment that the

NHS will deliver a 2 3rds reduction by November 2011


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Antipsychotic PrescribingThe NHS in the South West has started work on

ensuring prescribing follows NI E guidelines

and there is support for managing challenging

behaviours Audit of prescribing in mental health providers will be

concluded by January 2011

P Ts are undertaking a range of local audits over the

next 15 months Support material to help with managing challenging

behaviours was shared in October


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Antipsychotic Prescribing

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Tho gh NHS in So th West h s the owest eve s of prescribing in Eng n there is

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The prob emwith the t is

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The Dementia DeclarationForty national organisations have signed up to the Dementia Action Allianceand made a declaration supporting seven outcomes that have been

developed with people with dementia and their carers

1. I have personal choice and control or influence of decisions about me

2. I know that services are designed around me and my needs3. I have support that helps me live my life

4. I have the knowledge and know-how to get what I need

5. I live in an enabling and supportive environment where I feel valued

and understood

6. I have a sense of belonging and feel a valued part of family,

community and civic life7. I know there is research going on that delivers a better life for me

now and hope for the future


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Leadership Challenge

Leading Improvement a major challenge

Not only due to the increasing need

Also the scale of quality and productivityimprovement required

Leadership capacity at local level is vital

Role of GP consortia rapidly crucial Maintaining passion and inspiration will

contribute to success

Dementia - Leading for Improvement

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