13 August 2014 Dementia Services and BSC CCG

1. 13 August 2014Dementia Services and BSC CCG Presented by Dr Andrew Coward Chair, BSC CCG

2. The facts • Between now and 2030 the number of people with dementia in the UK will double to 1.1 million • This will have a profound effect on health and social care, as well as carers, Government and business • The Secretary of State has said, “Dementia is one of the biggest challenges we face. Our ambition is to become one of the best countries in the world for dementia care”.

3. Prevention and health promotion are vital • A five year delay in the onset of dementia can result in a 49% reduction in projected dementia prevalence, and reduce deaths by 30% • Early targeted support can result in a 23% reduction in the need for institutional care So, both healthy lifestyles and early diagnosis are pivotal

4. BSC Governing Body and Network Areas

5. A Community CCG • Our PPLEA: • Prevention • Partnership • Localism • Education • Access and Quality of Primary Care

6. A patient’s story An 83 yr-old was diagnosed with dementia two years ago and referred to Moseley Hall Hospital. There he saw two doctors, a health visitor and had sessions with a clinical psychiatrist.  On his third visit he was discharged and told to go to his GP for re-referral when his condition worsened.  Despite early diagnosis being a key to success, there are more services available for those with a more advanced condition. There is insufficient community support for those with an early diagnosis.  The patient’s GP carries out regular blood tests and sees the patient on request but can do little else. The patient currently attends sessions run by the Alzheimer’s Society, funded by the council.  The patient’s wife felt that early diagnosis is pointless if support is not there. The patient’s condition has deteriorated and he has been referred to a consultant, Social Services and the Admiral Nurses. There are only two Admiral Nurses for the whole of Birmingham.

7. What have we done? • Worked in engaged networks • Shared data: • Big variance • One practice at 15% • Focused on long-term conditions and local improvement schemes

8. Our operational plan

9. Moving forward • Commissioning of NHS Health Checks and GP Dementia Direct Enhanced Services • Training for GPs, primary care professionals and nursing home staff on recognition and identification of dementia • Dementia CQUIN in place across acute trusts 4. Acute psychiatric liaison service • Letter recently sent out to every GP in the city • Targeted patients in care homes to ensure they are on their practice’s dementia register 

10. Moving forward Targeted practices with low diagnosis rates Funding of dementia/memory cafes and dementia support workers Intermediate and other bedded step-up and step-down care Discharge to assess schemes for people with dementia Development of dementia-friendly hospital environments Net effect: a reduction in inequalities of access for people with dementia and a positive assurance of the impact of diagnosis

11. “Years ago I recognised my kinship with all living things, and I made up my mind that I was not one bit better than the meanest on the earth. I said then and I say now, that while there is a lower class, I am in it; while there is a criminal element, I am of it; while there is a soul in prison, I am not free.” Eugene V Debs

12. Questions

13. Thank you