South West Dementia Partnership

Living well with dementia bulletin

Issue 5

Summer 2011

Living well with dementia across the South West

The South West Dementia Partnership brings together organisations from health and social care, the voluntary sector and people using dementia services to drive forward improvements in the care of people with a dementia, and their families / carers. Our summer issue focuses on the Dementia Commissioning Pack and the call to action on the use of antipsychotic drugs for people with dementia. We include information about the launch of the Dementia Awareness Resource Pack, our forthcoming Autumn home care workshops and the Transparency Projects consultation on the new Our Health website at www.southwest.nhs.uk/ourhealth. We also oer an in-depth review of the conference, Dementia Care in Hospital - Rising to the Challenge, held in July. Alison Moon, Regional Champion for Dementia Care in Hospital, says,

Dementia Commissioning Pack

A new resource to support clinical commissioning groups in designing and purchasing high quality dementia services was launched 21 July by Care Services Minister Paul Burstow. The Dementia Commissioning Pack provides a set of tools and templates for health and local authority commissioners, helping them to design services that are suited to local needs and are cost eective. It supports planning across the whole spectrum of dementia, from early diagnosis to end of life care, together with guidance on how to reduce the inappropriate use of antipsychotic medication. The pack has been developed in consultation with a range of health and social care experts, including people with dementia and their carers. It aims to: Improve quality of services for people with dementia by placing patient outcomes and patient choice at the heart of the commissioning process; Drive eciency by reducing unwarranted variation in services; Reduce bureaucracy for commissioners by providing tailored documents and templates, bringing together the dierent aspects of commissioning (clinical, nancial, commercial, contractual and procurement).

Our annual regional conference was a wonderful success again this year. The programme variety was excellent and people said they had really enjoyed the day. It was a great pleasure to meet with such committed, compassionate and caring people, who together are working to transform the quality of care that people with dementia receive while in hospital.
Read more about the conference on pages 7-10.

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin Paul Burstow said:

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With early diagnosis and good care, people with dementia can continue to live well for many years. But for this to happen, it is vital that services are designed and delivered to meet the needs of individuals and their local communities. This is why we want to devolve power to clinicians and patients but we also recognise that local commissioners need to be supported with expert tools and advice. The Dementia Commissioning Pack will save valuable time. It will help clinical commissioning groups avoid reinventing the wheel each time they provide a new service, will give patients the best outcomes and use money effectively.

Sir Ian Carruthers, OBE, Chief Executive NHS South West, and dementia champion for the NHS said:

Dementia is one of the greatest challenges society faces today, and it is essential that we get commissioning right so that people can live well in their community, and access more support when they need it. Strategic Health Authorities across England have signed up to this work, ensuring that this important resource is made available to clinical commissioning groups so that we achieve real improvements in quality and productivity.

The Pack provides detailed specications and other material for local commissioners to use, thereby reducing bureaucracy and enabling commissioners to spend more time focusing on matters that will make the most dierence to patients, rather than process or bureaucracy. National Clinical Director for Dementia, Professor Alistair Burns said:

Alongside the Dementia Commissioning Pack, the Alzheimers Society has produced a series of patient information leaets to make patients aware of what they should expect from good dementia services.

Andrew Chidgey, Head of Policy and Public Aairs, Alzheimers Society said:

This is a key resource which will enhance the commissioning of dementia services, and ultimately lead to improved outcomes for people living with dementia and their carers and families. Most importantly, it has been co-produced with clinicians and reflects the perspectives and expertise of a wide group of stakeholders, including people with dementia.

Dementia is one of the greatest challenges society faces today, and it is essential that we get commissioning right so that people can live well in their community, and access more support when they need it. Strategic Health Authorities across England have signed up to this work, ensuring that this important resource is made available to clinical commissioning groups so that we achieve real improvements in quality and productivity.

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin

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Guidance

The Right Prescription: a call to action on the

Handbook: using the Dementia

Commissioning Pack Commissioning framework for dementia Briefing paper - Dementia Commissioning Pack Technical Annex - agreeing and monitoring services using the service specifications Additional resources via the Dementia information portal http://dementia.dh.gov.uk/dementiacommissioning-pack/ Early diagnosis and interventions

Case for change - memory service for people

with dementia At home, and in care homes

use of antipsychotic drugs for people with dementia (Dementia Action Alliance and NHS Institute for Innovation and Improvement, 2011) The Right Prescription: a call to action on the use of antipsychotic drugs for people with dementia. Commitment for commissioners in heath, social care and GP commissioning (Dementia Action Alliance and NHS Institute for Innovation and Improvement, 2011) Optimising treatment and care for behavioural and psychological symptoms of dementia. A best practice guide for health and social care professionals (Alzheimer's Society, 2011)

Templates
Early diagnosis and interventions

Case for change - community-based services

for people living with dementia Hospital

Service specification for dementia: memory

service for early diagnosis and intervention

Case for change - mental health liaison

service for dementia care in hospitals Reducing inappropriate prescribing of antipsychotics

Reducing the inappropriate use of

antipsychotic medication for people with dementia At home, and in care homes

Service specification for dementia: better care

at home, and in care homes Template action plan to improve care for people with dementia in the community Better care at home and in care homes contract inserts

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin Hospital

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Patient information
Early diagnosis and interventions

Service specification for dementia: mental

health liaison service for general and community hospitals Request for proposal: action plan to improve care for people with dementia in hospital

Worried about your memory? (Alzheimer's

Society, 2011) What your diagnosis means for you (Alzheimer's Society, 2010) Memory service - easy read At home, and in care homes

Keeping safe in your home (Alzheimer's

Society, 2010) Living alone (Alzheimer's Society, 2010) Dementia service for people living at home or in a care home - easy read Hospital

Dementia service in hospital - easy read

Reducing inappropriate prescribing of antipsychotics Reducing inappropriate prescribing of antipsychotics

Reducing the inappropriate use of

Tools

Reducing the use of antipsychotic drugs. A

antipsychotic medication for people with dementia

guide to the treatment and care of behavioural and psychological symptoms of dementia (Alzheimer's Society, 2011)

If you would like to receive a copy of the following tools, please email dementiacommissioningpack@dh.gsi.gov.uk

The Right Prescription: a call to action on the use of antipsychotic drugs for people with dementia
The NHS Institute for Innovation and Improvement and the Dementia Action Alliance have launched a call to action for people to work together to improve the quality of life of people with dementia and their carers by reducing the inappropriate prescribing of antipsychotics. A specic commitment has been developed for eights groups to enable everyone to play their part to achieve the overall goal.

Assessment tool Memory service cost / benet tool Primary care cost / benet tool Hospital cost / benet tool

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin

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Research helping to reduce inappropriate prescribing of antipsychotics

According to Alzheimer's Society symposium at the International Conference on Alzheimer's Disease, studies into depression and agitation and aggression will play a key role in helping to reduce inappropriate prescriptions of antipsychotics for people with dementia. These symptoms can cause signicant distress for people with dementia and carers and are often the reason for antipsychotics being prescribed. Findings from the studies include: two common antidepressants are not clinically eective for treating signicant depression in Alzheimers agitation levels of people with moderate or severe dementia in care homes who were treated with pain medication were reduced by 17 per cent over eight weeks the Alzheimers drug Ebixa was not benecial for treating clinically signicant agitation in people with later stage Alzheimers although there was a potential benet for aggression and it did improve cognition Read more on the Alzheimer's Society website

The groups include: People with dementia and their carers& voluntary sector and advocacy groups (local and national) Leaders of care homes General Practitioners and primary care teams Psychiatrists and mental health teams Pharmacists Hospital doctors and multidisciplinary teams Commissioners of health and social care services Medical and nursing directors of acute and foundation trusts Download

Improving prescribing resource library

We have developed an online library of useful resources to support improved resources via the Partnership website. The resources are organised into key topic areas: Assuring quality and safety Decision support tools Needs assessment and datasets Prescribing guidelines Undertaking high quality audits

The Right Prescription: a call to action on the

use of antipsychotic drugs for people with dementia Commitment for commissioners in heath, social care and GP commissioning

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin

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Summer 2011 South West Commissioners Network - this page provides information about the Network, including access to agendas, notes and presentations from meetings Commissioning resources library - this library includes resources to support commissioners to promote living well with dementia. The resources are organised into the four key themes of the Dementia Commissioning Pack.

Commissioning section on the Partnership website

In line with the publication of the Dementia Commissioning Pack we have developed the commissioning section of the Partnership website at www.southwestdementiapartnership.org.uk/com missioning/. The commissioning section of the website provides information about: Dementia Commissioning Pack - this page introduces the Pack and provides quick access to all of the documents. Commissioning framework for dementia this page summarises the framework which underpins the Dementia Commissioning Pack.

The new web pages were launched at the South West Commissioners Network meeting on 27th July in Taunton. Feedback from Network members was very positive. We will continue to enhance this section of the website so that it benets Network members and others interested in the commissioning agenda.

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin

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Summer 2011

Dementia Care in Hospital - Rising to the Challenge

Professor Alistair Burns, National Clinical Director for Dementia, was joined by one of the nations favourite poets as well as doctors, nurses, voluntary group members and people living with dementia at the Hospital care conference 2011. The conference, held in Taunton on Tuesday 5 July, opened with poetry by Matt Harvey, well known humorist and poet who has a special interest in mental health. The conference provided delegates with opportunities to: look at the interim ndings from the National Audit of Dementia, exploring lessons for improvement in the South West nd out more about the implementation of the South West Standards for dementia care in hospital, and next steps for the peer review 2011/12 share and spread learning and positive practice focus on action planning and improvement

Discussing the workshops over a cup of tea The conference showcased areas of excellence including: A Dementia Charter at Royal United Hospitals, Bath Partnership working between care homes and hospitals in Cornwall to ensure better end of life care Dementia education for sta in Torbay Hospital Personalised information for dementia patients at University Hospitals NHS Foundation Trust, Bristol, and a specialist ward for patients with dementia at Southmead Hospital, Bristol; Working with compassion and care, drawing on the experiences of people living with dementia

Discussing the morning plenary during a coffee break

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Living well with dementia bulletin Alison Moon, Chief Nurse at University Hospitals NHS Foundation Trust, is NHS South West Champion for Dementia Care and leads a regional Expert Reference Group which brings together clinical leads in dementia from hospitals across the South West. Alison said:

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Hospital staff, patients, volunteers, relatives, carers and commissioners all have roles to play in achieving these standards and we are working closely with them to ensure that people with dementia receive consistently high quality care and support.

In the South West we are working hard in partnership with the Alzheimers Society to improve hospital care for patients with dementia. A national audit of dementia care in hospitals has been conducted and the full report will be published later this year. Here in the South West we are listening to the experiences and concerns of people with dementia, their families, carers and staff and developed eight common standards for hospital care. This means that patients should expect the same standard of care in any general hospital across the South West. Over the next two years we will systematically implement these standards, alongside the findings of the national audit to transform hospital care for people with a dementia.

Professor Alistair Burns, National Clinical Director For Dementia at the Department of Health addressed the conference on What Does Excellence Look Like?. Professor Burns said:

Dementia Awareness Week is a great opportunity to focus on what matters most for people living with dementia, not just patients and carers but the wider health and social care community. I know there has been significant progress in the South West and I am very much looking forward to sharing the latest ideas at this regional conference, which I know will celebrate success but also calls everyone to rise to the challenge of improving dementia care.

Browsing the display stands and posters

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin Other expert speakers are listed below along with their presentations for download

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The workshop facilitators are listed below along with their presentations for download:

Findings from the National Audit of Dementia

Interim Report Chloe Hood, Programme Manager, National Audit of Dementia, Royal College of Psychiatrists Creating Change in the South West Alison Moon, NHS South West Champion, Dementia Care in Hospitals; Chief Nurse, University Hospitals Bristol NHS Foundation Trust; Kate Schneider, Programme Lead, Mental Health and Wellbeing; Dementia, Autism, South West Strategic Health Authority The Development and Use of the Person, Interaction and Environment (PIE) Observational Tool Jill Hoyle, Matron in Elderly Care, Bradford Teaching Hospitals NHS Foundation Trust The Development and Use of the Person, Interaction and Environment (PIE) Observational Tool Jane Buswell, Nurse Consultant, Older People and Clinical Lead Dementia Care, University Hospitals Bristol NHS Foundation Trust Royal United Hospital Bath NHS Trust Dementia Charter Dr Chris Dyer, Consultant Geriatrician and Clinical Lead, Older Peoples Unit, Royal United Hospital Bath NHS Trust

The Development and Use of the Person,

Interaction and Environment (PIE) Observational Tool Jill Hoyle, Matron in Elderly Care, Bradford Teaching Hospitals NHS Foundation Trust The Development & Use of the Person, Interaction and Environment (PIE) Observational Tool Jane Buswell, Nurse Consultant, Older People and Clinical Lead Dementia Care Bradford Teaching Hospitals NHS Foundation Trust University Hospitals Bristol NHS Foundation Trust Implementing This is Me Carly Hall, Infection Prevention and Control Nurse, University Hospitals Bristol NHS Foundation Trust Partnership working between the acute environment and care homes to enable people to die in their place of choice Beverley Chapman, Clinical Lead Nurse of Dementia, Cornwall Partnership NHS Foundation Trust Dementia Education in Torbay Hospital Maggi Dunbar-Douglas, Dementia Specialist Nurse South Devon Healthcare NHS Foundation Trust Experience with a specialised ward for people with dementia in the acute hospital Dr Judy Haworth, Speciality Doctor for Dementia Care and David Fearon, Ward Manager, North Bristol NHS Trust

Making commitments in the Creative Compassion workshop

www.southwestdementiapartnership.org.uk

Living well with dementia bulletin

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Summer 2011 contribute perspectives and expertise to system wide Partnership initiatives such as workforce improvement, involvement and volunteering Enables lively discussion and networking with others; an on line discussion group is available to enable ongoing sharing and debate

Volunteering at Mealtimes Debra Parsons,

Matron Lead for Learning Disabilities, Susie Milton, Outreach Liaison Nurse and Sue Tarpey, Voluntary Services Manager, Weston General Hospital, Weston Area Health NHS Trust Royal United Hospital Bath NHS Trust Dementia Charter Dr Chris Dyer, Consultant Geriatrician and Clinical Lead, Older Peoples Unit, Royal United Hospital Bath NHS Trust A Dementia Awareness Raising Training Model Fiona Higginson, Matron and Mandy Carney, Yeovil District Hospital NHS Foundation Trust Addressing psychosocial issues as a way of reducing length of stay Dr Nigel North, Head of Clinical Psychology,Salisbury District Hospital NHS Foundation Trust Access documents from the Creative Compassion Your Stories workshop run by Caroline David.

Transforming the experience of care in hospitals

The Expert Reference Group contributes to the design and development of important pieces of work aimed at transforming the experience of care in hospitals: The South West Hospital Standards in Dementia Care Peer Review of the Standards Route Map to improve Assessment and Care Resource Pack of Awareness Resources Volunteering in hospital.

South West Expert Reference Group for Dementia Care in Hospital

The Expert Reference Group brings together experts with personal experience of dementia, carers, and representatives from the Alzheimers Society, clinicians and managers from acute hospitals and mental health trusts, and a number of locality commissioners. Alison Moon, NHS SW and South West Dementia Partnership champion for dementia care in hospital chairs the Group. The Expert Reference Group: Identies priorities for action to improve the experience of people, carers and families Showcases examples of positive practice and innovation and provides opportunities to share, discuss and suggest solutions to barriers to improving services Provides an opportunity to hear about and

The Expert Reference Group meets quarterly, future meetings; 10 October 2011 9 January 2012 12 March 2012 New members will be welcomed. The group would benet from input from hospital based therapists and social workers. For an invitation to the next meeting contact jane.rawlinson@swdc.org.uk. Further details about the ERG work, members and meetings are available via the Partnership website at www.southwestdementiapartnership.org.uk/ hospitals-erg

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Living well with dementia bulletin

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Dementia Awareness Resource Pack

The Dementia Awareness Resource Pack was launched at the Hospital Care conference. The Pack contains a selection of quality assured awareness raising resources designed to promote living well with dementia. The resources include leaets, factsheets, contact lists and a DVD. The Pack is intended for hospital care sta for use with people coming into hospital who may have dementia or experience symptoms associated with dementia. The pack contains specic examples and also signposts people to the organisations themselves. Although the pack is designed for use in a hospital setting there is clearly scope for it to be further developed for use in other settings. The Pack has been produced to support the implementation of the South West Hospital Standards in Dementia Care, intended to

Responding to lived experience

Important messages from the research into the lived experience of people living with dementia, their carers, families and friends, includes: every persons journey with dementia is unique people would like information tailored to their requirements at that time people want to be signposted and supported to information and resources sometimes people need support to understand and access what is on offer, and a key point of contact can make a real difference transform hospital care for people with a dementia. www.southwestdementiapartnership.org.uk/hospi tal-standards/ The implementation of the South West Hospital Standards intends to make a signicant contribution to improving care and services in general and community hospitals. The provision of a Resource Pack will provide accessible information in the format that is suitable, appropriate and can be tailored for people living with dementia. A recent survey illustrated the need for a core information pack, which could be provided to people in all South West hospital settings. We found that many hospitals were promoting the use of nationally recognised resources, such as the This is me leaet (Alzheimers Society, 2010). However some hospitals do not signpost people consistently to the most valued resources and remain unaware of the wealth of awareness resources which exist. We also identied excellent

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Living well with dementia bulletin examples of local handbooks and signposting guides. A few of these are well known and have been adapted for use in other localities. However there remain a number of hidden gems, which many could benet from knowing more about. We are working with South West hospitals to encourage sta to adopt and adapt the dementia awareness resource pack making it relevant for local use. For more information about the pack contact anne.rollings@swdc.org.uk

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Summer 2011 commissioners of home care services to network and learn about improving dementia care in the South West?

Then come along to one of these FREE half day workshops to learn more about Recent research in the South West into the needs of home care providers and people with dementia Practical examples of organisations and places that are making personalised dementia care at home a reality Please download the booking form, complete it and return to jane.rawlinson@swdc.org.uk fax: 01278 432003. For more information please contact rebecca.hardwick@swdc.org.uk tel: 07768 612 736

Living well with dementia - developing the home care response

FREE Half-day workshops for Home Care Providers and Commissioners. Bristol 5 October Bournemouth 6 October Exeter 7 October 2011 9:30am to 1pm with lunch The South West Dementia Partnership is running a series of half-day workshops to assist providers and commissioners with the exciting but challenging task of developing services to support people with dementia at home. Are you: Wanting to develop services and grow the business for clients with dementia, but arent sure where to start? Wanting to make sure your commissioning activity tackles some of the obstacles in getting better outcomes for people with dementia at home? Interested in learning how your sta can improve the quality of care they give to clients that have or may have dementia with free, easy to use resources? Keen to meet with other providers and

www.southwestdementiapartnership.org.uk

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Living well with dementia bulletin

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Our Health website consultation

The Transparency Project has produced a prototype website called Our Health www.southwest.nhs.uk/ourhealth which provides information on how services in the South West are performing. The website aims to help patients and carers work with health and care sta to improve their experiences and the experiences of others. The website provides transparent information that will empower people to improve both the services and the care provided, as well as help patients and their families to make informed decisions about their care.

Increasing transparency is a central theme of Government policy. One of the key features of the NHS reforms is the information revolution to ensure that patients have greater control and choice no decision about me, without me. The announcement by the Prime Minister on 7 July 2011 commits the NHS to publishing clinical outcome data in primary care as well as the results of nationally funded clinical audits. Our Health seeks to contribute to the national and local discussions about what this means in practice. The information on the Our Health website is structured along the care pathway or patient journey, providing performance data on the services available at each stage. The website currently provides information about dementia

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Living well with dementia bulletin care and stroke care. The project is seeking feedback about the Our Health website from a wide range of stakeholders. The website includes a survey and people are encouraged to feedback what they like and dislike, where they feel information is unhelpful or even inaccurate, and what additional features could be considered. The feedback will inform the next iteration of the website. The deadline for feedback is 21 August 2011.

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An audio talk through of the key features of the site will be available on the prototype from Tuesday 26 July. This illustrates how a couple of sample patients and carers might use the facility and highlights some of the unique aspects of this site. We will provide more information about the development of the Our Health website in future bulletins.

More information
The South West Dementia Partnership website www.southwestdementia partnership.org.uk provides further information about implementing the strategy along with examples of innovative practice. The National Dementia Strategy website http://dementia.dh.gov.uk provides access to the latest national policies and research findings. The Dementia Gateway www.scie.org.uk/publications/dementia/ produced by the Social Care Institute for Excellence(SCIE) offers high quality information, video and training programmes.

The Alzheimers Society website www.alzheimers.org.uk offers a wide range of fact sheets, studies, discussion forums, advice and sources of support. Regional lead Kate Schneider, Programme Lead, Mental Health and Wellbeing; Dementia, South West Strategic Health Authority, kate.schneider@southwest.nhs.uk, 01823361227, 07973732766. Bulletin and website If you have information that you would like to appear in a future bulletin or on the Partnership website then please send it in to info@southwestdementiapartnership.org.uk or call Rowan Purdy to discuss it on 07852175374.

A partnership to promote living well with dementia