The Dementia Network is one of three Networks that together form the Strategic Clinical Network (SCN) for Mental Health, Dementia and Neurological Conditions, established by NHS South of England (West).

Strategic clinical network (SCN) structure

Kate Schneider and Nick Cartmell have now been appointed to positions within the new SCN (Mental Health, Dementia & Neurological Conditions) structure for the South West. Kate is Deputy Associate Director and Nick is joint Clinical Director with Dr Adrian James (who will lead the Mental Health component of the Network). Their appointments ensure that Dementia will be a priority within the Network and the work undertaken by the South West Dementia Partnership and shadow Dementia Network will continue to support CCGs in commissioning for quality.

The shadow structure, with a Dementia Network sitting beneath the overall SCN, will continue. The Dementia Network will be supported in its work by four Expert Reference Groups (ERGs) for:

• Diagnosis (working on diagnosis work stream as below)
• Acute hospitals (embedding Hospital Standards and working towards an action plan to reduce acute admissions of people with dementia)
• Community hospitals (undertaking peer review process and development of community hospital standards for dementia care)
• Care in the community (working on care home work stream as below)

These ERGs will lead on the specific work streams and assist the Dementia Network in the delivery of outputs as detailed below.

Your Dementia Network

Thank you to those many CCG commissioners and clinical leads for dementia who have contributed their thoughts to Nick Cartmell’s call for feedback in the last newsletter.

Two consistent requests were voiced, that the Network:

• Encourages two-way communication and engagement with CCGs without relying on too many central meetings, and
• Describes what ‘good’ or ‘excellent’ dementia commissioning should look like, and provides resources and examples of how to achieve this.

The Dementia Network will work with these requirements in mind and will always be open to further suggestions as each new organisation in the South West develops now that we are all officially ‘live’.

Please continue to prioritise regular reference to the Dementia Network website and these newsletters, which will be the main routes of information dissemination.

However, whilst we will aim to keep meetings involving all South West commissioners and/or clinical leads to a minimum, it is important that we recognise that there remains great value in periodical regional or sub-regional gatherings to:

• share ideas and problem-solve challenges;
• share ways of working and how they are achieving identified outcomes;
• allow us time and head-space to focus properly on the issues at hand away from day to day distractions.

Work streams for 2013-14

Draft work streams have been agreed by the Dementia Network and SCN and currently await sign-off and budget allocation by NHS England. In order to focus on areas where whole systems change may be required the Network has identified two main work streams.

1. Diagnosis in primary care

This work stream is already underway and includes:

• An evaluation of existing primary care diagnostic pathways;
• Mapping primary care competency requirements against pathways;
• Provision of guidance on the use, and commissioning, of structural brain imaging;
• Provision of guidance on the initiation of anti-dementia drugs in primary care;
• Facilitating diagnosis in a timely and cost-effective way, with reference to the new Dementia Prevalence Calculator and Dementia Direct Enhanced Service 2013-14.

2. Dementia care in care homes

This work stream includes focus on:

• Provision of guidance on the management of BPSD, in particular alternative strategies to prescribing anti-psychotics;
• Strategies to promote safer prescribing and reliable monitoring/review of anti-psychotics;
• End of Life care quality in dementia including decision making and documentation;
• Strategies to reduce emergency acute hospital admissions;
• Promoting compassionate caring in leaders.

Other Dementia Network activity in 2013-14

In addition the Network will be involved in, but not necessarily lead on, other work which will enhance the main work streams and dementia care overall. This work will involve the development of close links with partner organisations.

Communication strategy

Effective sharing of information with CCGs, other organisations and the public through our website as part of a wider Strategic Clinical Networks website network.

Proper service user engagement

The production of guidance to support CCGs in the development of Local Interest Groups or Engagement Networks to facilitate service user input into all CCG commissioning decisions. This will include examples of groups already in existence across the South West and will be undertaken through close links with the Alzheimer’s Society.

Workforce dementia training

Continued engagement with, and resource provision to, Peninsula and Severn Deaneries to support  dementia education programmes for both the current and future workforce

Dementia Friendly Communities

Debbie Donnison and Ian Sherriff of the Alzheimer’s Society and Plymouth University are developing a paper providing CCGs with information about the Dementia Friendly Community concept, and advice on how to support their development locally through close engagement with Health & Wellbeing Boards. The paper will include reference to intergenerational projects already underway with schools and proving very successful already.

Dementia prevention strategies

Close engagement with Health & Wellbeing Boards and Public Health departments to identify and promote regional public awareness of proven strategies to reduce the risk of developing dementia, and thereby help mitigate against the projected rise in prevalence. In addition to stimulate regional research into any potential but as yet unproven strategies through engagement with Academic Health Science Networks.

Leadership development

Continuation of the development programme for CCG clinical and commissioning leads, and development of a programme to promote compassionate dementia care in health and social care workforces.

Minority group dementia care

Ensuring the needs of people in black and minority ethnic groups and people with Learning Disabilities are prioritised in dementia service provision.

Dementia research

Promoting the inclusion of a quality research component in service contracts in order that all outcomes and benefits are properly evaluated and can therefore better inform future commissioning decisions.

Pharmacy dementia care

Engaging with Local Professional Networks to support and provide expert advice for the development of dementia care approaches by community pharmacies, in particular towards providing a hub for Dementia Friendly Communities and improved medicine use safety.

Dementia Network outputs

The Network will provide CCGs with dementia commissioning support in the form of:

• Peer-reviewed guidance and evaluation papers as detailed above.
• A community hospitals peer review programme which builds on the success of the acute hospitals peer reviews.
• A commissioning to outcomes resource document which, in response to feedback, identifies what ‘good’ or ‘excellent’ looks like, provides examples and resources to assist CCGs in reaching their aspirations, and which brings together other national guidelines and policies.

We also aspire to develop with stakeholders a dashboard of outcomes which is more ‘real-time’ than existing measures of improvement – for example prevalence data is often over 6 months out of date when finally published – and using which progress in the South West can be readily seen. The success of Dementia Network work streams and the hard work of CCGs in the South West may therefore be more easily observed through dashboard performance and achievements feted nationally.

Other items of interest

Prevalence and QOF earnings
This information provides a useful illustration for GPs on how improving prevalence can make a big difference to QOF earnings even if they don’t manage to hit the target for maximum points. Read more »

ACEmobile dementia assessment tool
A new mobile application has been developed by clinicians in Plymouth, supported by international colleagues, that includes a dementia assessment tool that can be used by a wide range of medical and other healthcare staff. Read more »

Making a Difference in Dementia: Nursing Vision and Strategy
This nursing vision and strategy for dementia care, published by the Department of Health, makes clear that every nurse can make a difference to the care of people with dementia. Read more »

Dementia Challenge Fund
The Dementia Challenge Fund is enabling local communities to identify and implement practical solutions to the problems faced by people living with dementia. Our new knowledgebase provides detailed information about the projects which have been awarded funding. Read more »

Compassion, Care, and Community
Staff and volunteers from general and community hospitals and voluntary organisations in the South West attended an inspiring, uplifting and stimulating conference in Taunton on 8 March 2013. Read more »

Community Hospitals Dementia Care Network South West
The papers and presentations from the third meeting of the Community Hospitals Dementia Care Network South West, held on 11 March 2013 are available to download. Read more »

Dementia Care in Hospital: A compendium of positive practice
This compendium brings together a selection of some of the many positive developments and practices initiated to improve the quality of dementia care in hospitals across the South West of England. Read more »

Contacts

To discuss any aspects of the work of the Dementia Network please contact Dr Nick Cartmell [email protected] or Kate Schneider [email protected].