DEMENTIA
MENTAL HEALTH IN SCOTLAND DEMENTIA:A NATIONAL PRIORITY SUMMARY PAPER (July 2009)
Dementia is a national priority for the Scottish Government.
Dementia Strategy
Recently announced the development of a Dementia Strategy to ensure high quality care is available for people with dementia and their carers and families. To be consulted on over the summer months and developed by Easter 2010.
HEAT Target
From April 2008 each NHS Board is to deliver agreed improvements in the early diagnosis and management of patients with a dementia by March 2011. Target linked to the number of people with a diagnosis of a dementia on the GP’s dementia register.
Standards for Integrated Care Pathways for dementia
Published December 2007. Set the standard for care; underlining the need for partner system developments; incorporating an accreditation process; and systems support. Accreditation system introduced November 2008 and all NHS Boards are now working towards this. A target date of September 2009 has been set for achievement of this.
In addition to the generic standards developed for integrated care pathways, several dementia specific standards have been developed. These include:
- Recording of treatment for cognitive impairment;
- Ensuring service users who develop behavioural or psychological dementia symptoms receive an intervention matched to their needs; and
- That advance care planning is in place in relation to end of life care.
Dementia Forum
Multi representative Dementia Forum continues to provide ongoing input and advice on all aspects of the dementia agenda to the Minister for Public Health.
Dementia friendly premises
In conjunction with Health Facilities Scotland, the Dementia Services Development Centre and Fair for All, an “Initial Survey Checklist” has been developed and published as well as guidance for new primary care premises onnon stigmatising design considerations to meet the needs of those with dementia.
A range of professionals from each NHS Board have been trained in the use of an NHS Scotland dementia design audit tool. All NHS Scotland Boards now have a team of accredited auditors to advise on the suitability of existing and new NHS facilities for people with dementia. Fourteen pilot audits have already taken place to inform and improve the design of facilities.
Primary Care Register and Annual Reviews
On latest figures, towards 100% of GP Practices have a dementia register, and significant numbers of those registered with dementia receive an annual review assessment whether specifically arranged or as part of other routine or in year appointments.
Reviews should address the support needs of the individual and carer and cover:
- physical and mental health needs for the patient;
- if applicable, the carer’s information needs;
- if applicable, the impact of caring on the carer (respite consideration); and
- communication and co-ordination arrangements with secondary care (if applicable).
Dementia Improvement Project
Funded and supported the Forth Valley Dementia Project, a ground-breaking initiative designed to improve standards of care for people with dementia, as well as providing better support for their families and carers. Outcome report published (April 2008).
Focus was on improving care for people with dementia to reduce/remove unnecessary admissions to care homes and hospitals. Participants learned more about dementia and used change techniques to evaluate their existing practice, introducing improvements based on the knowledge they had acquired.
Post Diagnostic support
Working with Alzheimer Scotland and the Dementia Services Development Centre and linked to findings reported from the Forth Valley Dementia improvement project, £600k is being invested over 3 years on pilots in Lothian, East Renfrewshire and Renfrewshire, and Shetland forstructured intervention, support, and information following diagnosis.
Working with Older People in Scotland – A Framework for Mental Health Nurses
Published (through NHS Education for Scotland) the Framework outlines the specific knowledge, skills and values mental health nurses require to work with older people’s mental health services.
The Framework consists of six main themes – respect, rights and choice; communication; relationships; health and wellbeing; dementia care; and end of life care.
Collaborative
The Mental Health Collaborative continues to drive and support the delivery of the HEAT target objectives through national, regional and local approaches and systems. Links established with the Long Term Conditions Collaborative Programme.
Secured £9 million to 2011 to fund improvement infrastructures to enable delivery of mental health on attention to mental health HEAT Targets, including the target for dementia.
Has allocated funds to each NHS Board for them to establish local teams to support the delivery of this and other 3 mental health HEAT targets. Nationally a Reference Group has been set up for the Dementia work stream that has representation from a range of stakeholders.
Published a toolkit (December 2008) to help Boards analyse their Dementia service from the perspective of those using the service. The Collaborative team in each area will, using small scale changes, identify and address some of the underlying reasons as to why dementia diagnosis is lower than expected prevalence together with looking at improvements in the management and support of those with Dementia.
Elderflowers
Providing £30k over 3 years to support Elderflowers initiative helping the elderly with dementia in hospital and other care settings. The Elderflowers programme engages and stimulates people with dementia to reach the person behind the illness.
Public Awareness Raising and information Sharing
A scoping study undertaken by See Me to inform future decisions on the need for and design of a national awareness raising and information campaign on dementia. Three month pilot test campaign entitled “Worried about your memory?” launched in Dundee in March 2009 to raise awareness of the symptoms of Dementia and signpost people (or their families) to seek help and advice. The campaign used the main messages from the information booklet of the same name. Evaluation of pilot is currently underway.
Information
Coping with Dementia – a Handbook for Carers” has been updated and widely distributed. NHS Health Scotland, A DVD resource is currently in production to be available early 2010 which will be available in languages other than English and British Sign Language (BSL).
The Scottish Dementia Working Group and Alzheimer Scotland’s Information Guidelines Working Group also updated “Worried about your Memory?” and “Facing Dementia: how to live well with your diagnosis”. Both publications are now widely available, free of charge, for people with dementia and their carers and families.
“Facing Dementia” provides practical information for people who have recently been diagnosed with dementia. “Worried about your memory?” is aimed at helping people who are concerned about their memory to decide whether they should see a doctor.
Guideline on the provision of information to people with dementia and carers throughout all stages of their journey developed by the Information Guidelines Working Group. To be aimed at staff,and to be published by 14 September 2009.
Alzheimer Scotland and Deaf Connections launched a DVD called “Talking about dementia” aimed at deaf and hearing impaired people with dementia and carers. The DVD includes a BSL version of the Scottish Dementia Working Group’s film “Listening to the Experts”, a new film where deaf carers discuss their experiences, and BSL versions of 2 Alzheimer Scotland leaflets. 1,000 free copies will be produced initially.
Dementia Awareness in Children – National Conference
Funded, supported and promoted the national event in May 2008 which explored the education, training and care needs for children undergoing changes similar to those associated with dementia. This raised a number of emerging issues about how children with a cognitive impairment, their families and support organisations can respond to their changing needs. A reportof the key issues raised at the conference and a summary leaflet published in September 2008.
Research
The Dementia Clinical Research Network was launched in August 2008 with Chief Scientist Office funding of over £1 million over 3 years. As one of several clinical research networks in Scotland, the Dementia Network will develop an infrastructure to support NHS clinicians and clinical academics in research on dementia, as part of the UK Clinical Research Network (UKCRN) Email for further information.
Alzheimer Scotland has agreed to fund a research fellowship in partnership with the Dementia Research Network. The application process commenced in January 2009and the appointment will commence in August 2009.
International dimension/attention
Our partners at the Dementia Services Development Centre continue to observe, learn and disseminate lessons learned from international practice. They contribute to information exchange promoting Scotland’s approaches.
An international Conference ‘Celebrating Innovation & Excellence: Making Change Happen’ took place in September 2008 at the University of Stirlingbringing together expertise and opinion from 12 countries.
Palliative care
Among a range of other initiatives our partners Alzheimer Scotlandis advancing their Beyond Barriers campaign on palliative care for people with dementia. The third of three tranches of training of 100 care home staff as palliative care champions is almost complete and approximately 60 relatives of care home residents with dementia have participated.
Funded Beyond Barriers Project. Launched on 2 June 2009 project has provided an innovative educational programme for care home staff across Scotland and relatives of their residents who have dementia. The project has resulted in a training resource which is being accredited by the Scottish Qualification Authority.
Befriending Network
Providing funding for Befriending Network Scotland and Alzheimer Scotland to develop a national training pack to enable volunteer befrienders to understand dementia. Training toolkit and good practice guidelines to be ready next summer when training and trainer days will be organised.
Early intervention training
NHS Education for Scotland commissioned the Dementia Services Development Centre to design and deliver training to support early interventions for people receiving a diagnosis of dementia. Forty nurses and Allied Health Professionals from across Scotlandhave now completed this training.
Care of people with dementia in acute hospital settings
The Dementia Services Development Centrelaunched in June 2009 a resource pack to support staff in acute care in their care of people with dementia. Addresses a range of subject matter includingstaff knowledge,the accident and emergency department, promoting dementia-friendly hospital environments and understanding and managing behaviours. Contains a guide and a range of multimedia materials that will assist therange of professionalssupporting people with dementia inNHSScotland hospitals.
Attention and Care for those with Dementia presenting in Accident and Emergency Departments
Endorsed and provided guidance to support local delivery of the recommendations made in the Scottish Parliament’s Cross Party Group on Alzheimer’s on the most appropriate care of people with dementia attending Accident and Emergency Departments.
Allied Health Professions and dementia care
Providing funding for 3 Allied Health Professions (AHP) Consultant Posts in Mental Health (Dementia Care) for the next 2 years to provide clinical leadership and maximise the impact of the allied health professionals in dementia care. The AHP consultants will work in partnership with all key stakeholders and review the contribution of the AHPs in the patient pathway enhancing current models of working, consider new models of working and their contribution to the key messages in the recent report by the mental welfare commission and care commission.
1
SE Approved
Version 1.4