In the progress report published on 8 November the health and care champion group outlined its achievements in the first 7 months since the launch of the challenge:
Improving the quality of care in hospitals
Building on an objective within the National Dementia Strategy to improve the quality of care for people with dementia in general hospitals, including identifying a clinical leader for dementia in every hospital, the NHS Institute has set out a call to action for every hospital in England to commit to being dementia friendly by 31 March 2013. This means hospitals responding to the specific needs of people with dementia and their carers. The call to action involves people with dementia and their carers, and uses partnership working between the NHS, social care and the voluntary sector to share best practice to improve the quality of hospital care for people with dementia.
Since the introduction of the Commissioning for Quality and Innovation (CQUIN) payment to hospitals offering risk assessments to all over 75s, over 2800 people have been referred to a memory service. In total, approximately £54m is available to hospitals through these CQUIN payments. As more people in hospital are having their risk of dementia assessed, they will be better able to manage the condition and its symptoms and should receive better care in hospital.
Improving the quality of care in care homes and care at home
More care homes and providers are taking action to improve the quality of dementia care, so that more people will get personalised care and support to enable them to live well. From the initial 10 organisations that signed up to be part of the Dementia Care and Support Compact there are now over 42 signatories representing over 1,800 care services this will mean improved care for over 200,000 people.
We are working with local authorities, housing associations, care homes and domiciliary care associations to encourage their members to sign up to the Compact and to take specific action to develop innovative fit-for-purpose solutions to help people stay at home with the right level of personalised support.
Improving housing choices
There is a need for a clearer understanding of the role good housing plays in helping people with dementia to live independently for longer and improving the quality of care and support on offer. The Department of Health, working with the Homes and Communities Agency and the Greater London Authority (for London based schemes), has committed
up to £300m over 5 years to encourage local authorities to build effective partnerships with housing associations and private house-builders to develop innovative housing solutions for people with long term conditions, including dementia.
Improving dementia diagnosis rates
We have developed an analytical model toolkit to support the NHS to achieve a significant increase in diagnosis rates from the current 42%. It will support clinical commissioning groups to set a local ambition to improve their dementia diagnosis rate, commission sufficient memory services to deliver their ambition, and to track and demonstrate their progress.
We are working with the Royal College of Psychiatrists Memory Services National Accreditation Programme (MSNAP) to assure and improve the quality of memory services for people with memory problems and dementia. MSNAP engages staff in a comprehensive process of review, through which good practice and high quality care are recognised, and services are supported to identify and address areas for improvement. There are currently only 34 accredited memory services. We have written to the NHS to encourage memory services to sign up to MSNAP and to also sign up to the National Memory Services Register. This will enable us to develop a complete map of services across England.
We will use the NHS Outcomes Framework 2013/14 to measure progress on diagnosis rates. Early diagnosis will help people with dementia have more control and to be better able to manage the condition, cope with the symptoms, plan and make informed choices about how they would like to be cared for.
Improving education and training for GPs on dementia
We will shortly be putting out a tender for the development of a toolkit to support GPs to understand, diagnose and support people with dementia, as well as help their families and carers. The toolkit will be available next year and will complement the analytical model.
Improving end of life care
Working with the National Council for Palliative Care (NCPC) and others, we are working to raise awareness with health and care professionals of the possible alternatives to hospitalisation so that people with dementia have more choice and control over their care. To support ‘planning ahead’ discussions and to ensure that peoples’ needs and wishes are respected, the NCPC has developed a leaflet to help GPs have these important conversations in a sensitive way with patients and carers. Practical guidance for all professionals and carers will be launched in 2013.
Encouraging innovation in dementia care
3 prize funds have been established as follows:
- The Innovation Challenge Prize for Dementia, announced by the Prime Minister in March, was formally launched by the Secretary of State for Health on 25 June. The Challenge is making £1m available to the NHS for projects that demonstrate innovative ways of achieving a dramatic reduction in the proportion of people who have undiagnosed dementia, with evidence of a step change in the diagnosis rate and a strong service response. To date 28 expressions of interest have been received. The prize winners will be announced in 2014.
- Nationally, a new partnership between the Department of Health and Janssen Healthcare Innovation (JHI) has been established to create a Challenge Prize for those who support people with dementia. The prize, of up to £150,000, is being provided by JHI for evidence of meeting the challenge in a sustained way that can be spread across the NHS and social care.
- NHS South of England have announced a regional Dementia Challenge Fund of £10m to support the adoption and spread of proven innovations in dementia care. Awards will be made this month.
Supporting the workforce through networks and training
- The NHS Commissioning Board Authority has created a Strategic Clinical Network for Mental Health, Dementia and Neurological conditions. The network will help NHS commissioners to reduce unwarranted variations in services and to encourage innovation.
- Via Skills for Care, the Department of Health has a fund of £2.4m for social care employers and providers who support people with dementia, including those who employ their own support staff, to build the skills of their employees by completing relevant accredited qualifications.
- On 8 June 2012, e-learning for Healthcare published an e-learning package, funded by the Department of Health, to train health and social care staff in recognising, assessing and managing dementia and providing high quality dementia care. There are ten sessions covering a wide range of issues relevant to dementia, such as diagnosis of dementia and managing symptoms. The first session, on general dementia awareness, is also available to the public and to anyone working in the public environment such as shops, transport and banks.
Improving information provision
The government’s information strategy for health and social care in England ‘The power of information’, published in May 2012, aims to harness information and new technologies to achieve higher quality care and improve outcomes for patients, families and the public.
The Our Health website is the first of its kind in England. It aims to transform the way patients, their carers and health professionals access and share the latest information on a range of key local health and care services across the South West. The website now offers the most comprehensive local service directory in the region.
Our Health publishes the local performance of health and care services for people with dementia through 25 indicators covering the whole spectrum of dementia services. This enables comparison between localities that can support patients and carers in making choices about their care and support and demanding improvements in local services. As part of the PM’s Dementia Challenge, Our Health is being rolled out across the South of England by the end of December 2012 and similar services will be available across England by the end of March 2013.
More generally, we are making links to the proposals for improving the provision of information
set out in the White Paper ‘Caring for our Future: Reforming Care and Support’. This includes every registered residential or home care provider having a provider quality profile on the NHS and social care information website.
By April 2013, the Department of Health will also publish clear and accessible information on staff training as part of the provider quality profiles, so that people can understand the skill mix of staff at different care providers. We are working to ensure that services and support for people with dementia and their families are a key consideration in the implementation of the White Paper.
Better support for carers
Dementia cafes – like those set up in Dartford, Gravesend and Swanley – are helping to reduce social isolation and providing tools to enable carers and the person with dementia to live well with dementia.