Agenda item

This report provides an update on progress achieved on the Dementia Review since the last report was presented to the Health and Wellbeing Board in January 2016. It sets out the opportunities and challenges which have emerged during the intervening period, and makes a number of recommendations for next steps. Among these, the key proposal is for the development of a ‘Test for Change’ pilot site for integrated, improved dementia care and support, located and designed around Health and Wellbeing Centres in Medway, as part of a phased approach to achieving full service redesign and implementation across the borough by 2020.

Discussion:

The Assistant Director, Partnership Commissioning, Medway Council, presented a report which provided an update on progress achieved on the Dementia Review since the previous report that had been presented to the Board in January 2016. The report set out the opportunities and challenges which had emerged during the intervening period and made a number of recommendations for next steps. Among these, the key proposal was for the development of a ‘Test for Change’ pilot site for integrated, improved dementia care and support, located and designed around Health and Wellbeing Centres in Medway, as part of a phased approach to achieving full service redesign and implementation across the Borough by 2020.  A Members’ Task Group had been launched investigating how far Medway has come in becoming a dementia friendly community.

Members of the Board raised a number of issues that were responded to as follows:

·         The selection of the Rainham Health Centre as the location for the first testing phase of the new integrated, community based model was welcomed as it would be more complex to locate it in any of the other four town centres.

·         The Board was advised that Public Health maintained a record of all people who had received training to be a ‘dementia friend’; further information would be provided on the level of engagement with them, and also, supported by the Alzheimer’s Society locally, with Dementia Champions, who received a more advanced level of training and who could themselves deliver Dementia Friends training. 

·         Appendix 2 to the report stated that, according to local data, the average cost of a day bed for a patient with dementia was less than for other patients. The report also noted that national research from 2009 suggested that patients with dementia were less likely to receive palliative care, palliative medication or certain other specific medical interventions, though it is not known whether this is the case in Medway. In response to a concern expressed about the level of care provided to patients with dementia, the Board was advised that this local data was being further analysed to establish a clear picture of the underlying position. For example, an alternative explanation for  the local data described above may be that in Medway, people with dementia were not receiving unnecessary hospital intervention, and were instead being supported within their home. Attempts would be made to test these various hypotheses and clarify the position.

·         More work was needed to extend the range of cost effective technical solutions, such as telecare, to enable people with dementia to be supported at home.  This should include the provision of advice to sheltered schemes, and could build on the strong progress which had already been made by Medway’s Telecare service, working with key partners locally, in this area to date.

Decision:

The Board:

a)    agreed to support the proposal that the next steps of the Dementia Review should focus on a ‘Test for Change’ exercise located in Rainham Health Centre in Medway. This would represent Phase 1 of a longer planned programme of work.

b)    noted that the learning from the exercise would lead to and shape the development of a whole system recommissioning plan for Medway, enabling full redesign by 2020.

c)    noted that Members have the opportunity to influence the development of future service design via the current Task Group.

d)    noted that the comments of the Board, together with the comments of the Health and Adult Social Care Overview and Scrutiny Committee on 23 August  2016, would be provided for approval via the appropriate CCG governance arrangements.