A proposal has been established for the redesign and refurbishment of a designated dementia ward which will be sited in the old ESS ward opposite EAU. D7 will move into the dementia ward, supervised by Dr. Daryl Leung. There will be a loss of beds relating to the move of ESS onto D17, 3 beds, and a loss of 8 beds by moving D7. There is a cost of developing the new dementia ward of £920,000. As staff move from D7 to the dementia ward this would also incur an increased cost which is due to the required nursing and non-nursing levels on that unit compared with the establishment on D7. This, together with the cost of the outreach service using a team to provide a hospital wide dementia service, and a Nurse Consultant comes to £320,000. The benefits of having a dementia ward were outlined in the business case. The success of the project will be assessed objectively by reviewing length of stay, morbidity and mortality and considering the mental state of patients on discharge.
The Divisional Medical Director, Division 1 questioned which patients were going to use this facility. There were patients currently in the Trust suffering from dementia but with acute physical problems and he questioned whether they would still be treated in specialty units or whether they would be stepped down into this facility. The Divisional Medical Director, Division 2 advised that the dementia ward would be the focus as the centre of excellence in the hospital to deliver quality dementia care. Dr. Leung has drawn up admission criteria to this ward and this is mainly orientated around those patients with cognitive dysfunction who present with an acute illness. They are managed in an environment that manages their acute medical problem in a way that is in the best interests of the patient which minimises the effect on their cognitive function as well as length of stay.
There will be patients with dementia and other medical needs such as Orthopaedics, Cardiological and Surgical where it will not be appropriate for their admission to this ward. The outreach team will help to manage these patients with a link back to the expertise on the dementia ward. A tiered training exercise will be undertaken Trust wide to raise awareness of dementia and dementia patients needs.
The Director of Nursing and Midwifery advised that this is a project and a rigorous evaluation framework was established around it. Should the project prove unsuccessful the Trust would revert back to a different model of care.
The Divisional Medical Director, Division 1 questioned the input of Social Services into this service and whether mortality should be an outcome measure. The Divisional Medical Director, Division 2 advised that input from Social Services was unclear at the moment. Mortality is an independent risk factor.
Minutes of the Meeting of the Trust Management Team held on Friday 4th June, 2010 at 1.30 p.m. in the Board Room of the Clinical Skills and Corporate Services Centre. Wolverhampton: The Royal Wolverhampton Hospitals NHS Trust, 2010.