[A brief reference to this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 1 Issue 10, May 2011].
Inappropriate and unscheduled admissions in acute settings for those with a diagnosis of Dementia costs £32 million across the West Midlands. If this continues at the same rate, costs will rise to at least £38 million by 2015. Many of the persons with dementia will develop other co-morbidities. Joint working between all clinical services is crucial in the delivery of a quality, safe, personalised and effective service fit for the 21st Century.
Dementia services straddle Mental Health Services and Older People services alongside Primary Care, Social Care, Acute care, Care Homes, and the Independent, Charity and Voluntary sectors. Funding sources vary and there is no overarching co-ordination of services for dementia sufferers across their disease journey. Quotation:
“Currently there is no overarching ‘Dementia service’. This leads to many key and unnecessary issues for people with Dementia and their carers. These issues include lack of access to services, lack of continuity within and between a range of services and service providers, inconsistencies between funding sources during the disease journey and lack of advanced care planning. A noticeable absence of any advanced care planning is evident for end of life care for people with Dementia”.
While there are “pockets” of innovative developments in parts of service provision across the SHA, these are insufficient on their own to address the existing issues. Innovative developments should be strengthened as a part of a cohesive, seamless and pro-active strategic approach to dementia care.
The absence of a single ‘Dementia’ service leads to many burdensome, confusing and unnecessary issues for people with dementia and their carers. These issues include lack of access to services, lack of continuity within and between a range of services and service providers, inconsistencies between funding sources during the disease journey and lack of advanced care planning. This report highlights why there is much that could be done more coherently, more efficiently and cost-effectively to provide better care and support to people with dementia and their carers.
The sections in this broad-ranging report comprise:
- Background and context.
- Where now overviews: Current Problems and Issues & Useful Initiatives.
- Case for Change.
- Where to: Features of a good pathway.
- Outcome measures.
- Priorities for development.
- Obstacles to achieving delivery.
- List of members of the group.
- Summary of National Audit Office report.
- Projected prevalence for Dementia by PCT in NHS West Midlands.
- Dementia and co-morbidities as listed on death certificates.
- Costs and projected costs of use of unscheduled care.
- Place of death for people with Dementia in NHS West Midlands.
- Unscheduled care episodes and length of stay for people with Dementia in NHS West Midlands.
- Ipsos MORI Supporting Carers of People with Dementia: An In-Depth Analysis from the Carers Perspective.
- Numbers of registered Dementia care beds in Care Homes in the West Midlands.
- Ipsos MORI Teenagers: lifestyles and communications.
- Dementia Workforce Themes.
- Details of an early Intervention Service: Worcestershire.
This report also makes national, regional and local recommendations to boost prevention of dementia, to reduce the stigma associated with this condition and to improve public awareness of dementia in the West Midlands.
A regional Dementia Pathway is proposed in this report. This would include new roles, including that of a Dementia Pathway Coordinator (a shared cross-cutting theme reflected in other clinical pathway groups). This may assist service users and their carers to navigate services, and may have an important role helping the necessary funding to follow service users.
Saad, K. Smith, P. [and] Rochfort, M. (2008). Caring for people with dementia: it’s really time to do something now! Birmingham: West Midlands Strategic Health Authority (Dementia Clinical Pathway Group), April 2008.