The New Cross Hospital Dementia Project: Contextual Overview

Introduction

The Royal Wolverhampton Hospitals NHS Trust has been sponsored by Chief Executives in the West Midlands, via NHS West Midlands, to develop a care bundle for dementia care within the acute hospital. This care bundle will be used to improve clinical outcomes and provide more cost-effective care for people with dementia.

A two-year programme of service development and improvement began in July 2009. This page provides a brief summary of the background and context of this project. It is adapted from the official project proposal, as presented by Grace Hampson, namely “Delivering Excellence in Dementia Care in Acute Hospitals“.

Background / Context

Numerous reviews studying the needs of people in hospitals with dementia have highlighted poor standards of care in hospital and pointed out that the costs are too high. These studies reveal that comprehensive and radical approaches are required, adopting a whole system basis. Research is needed to explore how care for such persons can be delivered more cost effectively while achieving best outcomes for people in acute hospitals.

The National Dementia Strategy and the SHA Darzi Report provided critical evidence about the current quality and costs of care for those with a dementia diagnosis in the acute care setting.

Quoting the National Dementia Strategy:

“Up to 70% of acute hospitals are currently occupied by older people and up to half of these may be people with cognitive impairment including those with dementia

People with dementia in general hospitals have worse outcomes in terms of length of stay, mortality and institutionalization”.

The National Audit Office estimates the excess cost to be more than £6 million per year in the average acute hospital.

People with dementia are admitted to acute hospitals usually for acute medical / physical care needs (not dementia itself). These patients often have multiple and complex long-term conditions besides dementia. Most wards (excepting maternity and paediatrics) are likely to hold people with dementia.

Core References

To clarify the progress of ideas (and events), these references appear in chronological order:

National Audit Office (2007). Improving services and support for people with dementia. London: National Audit Office / The Stationery Office, 2007. (Click here to read just the executive summary of the 2007 NAO report).

High quality care for all: NHS next stage review final report, presented to Parliament by the Secretary of State for Health by Command of Her Majesty, June 2008, CM 7432. Norwich: Great Britain, Department of Health, 2008.

National dementia strategy: living well with dementia. Leeds: Department of Health, 2009.

Alzheimer’s Society (2009). Counting the cost: caring for people with dementia on hospital wards. London: Alzheimer’s Society, 2009.

The King’s Fund / Templeman, Pamela (2009) Enhancing the healing environment: a guide to NHS Trusts. London: The King’s Fund, 2009.

Heath, H. Sturdy, D. [and] Wilcock, G. (2010). Improving quality of care for people with Dementia in general hospitals. London: RCN Publishing, 2010.

Suarez, P. and Farrington-Douglas, J. (2010). Acute awareness: improving hospital care for people with dementia. London: The NHS Confederation, 2010.

Hampson, Grace (Project Manager). Delivering Excellence in Dementia Care in Acute Hospitals. Wolverhampton: The Royal Wolverhampton Hospitals NHS Trust, May 10th 2010.

 Quality outcomes for people with dementia: building on the work of the National Dementia Strategy. Leeds: Department of Health, 2010.

Royal College of Psychiatrists’ Centre for Quality Improvement, (2010). National audit of dementia: care in general hospitals. London: Healthcare Quality Improvement Partnership (HQIP), December 16th 2010.

Abraham, A. (2011). Care and compassion? Report of the Health Service Ombudsman on ten investigations into NHS care of older people. London: The Parliamentary and Health Service Ombudsman, February 2011.

The £20 billion question: an inquiry into improving lives through cost-effective dementia services. London: All-Party Parliamentary Group on Dementia, July 2011.

Care Quality Commission (2011). Dignity and nutrition inspection programme: national overview. London: Care Quality Commission (CQC), October 2011.

Royal College of Psychiatrists (2011). Report of the National Audit of Dementia Care in General Hospitals 2011. Full Report. London: Royal College of Psychiatrists’ Centre for Quality Improvement, December 16th 2011.

Cross-References to Project-Related Publications

A brief list of links to key publications concerning the project to date is provided below:

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