Agenda item

1.               The Dementia Select Committee was reconvened one year on to monitor the progress of the 17 recommendations in the Select Committee’s final report, which had been approved by the County Council on 5 December 2011.

 

2.            The Chairman requested that the report and the appended document be amended before it was approved by the Select Committee.

 

3.          Referring to paragraph 8 of the covering report, it was advised that there had been no feedback from the Social Care and Public Health Cabinet Committee and that the report was noted at its meeting held on 11 January 2013.

 

4.          The Chairman agreed to take comments and questions by Members on each recommendation separately, which included the following:

 

Recommendation 1

 

·       Members were advised that the diagnosis rate had increased across the County.

·       South East Regional Health Authority Challenge Fund invited bid on £10 million funding.  Kent and Medway were successful in its bid and gained £1.2 million.  Part of this funding would be used in early intervention and care to ensure that patients received a speedy diagnosis.  Some of the investment would be used to trial the use of Ipad technology to aid memory assessment in primary care. Investment in training for primary care staff would also be included in the project to increase the skills of GPs and other primary care staff to improve the identification and management of patients with dementia. The aim would be to increase diagnosis rates across Kent and reduce the differences in rates between practices.

·       Some of the funding would be used to extend to acute Trusts the “Dementia Buddy Scheme”, a trained bank of volunteers who worked with people with dementia in hospitals, which currently operates in Darent Valley Hospital in the North West of Kent.

·       It was suggested that the successes should be celebrated.

 

Recommendation 2 

 

·   Members expressed their disappointment that Education had taken over the site of The Limes, Dartford, a KCC ex care home property and questioned whether this was the right site for a Pupil Referral Unit following incidents that had taken place involving the Police. The Chairman suggested that this would be managed by the Local Members.   

·    Examples were given of models where good work was is starting to take place for people with dementia including; the Minis Day Centre in Thanet, that was piloting the Community Hub model with the Youth Service, Bradstow Court, Broadstairs  and Emily Court, Dartford

 

Recommendation 3

 

·     It was advised that the Admiral Nurses “brand” brought limitations.  Dementia UK had advised that there would be no additional Admiral Nurses. However, Dementia UK was holding discussions with the Community Mental Health Team and KMPT regarding support for carers.    It was concluded that links were also required with other support systems that sat and linked with them.

 

Recommendation 4

 

• There had been an improvement in the rates of early diagnosis of dementia across Kent from 38% in 2012 to 43% in 2013.

 

The rates of diagnosis in Clinical Commissioning Groups Areas
Ashford	42.6%
Canterbury	38 %
Dartford, Gravesham and Stanley	47.3%
Swale	44%
Thanet	34%
West Kent	44%

 

• It was advised that the national figure for diagnosis was 46% which meant that across Kent there had been progress made in closing the gap but this was still below the national level. Members noted that Dartford, Gravesham and Swanley were above the national figure.
• The Cabinet Member for Families, Social Care and Public Health agreed to write to the CCGs using the figures to give them encouragement in improving early diagnosis rates.
• In reply to a question as to why some areas had low rates of early diagnosis, it was advised that it was not financial as GPs receive payment via their Quality Outcome Framework( QOF) . The CQUIN (Commissioning for Quality and Innovation) Framework is also looking to increase early diagnosis, by ensuring that GP QOF registers matched the KMPT lists of patients with a confirmed dementia diagnosis and encouraging further close working between primary care and secondary care.
• A Member predicted that with new younger doctors entering the practises in Thanet the rate of early diagnosis would improve.

 

Recommendation 5

 

• A suggestion was made that the Kent Youth County Council be contacted for their input.

 

Recommendations 6

 

Members noted the progress.

Recommendation 7

 

• It was proposed that Dementia Crisis was to be expanded in East Kent for a more flexible model of the current domiciliary care.  This would be carried out through the Transformation Plan.
• It was advised that West Kent CCG put forward a specific Dementia Challenge Bid and was working with Crossroads to work directly within Pembury Hospital identifying people who have dementia who could be supported to return home with their dementia care service.  Staff had already been recruited.
• Assurance was given that a lot of work was already being undertaken in care homes to stop dementia patients going into hospital.  This was being done through training and improving the standard of care in care homes.
• It was advised that the Kent Community Health Trust would be receiving funding from the Challenge Fund to improve the care of patients with dementia in community hospitals across Kent.
• Members were advised that Age UK had 5% of its budget “ring fenced” and not “top sliced”, as indicated in the appendix to the report, to encourage advocacy as a new service.

 

Recommendation 8

 

• It was suggested that officers spoke directly to the Director of Governance and Law, Mr Wild, regarding the promotion of awareness of Lasting Powers of Attorney (LPA) and using the KCC brand to add confidence.

 

Recommendation 9

 

• Police personnel were now receiving training on dementia as part of their formal training.  Personnel in the Ambulance, Fire and Police Services would receive training on how to respond to calls. (ROC Start had carried out work on this too.)
• An officer agreed to look into the suggestion made on The Lions Club “Message in a Bottle” scheme being promoted to GPs. [This scheme issued Green Cross stickers to be placed on the person’s back and front doors of their home and a standard form with their medical requirements on the door of their fridge should they require help from an emergency service]. 

 

Recommendation 10

 

• Members were advised that the specification and business case was ready to be implemented.  A lot of work had to be undertaken including working with providers of new technologies for this programme to be rolled out to domiciliary care and care homes.  It was advised that this technology was simple to set up.

 

Recommendation 11

• In reply to whether there were problems with self funding, it was advised that this was about making progress through general campaigns.  It was noted that there had been many hits on the DementiaWeb site.  There would be campaigns through the libraries, Mental Health Team and a bus campaign to promote DementiaWeb and the 24hr Helpline.  This would need to be monitored for effectiveness as it was expensive.   This was detailed in the Transformation Plans.
• Members were advised that a meeting would be held with the Director of Customer Services, Mr Crilley, regarding the redesigning the website in Social Care for clients etc.
• Members commented generally on the difficulties they had in finding information on the KCC website and that it was quicker to Google.

 

Recommendation 12

 

• Members were advised that each district had one Memory Café and Peer Support Group, which was a project group of providers that met quarterly.  This was detailed on DementiaWeb but not on Kick’s website.
• Members asked that a link be provided on the KCC website to DementiaWeb.

 

Recommendation 13 

 

• Members were advised that meetings had been held with Christ Church University regarding the Dementia Services Development Centre rebranding to become visible. 
• Work was also being carried out on the government initiative for             “Dementia Friendly Communities”.  Although “Community“ was to be defined, this would be carried out through working with SILK, Families and Social Care  to local businesses on how they could make their business more friendly with dementia.
• Members were informed that the Academic Health Science Network had chosen two themes which included Dementia and technology.  Work would be carried out to find out more information on this.
• It was suggested that Blue Water Shopping Centre should be approached as they may be willing to support this initiative.

 

Recommendation 14

 

Members noted the progress

 

Recommendation 15

 

• In reply to a question it was advised that it was not known whether GPs had brought in voluntary sector dementia support organisations into learning and training sessions.  The CCGs were aware of the voluntary sector and the resources they brought.
• It was advised that training had just started as part of the Carers Contract.  There was training for Carers in care homes.

 

Recommendation 16

 

• Members were advised that there was no predicted increase in younger age dementia.  There would however be growth in older age dementia.  People with a learning disability who developed dementia were supported through an integrated pathway between dementia and learning disability services.

 

 Recommendation 17

 

• Officers advised that they were greatly encouraged by work that is happening in the acute hospitals, there is now a national CQUIN for dementia.  This required that everyone over 75 years of age being admitted as an emergency patient would be going through a simple memory questionnaire. Where the results indicated concern of potential dementia the patient would be referred back to their GP for further investigations and diagnosis.

 

• It was anticipated that when the figures of how many people were kept out of hospital became available through interventions this could be used to further enforce intervention measures to keep dementia suffers out of hospital.

 

 

5.          RESOLVED that:

 

a)    the relevant Cabinet Committee be recommended to review the process of  Select Committees to ensure that they remain effective through sharing good practise;

b)    the “Dementia – A New Stage in Life: Response to the Select Committee Report” and its appendix  be edited

c)     A table to be added to the appendix of the edited report to include details of money gained through bids etc and good practise to be recorded.

d)    The Kent Youth County Council to be approached regarding action taken on recommendation 5.

e)    the Director of Governance and Law, Mr G Wild be approached regarding recommendation 8;and

f)      General Practitioners are encouraged to take steps to improve early diagnosis of dementia by using CCG figures presented to the Select Committee.