Agenda item

To consider progress made by the health and social care system towards Outcome 5 of the Health and Wellbeing Strategy

(1)       Alison Duggal (Deputy Director of Public Health) introduced the Assurance Framework report which set out information on indicators related to Outcome 5 of the Health and Wellbeing Strategy, focussing on “People with Dementia are assessed and treated earlier and are supported to live well” and also considered the interface with the Sustainability and Transformation Plan.  She said there was evidence that progress had been made in increasing the number of patients diagnosed with dementia as a percentage of the estimated prevalence; however, for some of the indicators data was either not available or very limited.

(2)       Anne Tidmarsh Director Older People and Disability - KCC), Elizabeth Lunt (Clinical Chair- Dartford Gravesham and Swanley CCG), Dave Holman (Commissioner – West Kent CCG) and Linda Caldwell (Commissioner - East Kent CCGs) gave a presentation which is available on-line as an appendix to these minutes.

(3)       During the discussion the move away from the medicalisation of dementia and increased support being provided by local communities and the voluntary sector to enable people to continue to live independent and social lives was welcomed and supported.  Some examples of good practice were shared including: dementia drop-in clinics being trialled in Deal; the development of extra care housing in conjunction with district councils; and the provision of training and education programmes for care and nursing home staff;

(4)       The importance of support and training for staff in nursing and residential care homes and for domiciliary care staff to enable them to respond to the challenging behaviour associated with some cases of dementia was emphasised.  The need to engage with regulatory organisations was also mentioned particularly as care home owners needed to be confident they would not transgress any regulation while providing good quality end of life care.

(5)       It was also said that the care pathway should start prior to diagnosis as there was evidence that the progress of or onset of dementia could be delayed.

(6)       In addition to prevention and early diagnosis, it was also acknowledged that some people will inevitably get to a more advanced stage of dementia, especially close to the end of their lives and it was important to ensure that training and attitudes in care homes and among regulators did not encourage unnecessary hospital admissions.

(7)       In response to a question Mr Holman said that the framework for commissioning services to provide support from diagnosis to end of life should be re-visited.  Ms Caldwell said that the mental health service could be involved in supporting patients make the transition into a care home and ensuring that the staff understood any individual needs.

(8)       Resolved that:

(a)     Given the changes made in the arrangements for data collection and reporting, Health and Social Care Commissioners would collectively develop and agree a new set of dementia related indicators across Kent and Medway;

(b)     NHS Clinical Commissioning Groups work with NHS providers to further consider ways of improving services for people with dementia who are admitted as an emergency;

(c)     Following the Dementia Risk Summit, Local Integrated Commissioning Groups be asked to ensure a robust local system for integrated commissioning and provision of care for people with dementia;

(d)     The Health and Wellbeing Board receive a further report in 2017 which would include: best practice in care pathways; workforce development particularly in relation to care homes and domiciliary care services; the prevention and delay of the onset of dementia including the programme of health checks; as well as considering the relationship with regulators.