Presentation on theme: "Overview Background & policy context The Framework"— Presentation transcript:
0 Update on the NSW Dementia Services Framework 2010 – 2015 Anne CummingNSW Dementia Policy TeamWendy NollerAgeing Disability and Home CareCollaborations and Innovations Symposium
1 Overview Background & policy context The Framework Draft Implementation PlanPrinciples – “I” statementsProgress so farKey Projects
2 Dementia prevalence in NSW by LHD by Year Rapid increase in the number of people with dementia due to an ageing populationIssues confirmed in development of the framework:The main burden falls on family carersLack of early detection and treatment denies opportunities for improving the quality of lifeThose who do access services, the services are overstretched now and are inequitably distributedAccess to diagnosis and appropriate services is a significant issue for younger peopleCurrent hospital experience leads to poor outcomes
3 Policy context Commonwealth Dementia Planning National Action Plan on Dementia CareThe Dementia Initiative – 2005Living Longer Living BetterNational Dementia PlanningNational Framework for Action on DementiaDementia as the 9th National Health PriorityNSW Dementia PlanningNSW Action Plan on DementiaFuture DirectionsNSW Dementia Action PlanNSW Dementia Services Framework 2010 – 2015
4 NSW Dementia Services Framework Launched September 2010 in Dementia Awareness WeekJoint publication NSW Health and ADHCs/gl/2011/pdf/GL2011_004.pdf
5 Draft implementation plan Approved and jointly signed by NSW Minister for Health and NSW Minister for Ageing and Disability ServicesLaunch by Hon Andrew Constance, MP at public seminar on World Alzheimer’s Day 21 September 2011
6 Version 1 WHAT WILL WE DO? WHO WILL DO IT? WHAT WILL WE REPORT ON? Provide clinical support, education and leadershipLocal Health DistrictsAccess to dementia expertise in hospitalsImplement Confused Hospitalised Older Person Study (CHOPS)Agency for Clinical Innovation, Aged Health NetworkEvaluation completed and findings promotedImprove dementia detection, care and interventionAdverse events monitored and reducedImplement the National Delirium Guidelines and PathwayDelirium pathways in place and monitoredIncrease dementia access to hospital substitution programsDementia patients access to hospital substitution programsExpand carer consultation and support strategiesCarer consultation and support strategies in placeIdentify and respond to current design constraints in hospitalsDepartment of HealthOutcomes of project reported, environmental audits conductedStrengthen evidence and support the development of behavioural unitsEvidence collected, site appraisals undertaken
7 Summary of changes – version 2 LHD reporting reducedEssential actions listed and sequencedImportance of parallel initiatives emphasisedChanged formatAdditional contentPrinciplesGovernance structure addedSelf assessment checklistState-wide projects tableEssentialsLocal governance structureDementia Service NetworksLocal dementia action plansDementia initiatives with Medical Locals5. Referral and care pathways6. Integrated dementia care models7. Routine cognitive screening over 70 years in hospitals8. Collaboration between specialist health and mental health servicesParallel EgCarers Recognition ActFalls policyFramework for specialist health services for older peopleConnecting CareHospital in the Home
8 Setting the direction for dementia care in NSW My community contributes to my quality of lifeI am valued, respected and treated with dignityI am supported to maintain my quality of life, based on what I consider to be important and meaningful to meMy family carer/s are valued, supported and consulted. They are recognised as experts and as partners in careWhen I need to go to hospital my cognitive difficulties are recognised and I receive the care and treatment I needI was given a timely diagnosis and follow up information and support for me and my carerWe know a professional whom we can trust, who knows us well who we can contact when required to resolve issues and provide adviceThe professionals I interact with have the right skills, knowledge and attitude and are valued for their expertise in dementia careI am free from pain and receive best possible end of life careMy end of life wishes are discussed and followed
9 Proposed essential actions for LHDs Local governance structureDementia Service NetworksLocal dementia action plansDementia initiatives with Medical Locals5. Referral and care pathways6. Integrated dementia care models7. Routine cognitive screening over 70 years in hospitals8. Collaboration between specialist health and mental health services
10 Steps Timeline 2010 2011 2012 Governance (2009) Framework consultation StepsTimeline201020112012Governance (2009)Framework consultationDraft for commentFramework releaseIssued as GuidelinePlan draftedPlan revised Plan submittedFinal plan releasedPolicy Directive ?Implementation
11 Implementation How? National reforms Parallel initiatives Who? InvestmentPlanningRedesignPolicyPilotsWho?Ministry of Health and ADHC4 PillarsLocal Health Districts and ADHC regionsLocal Dementia NetworksPartners and contracted projectsCritical to the implementation process is the recognition that service activity is being implemented at various levels.These include:State Govt Departments - NSW Department of Health and Ageing Disability and Home Care (ADHC)NSW Statewide Policy Teams – Dementia Policy Team , Older People Mental Health and Statewide Centre for Palliative CareLocal Health Districts (from July 2011) and ADHC regionsPartners and contracted projects - partners include the four pillars – ACI CEC, CETILocal Dementia NetworksIn some cases this has translated to the Framework being used at local service provision levels to reflect on service provision and practices, identifying opportunities for improvement- much like a self assessment/quality improvement tool.For example the Inner West Dementia Advisory Service located in Sydney has taken sections from the service pathway to the local dementia network meetings with question and discussion time among stakeholders to consider opportunities for service improvement.Also the Southern Dementia Network is drafting a Dementia Action Plan that is structured under the Service Pathway areas of the NSW Dementia Services Framework.
15 Ageing, Disability and Home Care Home and Community Care (HACC) Program transition1 July 2012 – NSW Community Care Supports Program for people aged 65/50Dementia remains a target group of ADHC’s Community Care Supports Program – under review in 2012/13Approximately 54,000 (was 280,000) people access community supports each yearSince 1 July 2012, the Commonwealth has assumed full funding and operational responsibility for aged care services, including the HACC program.This means that ADHC is now solely responsible for administering basic community care services for people aged under 65, and 50 for Aboriginal and Torres Strait Islander people.ADHC is currently in the process of approving new program arrangements, including program guidelines to support its community care program. As per the National Partnership Agreement in which both levels of government agreed to not substantially altering service delivery in the HACC program until 30 June 2015, the changes to the ADHC program guidelines is more about reflecting the new younger cohort.This means that dementia will remain as one of the five target groups for the ADHC community care program. And ADHC’s policy and program development in dementia will focus on services for younger people with dementia which as you know, is targeting dementia which occurs in people before 65 years.In saying that, although NSW does not retain a service delivery role for older people, it maintains an interest in this group. The Office for Ageing hold policy responsibility for this group of people.It’s estimated that approximately 54,000 younger people access community care supports in NSW. Based on the latest research from the Australian Institute of Health and Welfare – it could be estimated that there are approx 8000 people in NSW with younger onset dementia.
16 Dementia 2011/2012 – ADHC funded 65 new dementia projects across NSW $3.4 million in growth funding$1.4 million in non-recurrent fundsAnnouncement of Younger Onset Dementia Person Centred Packages – 3 year pilot ($1m recurrent)In 2011/12 through the Home and Community Care Program, Ageing, Disability and Home Care funded 65 new dementia projects across NSW.$3.4 million in growth funding (18.6% of total growth in 2011/12) was allocated to dementia related direct service delivery.In addition, $1.4 million in non-recurrent funds were allocated to support projects relating to the priorities and recommendations from the NSW Dementia Services FrameworkIn April this year, ADHC in conjunction with Alzheimer’s Australia held a Younger Onset Dementia forum in Sydney. 140 people attended from across NSW. At the forum, the Minister announced ADHC’s commitment of $1 million in recurrent funding for a new younger onset dementia program. The program will operate as a 3 year pilot that will provide flexible person centred packages for people with younger onset dementia.
17 ADHC Dementia projects under DSF Younger Onset Packages and evaluationPerson centred packagesGuidelines finalisedConsidering funding optionsYOD mapping and information / advisory serviceElla CentreYOD researchCompleted and about to be launchedIt’s difficult at this stage to predict was the sector will look like and where younger onset dementia will sit long term with the current reforms for aged care and disability servicesUntil more information becomes available ….?ADHC will continue to support the sector in adjusting to the changes as a result of the HACC transition…? Inclusion of this slide?
18 ADHC DSF projects continued Increase of funding to Dementia Awareness WeekMeets goals of awareness and community engagementHospital Dementia Services ProjectAANSW and University of CanberraStudies people in hospital’s experience of community care services, impact on carerTransport and Dementia Research ProjectAANSW – looks at community transport, personal transport, public transport
19 ADHC DSF projects continued Dementia and Disability Education Program66 workshops over three yearsIntellectual and physical disabilities targetedCarer Coaching ProgramCarer education workers / train-the-trainer modelAssist carers working with people or families with dementiaCALD Dementia Link Worker (now recurrent)
20 ADHC DSF projects continued Aboriginal Dementia Advisory Service expansion (Hunter)Koori Dementia Care Project5 communities across NSWState-wide Aboriginal project2 year projectDevelop strategic plan / link into existing strategiesADHC currently supports people with younger onset dementia through existing community care supports to help them continue to live at home.There are already some services that are specifically for people with younger onset dementia in NSW and people also access general community care services such as those offered through the HACC program.However, there are a number of issues that have informed the need to trial a new service model for people with younger onset dementia. Including: people with younger onset dementia do not always find it easy to access appropriate services in the community to meet their needs, andContemporary approaches to designing services emphasises giving people greater control over the supports they receive, through person centred planning.We’re still developing the program and are conducting extensive consultation to ensure the program aligns with ADHC broader policy and program direction for individualised funding and self-direct support models.ADHC has engaged Alz Aust NSW to assist in the implementation of the program by conducted the program’s evaluation and also provide support to providers that deliver the packages.
21 ADHC DSF projects continued Dementia Services Evaluation Grants ProgramAdministered by DCRCFunding grants for 11 projectsBuild evidence base through formal evaluationUpskill workersDementia Workforce Competencies Scoping ProjectFor managers and health practitioners in HACC and health settingSupport workforce recruitment, skills development and enhance career opportunitiesADHC currently supports people with younger onset dementia through existing community care supports to help them continue to live at home.There are already some services that are specifically for people with younger onset dementia in NSW and people also access general community care services such as those offered through the HACC program.However, there are a number of issues that have informed the need to trial a new service model for people with younger onset dementia. Including: people with younger onset dementia do not always find it easy to access appropriate services in the community to meet their needs, andContemporary approaches to designing services emphasises giving people greater control over the supports they receive, through person centred planning.We’re still developing the program and are conducting extensive consultation to ensure the program aligns with ADHC broader policy and program direction for individualised funding and self-direct support models.ADHC has engaged Alz Aust NSW to assist in the implementation of the program by conducted the program’s evaluation and also provide support to providers that deliver the packages.
24 In conclusion...Implementation of the NSW Dementia Services Framework is underway at state and local levels.The implementation plan will provide further momentum, direction and guidance for LHDs and ADHC regions with an emphasis on partnerships, collaboration and co-ordination.The work in NSW will build on a national agenda for improving the quality of dementia care.Nepean - implementation would be coordinated by working party under Chronic and complex Committee