The National Dementia Strategy in the East of England Maureen Begley Dementia Programme Manager East of England

Dementia – key facts Dementia results in a progressive decline in multiple areas of function, including memory, reasoning, communication skills and the skills needed to carry out daily activities. Individuals may develop behavioural and psychological symptoms such as depression, psychosis, aggression and wandering, which complicate care and can occur at any stage of the illness. Family carers of people with dementia are often old and frail themselves Dementia is a terminal condition but people can live with it for 7–12 years after diagnosis Two thirds of people with dementia live in the community. One third of older people live alone. Numbers will increase by 45% by 2025.

Dementia – key issues Poor levels of knowledge and awareness, coupled with stigma, leading to only one third of people with dementia being diagnosed Need to ensure early diagnosis, support and treatment for people with dementia, their families and carers Community services not designed to meet the needs of people with dementia Services need to be more person centred Quality especially important in acute hospitals and care homes (one third of people with dementia live in care homes) Need for training and specialist support

Current national focus Implementing the National Dementia Strategy sits within the overall context of the coalition government’s policies eg personalisation. The focus for 2010/11 is : Improving access to early diagnosis The quality of acute hospital care Care homes quality Reducing the use of antipsychotic drugs through training and support

NDS Objective 10 Considering the potential for housing support, housing-related services and telecare to support people with dementia and their carers. The needs of people with dementia and their carers should be included in the development of housing options, assistive technology and telecare. As evidence emerges, commissioners should consider the provision of options to prolong independent living and delay reliance on more intensive services.

Regional context Dementia is a focus of ‘Towards the best together’ (EOE NHS) PCTs have targets in their plans for 2010/11 around memory assessment services, mental health liaison services in acute hospitals, and keeping people at home by working with social care Joint working between PCTs, health services, social care incl. providers, third sector and users/carers Focus on person centred services which can be shown to be effective

Regional action Regional NDS implementation group. Its work plan includes the reduction in use of antipsychotic drugs for people with dementia. Commissioned a review of workforce development and training in the region. Working with workforce leads in localities on joint work. Bringing commissioners together to share good practice Working on how to capture the evidence around what works in acute and intermediate care (quality and savings)

Progress on diagnosis and support Awareness raising with primary care, national awareness campaign, followed up with dementia awareness week in July Most areas working on new/ expanded memory assessment services. Cambridgeshire has added support groups and therapy. Demonstrator pilots funded by Department of Health to find out what are the best models of peer support (Herts, Southend) and dementia advisers (Suffolk, Norfolk). Work on information eg standard pack across agencies in Essex

Progress on community support services Looking at whether we need specialised domiciliary care and when (Suffolk’s intensive support team) Project Manager promoting the use of personal budgets for people with dementia and their carers (flow chart on mental capacity and risk assessment tool) Carers courses. Looking at more flexible breaks for carers Continuing to promote telecare (Essex, Thurrock, Luton) Development of extra care housing for people with dementia (e.g. Norfolk, Essex, Peterborough)

Progress on acute and intermediate care Investment in mental health nurses to provide liaison service Acute hospitals looking at how to improve quality – link with dignity. Royal College of Psychiatrists audit of the quality of care for people with dementia in acute hospitals New services e.g. complex care team in 2 Suffolk Hospitals Promoting This is Me, a life story for people with dementia in acute hospitals Commissioners looking at intermediate care

Progress on care homes and end of life care Focus of work on training and workforce development including e-learning Support to reduce the use of antipsychotics (training and guidance – Norfolk) In-reach by specialist mental health teams developing Commissioners looking at new specifications Strong link with palliative care. Peterborough group on palliative care in care homes – conference, lots of documentation to support good care :

Key issues for housing Role in prevention – physical and mental activity Awareness raising amongst staff and service users Need to be part of the information for people with dementia Role in community support services, telecare, intermediate care and extra care housing – be part of local commissioning groups Ensure you are part of locality work on workforce development

Contacts ( workstreams – dementia) rowse/HousingandDementia/ ‘This is Me’ is currently free to people/ service providers in the East of England. To order copies call Xcalibre on