Hospital Dementia Support Service (HDSS) University Hospitals Leicester (UHL)

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1 Hospital Dementia Support Service (HDSS) University Hospitals Leicester (UHL) Caroline Kirkpatrick, East Leicestershire and Rutland CCG Michelle Larke, Services Manager, The Alzheimer s Society

2 Setting the context for this work Dementia is an enormous challenge: NHS figures suggest it accounts for 42% of older people with unplanned, acute medical admissions. Counting the Cost report: 97% of nurses said they always or sometimes care for someone with dementia Over 50% of carers felt a hospital stay had a negative effect on the person with dementia

3 HDSS 2015/16 Funded by 3 CCGs in LLR and Innovation Fund, East Midlands Strategic Clinical Networks: One year pilot project Staffing structure: 4 x FT Dementia Support Workers and 1 x FT Dementia Support Manager (Leicester Royal Infirmary and Glenfield Hospital) Matched funding from Alzheimer s Society for GH Governance: Alzheimer s Society Project Board and Steering Group

4 Funding - One Year Pilot Project April 2015 April 2016 LRI service only 3 CCGS: 18,000 each = TOTAL: 54,000 Innovation Fund: 54,000 OVERALL TOTAL = 108,000 Salaries, plus NI and pension Mileage Telephone, mobile costs Consumables Training Evaluation

5 What is the project aim? Designed to bridge a gap in current support provision. Designed to complement the care provided by hospital teams. By offering high quality information, guidance and support the service offers something unique and valuable, tapping a need not being met elsewhere.

6 Measurable Outcomes Short-term Improved experience for carers during the hospital stay (increased support, knowledge of correct care) Raising awareness in staff about carers and dementia Medium-term Improved ability of carers to manage the condition (when and how to get help when it is needed) Improved working with pre-op and GPs to increase use of service in planned surgery situations Improved working with care homes Long-term (impact) Contribution to the reduction of length of stay in patients with dementia Contribution to the reduction of readmissions in patients with dementia Improved cross organisational working (primary/secondary/voluntary care)

7 External Evaluation Key Points: Improved experience for carers during the hospital stay in terms of increased support and knowledge Improved ability of carers to manage the condition and have more confidence in their caring role and when and how to get help when it is needed Patients are usually admitted with a medical or surgical problem and this is initially the focus of attention Greatest potential for the HDSS appears to be around discharge planning and bridging into the community Main strength: bridges the worlds of secondary and primary medical care

8 Where are we now? Plans for sustainability Governance Better Care Together: Frail Older People and Dementia work-stream: Dementia Delivery Group The Alzheimer s Society Programme Board Continuation of service Extended the service for LRI site for 6 months; April 2016-September 2016 Funded by 3 50,100 in total for 6 month period

9 Where are we now? Plans for sustainability Commissioning Intentions 3 CCGs highlighted continuation of service within commissioning intentions for 2016/ Evaluation Pointers Review of UHL (acute) service and community service provision Appropriate commissioning, avoiding duplication, discharge/transfer planning and bridging into the community, across LLR Improved communication and engagement with GP practices to support the admission of patients with dementia

10 A case study Mrs A and her mum, Mrs L (person living with dementia) Identifying the support needs Falls Personal care Other information: legal matters and groups Action Conversations with ward staff and OT working with Mrs L prompted a further conversation with the family s social worker. Outcome An appropriate package of care was put in place by social worker. OT arranged for Mrs L s bed to be moved downstairs. A lifeline was also installed as a further precautionary measure. For Mrs A: information about local groups and LPA.