Hardwick Clinical Commissioning Group on behalf of North Derbyshire Joint Implementation Group for Dementia

Hardwick CCG takes a lead on Dementia commissioning in the north of Derbyshire supported by our colleagues in North Derbyshire CCG. As a result of the Derbyshire Joint Dementia Strategy, and under the auspices of the Joint Commissioning Board for Dementia, we set up an Implementation Group in order to support the actions identified in the Strategy. This group includes commissioners, providers, voluntary sector and wider stakeholder and we work together to implement changes, share learning and improve services. Hardwick CCG commissions health services on behalf of our member practices with a population based in the north east of the county. We plan and purchase care for our population and together with partners develop new services and pathways to lift the health of our population.

Updated:
31 July 2017
Location:
East Midlands
Sectors:
Care, Health, Clinical Commissioning Group, Social Care, Voluntary Sector
Local Alliances:
Derbyshire Dementia Action Alliance

1. Action Plan

1. The National Dementia Declaration lists seven outcomes that the DAA are seeking to achieve for people with dementia and their carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

We have now developed an action plan and we are putting our proposals within the NHS commissioning cycle.  Proposals will be finalised and timetabled as a joint exercise with the CCG and local authority partners to achieve a new joint dementia commissioning strategy.  We will be working with the Local Authority and other providers to achieve a new dementia pathway in Hardwick and North Derbyshire.

Broadly we see our role as helping to improve availability of diagnosis and support to people in our practices.

Supporting and developing our staff to be able to better help people with dementia and their carers. Reducing adverse outcomes for people with dementia in health care. Contributing to dementia friendly hospitals and care pathways. Contributing to dementia friendly communities with our community partners. Developing dementia friendly practices.

2. What are the challenges to delivering these outcomes from the perspective of your organisation?

We are particularly concerned at the adverse outcomes for people with dementia. Improving these is central to the challenges facing the NHS.  Supporting primary care in the context of rising demand, improving integrated care with the local authority and across providers, reducing emergency admissions and the Francis Report recommendations are all significant challenges which we are addressing in a number of ways.

We are working at a time when numbers of older people and incidence of dementia are rising. Resources are anticipated to remain constrained for the foreseeable future so the overarching challenge is to invest to save.

Member website

www.hardwickccg.nhs.uk

2. Actions

  • Dementia Support Service

    Continue robust contract management of newly commissioned service and continue future development / strategic alignment of this service.

    Status:
    Being implemented
  • Making diagnosis more available

    We now have a countywide Memory Assessment Service operating. We will look to ensure that the services works to one specification in order to achieve a fair and consistent offer. We will roll out nurse led diagnosis. We will re-model the current memory clinics in the north of the county into a specialist care home service.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Support hospitals to create dementia friendly care

    Chesterfield Royal Hospital has an Older Persons Team and an Enhanced Support Team, both of which are specialists in dementia care. These teams support the work of the whole hospital. The Lead Nurse for Dementia provides a range of training opportunities to staff and champions dementia care in a variety of Forums. There is a draft Dementia Strategy currently going through the process of approval. An Implementation Plan will then be developed and a Steering Group established.

    Status:
    Being implemented

    2017 - Third Quarter Update

    Updated Action

  • Support care homes

    Health Commissioners have re-procured care homes with nursing. Derbyshire County Council have a dementia premium they pay to care homes. GP practices in Buxton are considering the use of the Alzheimers Society tool DeAR GP with care home link workers. There is care home surge taking place in Hardwick CCG which aims to work intensively with a number of homes to reduce admissions and support people in the community. This involves the use of a Comprehensive Geriatric Assessment. The use of the DeAR GP tool will also be considered.

    Status:
    Being implemented

    2017 - Third Quarter Update

    Updated Action

  • Mobilisation of Dementia Reablement Service

    Derbyshire County Council continue the development and roll out of a Dementia Reablement service and the CCGs will promote to GP practices

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Support the development of Dementia Friendly Communities

    To continue to work with Alzheimers Society and the DFC worker in the north of the county, supporting the completion of their work programme.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Providing Better Care Closer to Home

    Following the decision by North Derbyshire and Hardwick CCGs to proceed with the Better Care Closer to Home proposals, we will support the development of this work to re-model inpatients services, creating a Centre of Excellence, re-model day hospitals to provide treatment and therapy in the community and to develop the role of beds with care. In addition these proposals will see the development of a Dementia Rapid Response Team in the north of the county. We will continue to contribute to the Implementation Plan of this programme.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Diagnosing and supporting in primary care

    3 GP practices are participating in the Dementia Friendly Practices project

    Promotion of the Dementia Friendly Practice toolkit.

    Develop a pilot using volunteers to promote the toolkit.

    The use of 'Cantab' continues in Buxton and the success of this will be evaluated as part of a wider review of practice based Dementia Support workers.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Training about Delirium

    Training has already been taking place in various care settings, including hospitals, community teams and care homes. Local providers have received some funding to continue this training alongside the Alzheimers Society, and are working to together to make this available to more staff.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action

  • Support the implementation of Derbyshire's Sustainability and Transformation (STP) Plan in relation to dementia and delirium

    We will work with the Project Manager leading on the work in relation to dementia and delirum and share our priorities and action plan.

    We hope to have a continued role as a group to implement the proposals of the STP.

    Status:
    Being implemented

    2017 - Third Quarter Update

    New Action