West London Mental Health NHS Trust

We are one of the largest and most diverse mental health services in the UK. We provide care and treatment for around 20,000 people each year and serve a local population of around 700,000 residents. We employ around 4,000 staff and serve a local community of many races, religions and languages, across three London boroughs Ealing, Hammersmith & Fulham, Hounslow. As well as community and inpatient mental health services, we are a leading national provider of forensic (secure) and specialist mental healthcare.

Updated:
13 March 2014
Location:
London
Sectors:
Health, Care, Medical, Hospitals and Hospital Trusts

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? 

The organization has to play a key part in what we have been pushing very strongly for, which is a ‘Whole System Approach’ to dementia care. The Trust holds the greatest expertise in relation to the healthcare aspect of caring for Dementia. Therefore the Trust sees itself as reaching out to all parts of the health and social care and other parts of the wider community and supporting whatever is needed to improve the way that Dementia is understood and how care is given.

The Trust is signed up to the principle of working across the ‘Whole System’around the need to identify people who have dementia,  at a much earlier stage than is currently the case. That by doing this, it will allow patients and their carers to be able to have control in terms of future planning and make choices in advance, with full knowledge of services and resources available to them.

As an index of the emphasis on Dementia care – WLMHT is one of the first NHS organizations in the UK to develop a stand-alone Cognitive Impairment and Dementia Service which stands alone from adult and older persons services.

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

There are a number of challenges that relate to the delivery of the outcomes which are detailed below

  • The financial challenge that all partners organizations are faced with
  • There will be an increase of prevalence of dementia in the area that the Trust serves, in the order of approximately 16%
  • The potential for individual organizations planning to downsize without planning this with their partners
  • Improving the quality of care to be consistent with NICE guidance, as well as patient and carer expectation in the context of the above

2. Actions

  • Working on a 'whole system' approach to dementia care

    We are working in all of our boroughs on a ‘whole system’ approach to dementia care. This entails the need to agree significant pieces of work to transform services. This is involving specific pieces of work on early identification, community pathway, psychological interventions and end of life care.

    Status:
    Initial Scoping

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Work closely with CCGs and GPs to adapt the Shared Care Protocols

    Specifically we are working very closely with the CCGs and local GPs to reinvigorate and adapt the Shared Care Protocols we have to reflect patients with earlier stages of illness seeking healthcare and managing symptoms jointly through all stages from early diagnosis to end of life.

    Status:
    Planning

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Develop an Integrated Transformation Board

    We are developing an Integrated Transformation Board which includes key partners. This will  include services for Dementia.

    Status:
    Planning

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Developing work around Payment by Results

    We are developing the work around Payment by Results as a means of describing qualitatively what packages of care we offer & by definition we can use to what degree we are meeting NICE Guidance.

    Status:
    Planning

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Involved in Integrated Care Pilots

    We are involved in the Integrated Care Pilots in Inner and Outer North West London which are concentrating on those who are frail elderly. By definition this means we are reaching out to colleagues in primary care, acute care, and social care in a very different way. This ‘integrated’ way of working is now starting to support a very different way of working for those with dementia, who access primary and acute care

    Status:
    Planning

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Working on specific CQUINS looking at anti psychotics

    We are working on specific CQUINS which are looking anti psychotic practices and focusing on a 3 monthly review of all with dementia who are prescribed anti psychotic medication. We are in addition, working with colleagues in acute services on their respective CQUINs.

    Status:
    Planning

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Reviewing accommodation

    We are reviewing accommodation to move towards dementia friendly environments

    Status:
    Implementation

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member

  • Nursing and Care Home Mapping

    We are supporting various initiatives in relation to nursing and care home mapping

    Status:
    Implementation

    Update - First Quarter

    N/A

    Update - Second Quarter

    N/A

    Update - Third Quarter

    In progress - new DAA member