Sandwell and West Birmingham NHS Trust

The Trust is one of the largest teaching Trusts in the UK with a reputation for excellent, friendly staff who provide high quality care from City Hospital in Birmingham and Sandwell General in West Bromwich. Both are busy acute hospitals providing many specialist services and a broad range of emergency services, including Accident and Emergency at both sites. In addition, the Trust provides comprehensive community services to the Sandwell area, including from Rowley Regis Community Hospital, Leasowes Intermediate Care Centre and the Lyng Centre for Health and Social Care.

Updated:
8 October 2015
Location:
West Midlands
Sectors:
Medical, Health, Care, Hospitals and Hospital Trusts, Emergency Services Sector
Local Alliances:
Sandwell Dementia Action Alliance, Birmingham Dementia Action Alliance

1. Action Plan

1.  The National Dementia Declaration lists a number of outcomes that we 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?

To move forward with the Trust’s role to deliver better outcomes for people with dementia and their carers we have formulated an action plan, monitored by a Dementia Steering group, chaired by the Chief Nurse. We have commenced a Trust-wide project to raise awareness of the specific needs of people with dementia , improve services, enhance patient and carer experience and reduce the stigma associated with mental health issues. We do, however, recognise that hospitals are not traditionally designed to cater for the needs of people with dementia, so anticipate commencing the work in four specific areas which will champion excellence in dementia care and act as learning environments for the rest of the organisation.

As part of our on-going work we aim to develop a specific pathway to provide early diagnosis support, appropriate management of symptoms, person centred care, discharge and, if need be, end of life care for patients with dementia and their carers.  To achieve this we will work in collaboration with our local CCGs, mental health liaison services, voluntary sector groups, representatives from carers organisations and local government to ensure integrated working practices, whilst being mindful of the national guidance around dementia care.

The action plan aims to achieve the following key outcomes:

  • Development of a specific dementia care pathway, from front door to discharge, which takes into account the specific needs of the individual.
  • Improved support and information services for patients and carers to include signposting to outside agencies.
  • Access for all patients with dementia, or suspected dementia, with diagnosis to appropriate mental health liaison services.
  • Environmental changes to make inpatient areas dementia-friendly using the Kings Fund Enhancing the Healing Environment principles.
  • Availability of training for all frontline staff and the creation of dementia champions who have had specialist training in person-centred care.
  • Monitoring the use of anti-psychotic medication and implementation of appropriate national guidelines.
  • Prescribing education for all medical staff.
  • Improvement in end of life care for patients with dementia and monitoring of the uptake of the supportive care pathway for this group.

Achievement of these actions and the outcomes will be monitored via the Dementia Steering Group.

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

  • Ensuring that dementia remains a high priority within the competing local health economy.
  • The challenge of working across four inpatient areas of differing design, plus community services.  The hospital environments are challenging when trying to plan environmental changes, either due to the need to decant wards to other areas to allow for the works to be carried out, or due to problems with infrastructure.
  • The allocation of resources to ensure that the programme of education can be delivered across the organisation
  • The allocation of resources within a competing environment to deliver the environmental changes required to make the organisation dementia-friendly.
  • Initiatives such as activities/reminiscence therapy to provide a stimulating environment will need dedicated activity co-ordinators which will have a financial implication.
  • The ongoing pressure of increased in patient activity.
  • Recruitment and retention of volunteers specifically to support patients and carers with dementia.
  • To be successful in Stage 2 of the DH initiative ‘Improving the Acute Hospital Environment for Patients with Dementia’.

Member contacts

https://www.swbh.nhs.uk/

2. Actions

  • Implement changes to improve the environment

    • To commence work on targeted wards to make them dementia-friendly, using the principles of the Kings Fund Enhancing the Healing Environment principles.
    • To submit the Stage 2 bid for the DH Improving the Environment of Acute Hospitals for Patients with Dementia and successfully achieve funding to improve 10 ward areas, one inpatient rehabilitation unit and one intermediate care facility.
    • To successfully recruit and retain a core of volunteers to offer support to patients and carers with dementia.
    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Develop the Workforce - Awareness and Education

    • Dementia awareness to be included in training for all staff groups
    • Specialist training re patient-centred care to be delivered to targeted groups.
    • Creation of dementia champion role to ensure the spread of good practice across the organisation.
    • Education around delirium
    • Education for staff on the use of anti-psychotic drugs and the Rapid Sedation policy
    Status:

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Implementation of the Composite Dementia Care Bundle

    • Develop and implement the “All about me” documentation in four specific areas and then roll out across the organisation.
    • Provide training to ensure the principles of person-centred care, as related to the care bundle, are implemented.
    • Cross reference the implementation with the targeted ward dashboards to monitor KPIs for improvement.
    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Partner/Patient Engagement

    • Ensure that voluntary groups, patient/carer representatives and the local health economy are included in the plans to improve dementia care within the acute environment.
    • Improve communication between the organisation and the local health economy.
    • Work with the local CCGS to ensure that the organisation’s plans are in line with local work plans.
    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • IT Systems

    • Work with the IT department to provide a flagging system on the electronic bed management system.
    • Work to ensure that the electronic safety briefing/ward handover contains information regarding dementia diagnosis.
    • Work towards an electronic solution for data collection regarding the national Dementia CQUIN.
    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Transformation Plans

    • To ensure that the needs of people with dementia and their relatives/carers are taken into account when reviewing services.
    • To provide a specific pathway from front door to discharge for patients with dementia.
    • To take into account the needs of patients and relatives/carers when planning services/environments within the ‘Right Care Fight Here’ work stream.
    Status:
    Initial Scoping

    Update - First Quarter

    Nothing to report - New DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A