NHS West Kent Clinical Commissioning Group

NHS West Kent Clinical Commissioning Group (CCG) is a body of GPs and other healthcare professionals, responsible for commissioning healthcare services across the west Kent region with a budget of £472m. We represent over 250 GPs and 463,000 residents. We recognise that by working together, we can design and provide better services for everyone. The mission of NHS West Kent Clinical Commissioning Group is: A safe, sustainable and affordable patient focused healthcare service that provides quality patient experience and improves outcomes for local people. The Group’s aims are to deliver the following improvements to services for local people over the next three years: - A thriving local NHS provider landscape for the West Kent population which delivers safe and high quality urgent and non-urgent care, in particular: • To work with MTW to support them to be a Foundation Trust in the top quartile in terms of productivity and safety - Improved patient and carer experience for End Of Life Care, in particular: • To develop a quality of care focus with increased levels of advanced care planning - Improved and integrated health and social care packages for the elderly population, in particular: • To align community health and social care team around clusters of practices to improve the integration of care and keep people out of hospital - To support and enhance healthcare provided by General Practice, in particular: • To develop a collaborative commissioning contract with primary care and community services, that reduces health inequalities, and achieves better outcomes - Engaged and empowered patients who are able to manage their own health and make informed decisions, in particular: • To develop peer support for long term carers and PPGs to work with schools and the media - Improved Value for Money and outcomes for Mental Health conditions including dementia, in particular: • Developing improved community based services that support individuals manage their mental health problems without the need to be admitted to an inpatient bed.

Updated:
5 May 2015
Location:
South East
Sectors:
Hospitals and Hospital Trusts
Local Alliances:
Kent Dementia Action Alliance, West Kent 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 carer’s. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carer’s?

NHS WK CCG commissions high quality and effective services for people with dementia and their carers.  NHS WK CCG are committed to commissioning integrated services across West Kent which improves outcomes for people with dementia. WK CCG also commissions some services with the voluntary sector in West Kent. 

WKCCG is working collaboratively with a number of organisations to deliver better care for people with dementia and their carers.

In alignment with the NHS England initiative GP’s in West Kent have signed up to deliver the Specification for a Directed Enhanced Service (DES) for facilitating timely diagnosis and support for people with dementia.

General practices are implementing integrated working through multi – disciplinary teams which proactively identify people with long term conditions, including dementia. People with dementia are supported in a holistic approach by the GP, community team, social services and mental health trust. 

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

There are currently 9,200 people living with dementia in Kent, and this figure is set to more than double over the next 30 years.  The proportion with severe dementia increases from 6.3% for those aged 65-69 to 23.3% for those aged 95 and over. 

Regarding dementia diagnosis rates West Kent CCG is ranked 128th out of all England CCGs (rank 1 has highest % of patients on register).  In order to meet the national target of 65% of people with dementia being diagnosed by 2015 an additional 1,112 people would need to be diagnosed with dementia, where the current diagnosis rate in West Kent is 44.4%. 

70% of GPs (up from 50% a few years earlier) feel they have too little time to spend on people with dementia, there were over 7 million primary care consultations in the UK due to dementia (only 3% of all consultations) with nearly 50% consisting of GP home visits. This cost over £317m (West Kent: £2.4m).

In addition every day up to 5 people die and 4 people suffer significant avoidable complications as a result of taking medications for dementia that add no value to their quality of life

2. Actions

  • Commissioning effective and high quality care in the community for people with Dementia and their carers

    NHS WK CCG is committed to commissioning effective and high quality care in the community for people with Dementia and their carers in West Kent to improve their physical, emotional and social wellbeing. This includes the commissioning of the mental health trust, community trust and voluntary sector for the provision of services which support the identification, management and treatment of dementia in primary care

    Status:
    Implementation

    2013 - Fourth Quarter Update

    New member

  • Reducing the inappropriate prescribing of anti-psychotic medication for people with dementia

    The inappropriate use of anti-psychotics in people with dementia is associated with 1,800 deaths every year (DoH, 2009).

    Training is being delivered to GPs and other primary care staff regarding the inappropriate use of prescribing anti-psychotics for people with dementia. This includes the provision of non-pharmacological interventions before prescribing medication, through reviews of existing prescribing and implementation of new guidelines on use of antipsychotics for people with dementia.

    Moreover there is a focus on training care homes in WK regarding anti-psychotic medications. Medication when used appropriately can significantly improve the physical and mental functioning of older people in residential care. However, inappropriate medication can have serious consequences in this vulnerable population.

    Status:
    Delivery

    2013 - Fourth Quarter Update

    New member

  • To increase dementia diagnosis from 44.4% in West Kent to 66% by 2015

    It is suggested that through receiving an early diagnosis of dementia, people will be able to make informed choices regarding their care and treatment whilst they have the mental capacity to choose for themselves. Advance care plans can be discussed, agreed, documented and shared with professionals involved in the care of the person with dementia. Carers can be supported to understand dementia, be advised of the range of services available and who to contact in a time of crisis. 

    Status:
    Implementation

    2013 - Fourth Quarter Update

    New member