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Lincolnshire Partnership Foundation Trust

LPFT provide specialist health services promoting recovery and quality of life through effective, innovative and caring mental health, social care and specialist community services.

Updated:
28 January 2014
Location:
East Midlands
Sectors:
Health, Care
Local Alliances:
Lincoln Dementia Action Alliance, South Lincolnshire 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? 

Lincolnshire Partnership Foundation Trust (LPFT) is the major provider of Mental Health (MH) Services for people with Dementia across the whole of Lincolnshire. The largest population areas are Lincoln. Boston, Grantham, Sleaford, Stamford, Spalding, Louth and Skegness. The service complements those services provided by the four Commissioning Care Groups and the Local Authority Teams. 

We at present have access to around 60 in-patient assessment beds for people experiencing dementia experiencing acute need, and provide eight Community Mental Health Teams (CMHT’s) to assess, diagnose and support community based needs. These, serve an estimated population of just over 10,000 people with Dementia countywide.  In addition, 3 of our CMHT’s also provide MH Liaison staff to support people experiencing dementia within acute hospital settings – at Boston, Lincoln and Grantham. These have recently been supplemented by the introduction of Intensive Support nurses to work within both A&E departments and alongside our liaison staff on the wards to promote hospital avoidance and/or timely discharge. Also within the CMHT, dedicated MH Intermediate-care nursing staff provide countywide support to mainstream Community Response & Rehabilitation services (CR&R) to support hospital avoidance and segue with acute-hospital in-patient colleagues to enable access to rehabilitative services for people with dementia and reduce hospital length of stay. As part of the National re-enablement initiative we are also currently participating in and evaluating a pilot scheme that has sought to provide exclusive mental health support to Nursing and Residential Care Homes within a locality. Via this scope of responsibility and service delivery we interface with high numbers of people experiencing dementia of all stages of severity and need at crucial points of the care-pathway. At these points it is crucial that we embed the elements of the NDD inform both the ethos and content of delivery. Most crucially, how we deliver information to ensure involvement and control for the people using our services. 

Whilst at present the services provided encompass both people with dementia of any age and people over 65 years with a so-called functional MH need (e.g. depression, anxiety, psychosis etc.) from November 2012 the Dementia Service will become part of the Trusts Specialist Services Division, and from April 2013 the service will exclusively deliver Dementia focused care. This specialist focus within the Trust will provide us the opportunity to re-design the services from top to bottom with a specific dementia ethos -such as that outlined within the NDD. Furthermore, as a specialist service working across multiple organisations we see a key role to be that of educating and empowering others (individual, societal and organisational) in terms of dementia awareness and preventative practices, and best practice with regards dementia assessment, care management and treatment. In this sense our key role is not just the delivery of services but to provide the expertise to others to do so as well.

Herein, we are committed to enhance community provision working exclusively with a number of partner organisations including the third sector using whole system methodology.

 

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

The biggest challenge is the scale of the problem. The elderly population of Lincolnshire continues to increase above that of the National average, and with this the age-associated risk of dementia – with a predicted 43% increase by 2021. Add to that the county’s size and rural nature with limited transport infrastructure and we are faced with a large, aging and dispersed target population to identify and support  in-line with a demanding National and local agenda. Primarily for our services this entails the expectations around increased detection rates and early diagnosis as set out in the NDS (2009), the desired reduction in antipsychotic use (DoH, 2009), and the meeting of both NICE (2011) and national and local dementia CQUIN targets. 

In terms of service delivery our primary focus is upon ensuring a greater focus on individualised care planning, with greater dispersal of knowledge to and enhanced management by people experiencing dementia and their family and significant others. This will be delivered via increased service user engagement and education and development of more   health promotional and psychosocial oriented interventions – that is, a more partnership/collaborative ethos that engages and maximises the total professional and social potential around the person experiencing dementia. 

Although the economic climate is difficult at present, this this brings opportunities as well as challenges. Of the latter we feel the galvanisation of services and bringing together of like-minded providers closer in more robust partnership arrangements is one. Whilst this represents a considerable challenge we feel this is an attainable objective. There is no doubt that this will lead to better outcomes in a cost effective way whilst also focusing on reducing the issues of duplication and waste. 

2. Actions

  • Increased detection of dementia

    1. Increased detection of dementia (from current 40% rate) (NDS, 2009)

    Status:
    Implementation

    2013 - Fourth Quarter Update

    In progress

    2013 - Third Quarter Update

    In progress

    2013 - Second Quarter Update

    In progress

    2013 - First Quarter Update

    New member

  • Provision of good quality information

    2. Provision of good quality information – to support dispersion of responsibility/control over care management (NDS, 2009)

    Status:
    Implementation

    2013 - Fourth Quarter Update

    In progress

    2013 - Third Quarter Update

    In progress

    2013 - Second Quarter Update

    In progress

    2013 - First Quarter Update

    New member

  • Good quality diagnosis and intervention

    3. Good quality diagnosis and intervention – with initial assessment within 2 weeks (CQUIN, 2012/13)

    Status:
    Implementation

    2013 - Fourth Quarter Update

    In progress

    2013 - Third Quarter Update

    In progress

    2013 - Second Quarter Update

    In progress

    2013 - First Quarter Update

    New member

  • Improve the standard of care

    4. To improve the standard of care and management in care homes for people experiencing dementia (NDS, 2009)

    Status:
    Implementation

    2013 - Fourth Quarter Update

    In progress

    2013 - Third Quarter Update

    In progress

    2013 - Second Quarter Update

    In progress

    2013 - First Quarter Update

    New member

  • Reduction in use of antipsychotic drugs

    5. Reduction in use of antipsychotic drugs in dementia (DoH, 2009) and improved access/provision of/to non-pharmacological interventions (NICE/SCIE, 2006).

    Status:
    Implementation

    2013 - Fourth Quarter Update

    In progress

    2013 - Third Quarter Update

    In progress

    2013 - Second Quarter Update

    In progress

    2013 - First Quarter Update

    New member