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Maidstone & Tunbridge Wells NHS Trust

Maidstone and Tunbridge Wells NHS Trust is a large acute hospital trust. We provide a full range of general hospital services to around 500,000 people living in the south of west Kent and parts of north east Sussex.

Updated:
9 December 2019
Location:
South East
Sectors:
Care, Communication, Health, Medical, 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 carers. How would you describe your organisation’s role in delivering better outcomes for people with dementia and their carers?

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? 

Maidstone & Tunbridge Wells NHS Trust is fully committed to meeting the Dementia statements appropriate to our services. Our role is pivotal in working within our own teams to:   

Ensure that all people with dementia in our care are seen and recognised as individuals and not a condition. With the ability to make choices about their lives and supported to do this.

We have an active collaboration with other members of the emergency services to assist in supporting people with dementia and their carers in the community and reduce uneccessary hospital admissions.

Our training is mandated across the organisation for all staff pertinent to their role, in line with HEE Tier 1 & Tier 2 training.

We report quarterly on any incidents associated with people with dementia within the organisation with a plan to reduce these and identify any common themes.

We are fully committed to working closely with carers, family and friends of people living with dementia to ensure they are equipped and supported both practically and from an information perspective so that people with dementia are properly cared for in their own homes, wherever that may be.  This involves working in partnership with external agencies such as our social work colleagues, community liaison teams, charitable and voluntary organisations. To ensure that all of us work towards shared goals that are person-centred.  This is evidenced through the membership and activities of the Dementia Strategy Steering Group. 

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

The Trust has an active Dementia Strategy Steering Group to deliver this strategy .  Challenges for the organisation include: 

Seeking adequate funding – both capital and revenue funding is a limited resource within the Trust with departments also required to make savings year on year.  Funding for dementia care can therefore be a challenge. The practicalities of delivering changes in the environment – major building works are required in some areas to deliver the improvements.  Available space to provide some of the planned initiatives is limited and is therefore considered in ‘competition’ with other bids.  Limitations exist within the PFI arrangements that potentially can hinder initiatives.  Releasing staff – to release staff from the clinical areas for an adequate amount of time to deliver the improvements is a potential challenge.  This includes allowing and rostering people time away from their work place for education and training activities.  Balancing this whilst continuing to deliver our core operational business can also be challenging. 

2. Actions

  • Maintaining appropriate flow through the hospital

    We have a work stream currently to look at the flow of people with dementia through the hospital to ensure that they are treated in the right place, first time where possible.

    Our work is starting in A&E, to ensure that decisions to admit are exactly that and if there are alternative pathways of care and support available in the community these will be followed.

    The decision to admit will then be based on predictive length of stay, if less than 48 hours, then the most appropriate pathway is to an assessment area. If greated than 48 hours then the most appropriate pathway is to an inpatient bed. Ensuring care is given in the most appropriate environment and thus reducing ward moves within the organisation.

    Ward moves are being monitored through our best quality dementia work stream, to ensure we reduce unecessary ward moves for people with dementia.

    Status:
    Implementation
  • Mandatory dementia training for all staff

    Our dementia training is now mandated for all staff within the organisation and meets the requirements of HEE Tier 1 & Tier 2 training. The level of training mandated depends on the individuals roles and responsibilities within the organisation, however we aim to ensure that 85% of staff employed have received Tier 1 & Tier 2 training commensurate to their role.
    Status:
    Delivery
  • Raising Staff awareness with regards end of life care and dementia

    To work with the palliative care team with regards providing support to staff on end of life care for dementia patients. Increasing their awareness through training and education and also confidence in conversations with patients and carers. Ensuring staff are aware of the various tools available, including advanced care plans, advanced directives, power of attorney etc.

    Status:
    Implementation

    2019 - Third Quarter Update

    End of life care training is included within the Tier 2 training to staff to assist awareness. All wards also have a palliative care nurse assigned to them to assist in supporting and educating staff in palliative and end of life care.

  • Collaboration with Emergency Services Colleagues

    We are committed to working with our emergency services colleagues to empower and educate staff to understand the services available to people with dementia and their carers to support them within the community. Thus reducing uneccessary hospital admissions and allowing people to continue with day to day and family life in their own environments.
    Status:
    Delivery