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Walsall Healthcare NHS Trust

Walsall Healthcare NHS Trust is a provider of local general hospital and community services to Walsall and its surrounding areas. Walsall Healthcare NHS Trust was formed on 1st April 2011, following the integration of Walsall Hospitals NHS Trust and NHS Walsall Community Health. The integration brought together all of Walsall Manor Hospital's services and Walsall's adult and children's community based health services. By bringing these services together the Trust is now able to provide patients with the best possible patient experience - moving them smoothly through the different stages of treatment and care. This is being done through an increasing number of integrated care pathways that support the key needs of acute illness and the full range of long term conditions as well as the needs of an increasing elderly population.

10 April 2017
West Midlands
Medical, Health, Care, 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 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?

We have a dementia project lead, identified dementia champions within the organisation and a dementia steering group that meets monthly to formulate and action plan to achieve the outcomes of the national dementia strategy.  The work is ongoing and progressive; it involves the organization and partner agencies to endeavour to meet the needs of the local population with dementia and their carers.  The action plan incorporates involvement of patients and carers in development of services, which should meet the dementia declaration’s outcomes 1, 2, 5 and 6.  We have developed an integrated pathway for patients with dementia, which should meet outcomes 2 and 3.  Outcome 4 is well provided for by our partner organizations (e.g. Alzheimer’s UK ) so we need a commitment to work closely with them and make use of the information that is available to promote services for our patients; this is also part of the dementia steering group action plan.  The commitment to outcome 7 is demonstrated by having a medical lead for dementia care, where research implementation and engagement is part of care delivery.  Working closely with our partner organizations is also a supportive mechanism to promote the research agenda.

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

Promoting patient and carer participation in care planning and delivery as cognition declines, the action plan and integrated pathway set the scene for this work but the evidence of success will be demonstrated by patient outcomes.

Logistics can be challenging in an environmental sense but by making positive changes that are easy to implement will start promoting the agenda, which can be developed as resources allow.

Research involvement is a challenge as much of the evidence base around treatments is initiated by mental health colleagues, which is a separate organization.  We need to have a system in place where information sharing around research and recruitment is a shared approach.  Also, research into other areas, such as nursing care or non-pharmacological approaches should be explored.  There is a reliance on national organizations to drive this forward, so we need communication channels in place to commit to supporting these initiatives where appropriate.

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

Achieving improvements in dementia care in a time where funds are tight and resources are limited. Though staff are keen it is difficult to generate committment to additional responsibilities when capacity to provide services is so stretched. Staff are committed to providing high quality care, they need the support to develop their skills. Measuring outcomes is difficult without the resources to gather the data necessary.

2. Actions

  • Engage with patients and carers to improve services

    To engage with patients and carers and partner organizations to identify how services can be improved and work out ways to address issues.

    The Trust continues to utilise carer questionaires as a mechanism to seek views on how they have felt supported by staff while their loved one has been in hospital.

    weekly Dementia cafe held weekly

    Trust sign up to Johns campaign and visiting policy updated to support adjustments to enable Carers to support. the care of their loved one in hospital


    2016 - Fourth Quarter Update

    the carer questionaires continue to be used as a means to seek the views of carers in relation to how they felt supported. Complaints and concerns recieved have been reviewed each quarter by the trust dementia steering group to identify any themes that need to be addressed.

    During the month of March throughout all of the Dementia cafes across Walsall- we have celebrated Dementia UKs ‘Time for cuppa Campaign’ we held an information stand concentrating on the Dementia cafes held within the hospital and raising awareness of Dementia in general at the disposal of all staff and patients.

    2016 - Third Quarter Update

    The carer questionaire feedback is reported / discussed at the Trust dementia steering group to identify key themes and areas for improvement. it also allows positive feedback to wards on how carers felt supported and engaged in care delivery.Return of the questionaire is predominately via our volunteer organisations  who sit with the carers to complete the questionaire post discharge.

    The weekly dementia cafe and tea parties- both delivered by volunteer organisations provide an arena for discussion and feedback to the Trust.

    2013 - Third Quarter Update

    We have consulted with carers around a carer questionnaire to use in the clinical settings to identify where support may be needed and to initiate sign-posting to other agencies. Carer support is a focus of the education we are delivering around dementia care, to give staff insight into the difficulties faced by carers and how the National Strategy and our new local provider strategy acknolwedges the importance of carer recognition and support.

  • Develop services

    To develop services sensitively with consideration of patient need and organizational resources


    2016 - Fourth Quarter Update

    The older peoples mental health lisaion team have commenced 7 day working and are prioritising A&E at the weekends with the aim to avoid admission.

    The older peoples mental health liasion team manager arranged for the  My Life Dementia Improvement Network Conference  to be  held at the hospital 08/02/17- the conference was well attended, and due to the positive feedback the conference will be an annual event at the hospital.

    The team were able to demonstrate and show case the 'nameste room' and discuss the principles behind nameste and the training that had been delivered to staff to be able to deliver this within the clinical areas to support patients.The  had been listed in the Dementia Times as being the first Trust to use Namaste

    The staff within the Retail outlets within the hospital have attended  'dementia friendly communities sessions held to enable staff to become dementia aware and be able to display a kite mark logo  that was chosen by people with dementia and their carers in Walsall who attend some of our seven dementia cafés. These sessions have also been delivered to departments across the site and our volunteer shops.

    2016 - Third Quarter Update

    The older peoples mental health liasion team  has been developed  and are now well established within the Trust. They support within the hospital setting but also support adults within the community rehabilitation units .They have supported with staff training in relation to the identification and management of delirium and management of behaviours which challenge to clinical and non clinical staff across the workforce.Working alongside the dementia support workers  and volunteers to focus on therapeutic activities thereby reducing the need for pharmacological therapies.The use of My Life soft wear is active across the trust.As the team support A&E they are actively involved in preventing admissions, similarly, reducing length of stay if the patients are admitted.

    2013 - Third Quarter Update

    We have worked with commissioners to develop a team for older people's mental health liaison service. They focus on patients with dementia in an acute setting and work with the patient and staff to identify reasons for behavioural and psychological symptoms of dementia. They focus care interventions to address the challenge, using dementia support workers and volunteers, therefore minimising the use of pharmacological therapies.

  • Promote information sharing so that services are accessible to all

    To promote information sharing with all patients, staff and partner agencies so that appropriate care, services, technology and support is accessible to all


    2016 - Fourth Quarter Update

    the steering group membership continues to reflect multi-agency involvement- Mental health, volunteer organisations, CCG, Student nurse.

    National dignity was used as a focus to re-launsh the trust revised record of behaviuor charts which give staff more guidence and clarity on how the use the forms effectively in order to give good outcomes for trhe patient.

    Early recognistion of end of life  for people with dementia has been a focus during this quarter.The palliative care consultant  is supporting and working with the clinicians within the hospital around managing the uncertainty around the illness in the hospital. Externally, the use of the advanced care planning is being promoted.

    2016 - Third Quarter Update

    we have worked with partner agencies to promote the 'dementia friendly communities initiative' across the Trust retail outlets. In addition, these sessions have been attended by the Trust volunteers who support across a variey of roles within the Trust.

    The CCG has supported The Trust by the  increased the number dementia support workers  and expansion of the older peoples mental health lisaion team.The my life soft wear is being utilised across ward areas  to support therapeutic activities   with the dementia support workers taking the lead on the 'my life' development with patients cand carers.

    bespoke 1 day training sessions have been delivered  to all the trust security guards around the needs of vulnerable adults across the Trust and part of this study day is a session on dementia awareness and behaviuoral and psychological symptoms of dementia.They have also recieved a 'dementia friends' session delivered by a group of students who have been supporting the Trust dementia programme.

    Support services staff, attend a bespoke session tailored to their needs.

    Dementia champions continue to be support care delivery across the organisation- hospital and community  and attend bi monthly meetings.

    The Trust has recruited volunteers who have specifically requested to support patients with dementia. These volunteers have accessed dementia awareness training and training in relation to supporting patients with nutrition and hydration on the wards when required.

    all activities is feedback into the trust demtia steering group which has members from acute trust, community, CCG, Mental health Trust, volunteers and university/ student representation.

    2013 - Third Quarter Update

    We have worked with partner agencies to evolve the role of the dementia support worker within the acute setting, a primary source of information sharing for patients with dementia and their carers. We continue to promote the Dementia Champions initiative where key staff are informed on specific information on dementia services so that they can share with their teams. We have commenced a development programme to educate clinical and non clinical staff around care of patients with dementia so that service delivery is equitable and individual for the specific needs of the patient.

  • Creating a dementia friendly environment

    To nurture a positive attitude towards dementia, promoting the notion that people with dementia have a valuable role in society; simultaneously reducing stigma and raising awareness


    2016 - Fourth Quarter Update

    Dementia friendly communities sessions continue to be delivered across the trust departments.

    Members of the steering group have veen invited to join and take part in the monthly  PLAICE  (environmental audits)

    Any on going decorating within wards / departments are based on dementia friendly principles

    2016 - Third Quarter Update

    The dementia friendly communities sessions allow the staff to review their environments to become 'dementia'friendly.

    The estates and facilities departments ensure that any new builds have 'dementia friendly' designs at the forefront.

    Any on going decorating within wards / departments are based on dementia friendly principles

    2013 - Third Quarter Update

    We have ongoing Dementia Awareness and Dementia Friends sessions to reduce stigma around dementia. Our Estates and Facilities Department are working to make the acute setting dementia friendly, with painting and decorating war areas, clear signage, accessories such as clocks and orange crockery.