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Barts Health NHS Trust

We are the largest NHS Trust in the UK serving a population of 2.5 million in east London and beyond. Our Trust, established on 1 April 2012, consists of six local hospital sites: Mile End Hospital, The London Chest Hospital, The Royal London Hospital, Newham University Hospital, St Bartholomew's Hospital and Whipps Cross University Hospital. At Barts Health NHS Trust our vision is to change lives. Our ambition is for east London to have health services in which we can all take pride. These services will reach beyond our hospitals and provide care where it is needed most - at home, in our communities, or in specialist facilities across the boroughs.

11 February 2015
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?

Barts Health is committed to becoming Dementia friendly and in 2013 we developed a Dementia and Delirium Strategy as our vision for achieving this. The strategy is based on seven key principles

  1. Strong ownership and leadership for Dementia throughout the Trust
  2. Care is person centred and individual
  3. Environments that are Dementia friendly
  4. Assessment and early identification of Dementia
  5. Supporting people with Dementia to be discharged back home
  6. Staff are skilled and have the time to care
  7. Strong partnership working with people with dementia, their carers and other agencies

The Dementia Strategy Group meets monthly to coordinate work on the action plan to ensure the key principles are being implemented across the trust and reviewed accordingly. The Dementia Strategy Group also supports the implementation the Dementia CQUIN in all departments of the trust.

As a large organisation our aim is to achieve high quality care for people with dementia on all our hospital sites and working with local voluntary sector organisations is an important part of that. We have links with the Alzheimer’s society in all local boroughs and also work closely with Age UK on specific projects.

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

Our biggest challenge as a large organisation is achieving consistency in the care and resources provided to those living with dementia, between the different hospitals within Barts Health.  Each site has it’s own unique challenges but it is important that patients and carers should expect the same standard of care wherever in Barts Health they are treated. The trust also serves 5 different local boroughs and ensuring information regarding support to people with dementia and their carers remains up to date and appropriate can be difficult. Our hospital environments were not designed with people with dementia in mind and despite some being new environments they require staff to think creatively in order to ensure they meet the needs of our patients.

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2. Actions

  • Initiatives to improve patient and carer experience

    We are currently implementing a number of initiatives aimed at improving the patient and carer experience:

    1. The “Forget me not” resources are currently being implemented within older people’s services to improve communication, interaction and patient experience. The resources encourage staff to be aware of the individual needs, preferences, habits and routines of the people with dementia they are caring for and are a key tool to involve carers.
    2. Key stakeholders in catering, therapies and nursing have been identified for all sites and are currently developing an action plan to support meal provision that meets the needs of people with dementia. This includes the review of specialist crockery and cutlery, appropriate menu choices and the availability of meals at different times of the day.
    3. Regular dementia carer satisfaction surveys are carried out, as part of CQUIN, and the results of these are fed back to the strategy group and trust board. Feedback from the surveys have led to improved carer information available and the implementation of the Forget me Not resources.
    4. We are currently working with volunteer services at the trust to identify roles for volunteers working in wards/ departments to support people with dementia to be stimulated and engaged during their inpatient stay.
    5. Dementia Champions have been identified on all older people’s wards to lead on ward based initiatives to improve care, be a resource for colleagues and carers and link into a network of volunteers across the trust to share best practice.
  • Assessment and early identification of Dementia

    As part of our work to achieve the Dementia CQUIN and improve the identification of people with dementia or memory problems across the trust we are:

    • Introduced an electronic recording form on all sites to record the responses to the Dementia CQUIN and improve our ability to collect data on the numbers of people with dementia admitted to the trust. This in turn will help us to plan and resource appropriately for the future.
    • Training on the importance of identifying people with a formal diagnosis of dementia or those with memory problems who have yet to be diagnosed is happening to groups of staff across the trust, particularly to specialities who would not usually consider dementia “their business”. This is increasing awareness and interest in dementia across the trust.
    • Guidelines in assessing, diagnosing and treating Delirium have been developed and a formal launch of these with a focus on training for Delirium is planned for mid-2015.
    • Geriatricians from Barts Health play an active role in memory clinic in three of our local boroughs which encourages information sharing and joint working.
  • Education and training about dementia

    A Trust Dementia training plan is in place. This is regularly reviewed and progress towards targets set are monitored by the strategy group. Our training plan includes:

    • Mandatory 1 hour dementia awareness for all trust staff (clinical and non-clinical on induction
    • 1 day enhanced training for clinical staff (open to all staff but a requirement in older people’s services)
    • Minimum half day training for all Health care assistants as part of the Care certificate course
    • 5 day course for Dementia Champions with a focus on improving ward based care
    • Bespoke training for individual teams based on their needs e.g occupational therapists, dieticians, cardiovascular MDT, CCU nursing staff, porters

    By the end of March 2015, over 3000 Barts Health staff will have received training in the last 12 months.