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East Leicestershire and Rutland CCG

East Leicestershire and Rutland Clinical Commissioning Group (ELR CCG) have full responsibility for commissioning healthcare services for residents in Blaby, Lutterworth, Market Harborough, Rutland, Melton Mowbray, Oadby and Wigston and the surrounding areas. ELR CCG also have responsibility for managing an NHS budget and monitoring contract performance of the services we commission. Our CCG is formed of GPs from 34 practices in the south and east of Leicestershire and Rutland serving around 315,000 patients. ELR CCG is led by a Governing Body comprising elected GP members, a secondary care clinician and lead nurse, independent lay members, representatives of Healthwatch and senior managers. It is supported by a team of staff overseeing the daily business of the CCG.

15 January 2016
East Midlands
Clinical Commissioning Group
Local Alliances:
Leicester, Leicestershire and Rutland Dementia Action Alliance , Blaby District 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?

ELR CCG has a vision to improve health by meeting our patient’s needs with high quality and efficient services led by clinicians and delivered care closer to home.

ELR CCG is committed to supporting people with dementia and their family carers to be able to live full, active and independent lives. Working in partnership with our local authorities we will support the memory service which aims to support people with dementia and their carers to maintain their independence and to continue to live at home. It is acknowledged that delivery of dementia care should be embedded into health and social care delivery across all health and social care sectors. We will continue to work across all disciplines of care, evaluating and reviewing service delivery, To ensure dementia care is embedded into service delivery within primary medical.

A programme of development has been undertaken within primary medical care to support practices with a proactive approach to the timely assessment and support for patients known to be at risk of dementia. The aim has been to encourage and work with practices to assess patients who may have dementia in a more structured way, such as appropriate referral to a memory assessment clinic, care planning, maintenance of adequate records, assess and review patients.

 This has involved close links with community health services and local authorities We will continue to develop primary medical care to develop the care of dementia with general medical practice as well as work closely with community and secondary care to ensure dementia has a key focus on care delivery.

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

Timely diagnosis of patients with dementia

Stigma attached to Dementia preventing people addressing memory concerns

Post diagnostic support services for patients with dementia and carers isnt clearly signposted 

There are differing levels of awareness and education of dementia across CCG and primary care services staff 

2. Actions

  • Increasing diagnosis in primary medical care services

    Regular communications  and support to GP Dementia leads by sharing of best practice

    Being implemented

    2015 - Fourth Quarter Update

    Continued regular targetted communtications to GP leads including off the shelf toolkit developed for GP practice memory awareness days and other dementia articles and toolkits

    •GP Locality Forum agenda slot January 2016 to discuss dementia patients in care homes and promote dementia screening in addition to LD checks.

  • Advanced Care Plan for Dementia patients

    Multi-agency workshop to devise a fit for purpose Care plan specifically for patients with dementia 

    Being implemented

    2015 - Fourth Quarter Update

    Now booked for 10th February with Sir Alistair Burns (National Dementia Lead) facilitating. All major stakeholders in LLR invited.

  • Education and awareness training

    Increase awareness and education of ELR CCG and Primary Medical Care Services staff of dementia

    Being implemented

    2015 - Fourth Quarter Update

    Protected Learning Time event now confirmed Dementia as topic for June 2016.  GP, Nurse, HCA and Managerial learning sessions.

    •Dementia patients carer case study video to be shown to ELR CCG Governing Body March 2016 pan>

  • Improve sign posting of post diagnostic services

    Localised resource packs developed for practices to give to patients and carers

    Initial Scoping

    2015 - Fourth Quarter Update

    Local services and contacts gathered and a workshop session is booked on the 10th of Feb to add any other additional services.

    •Sir Alistair Burns facilitating multi-stakeholder Dementia Workshop February 2016 with aims to •Develop a multi agency recognised care plan template •Map the impact on current services of increased dementia diagnosis •Scope different service models? •Scope post diagnostic support