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Stag Medical Centre - Rotherham

We are a general Practice serving 11,500 patients. We have one of the highest elderly populations in Rotherham. We have 3 female gp partners and 3 male plus 1 regular locum female part time gp. We have 5 part time nurses and 4 health care assistants. We achieve well in preventing unplanned hospital admissions and endeavour to provide good preventative clinical care for our patients

6 April 2016
Local Alliances:
Rotherham 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?

Though we provide good care for the physical health of our patients we would like to be more proactive in screening our patients regarding mental health issues, in particular dementia.  We have an active patient participation group and I think if we identify patients with dementia, we can provide better and earlier support. We invite someone from the carers resilience service to our monthly long term condition mdt meetings and are able to discuss the most appropriate support for the newly identified patients.   We plan to organise a carer support group to meet within Rose Court Surgery on the afternoon that it closes 


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

Over the past few months after having had the dementia awareness training, all the staff feel they want to do more, so I think there will only be a few challenges. Time is always a challenge but I think the will and effort will be there

2. Actions

  • Increasing diagnosis rates

    Use the worried about memory campaign to advertise within the surgery & on the website.

    Work in partnership with others to screen patients over 50 with long term conditions who may be a risk of developing dementia ,especially elderly house bound .

  • Identification of people with dementia and their needs

    Reassess the dementia register. Ensure all patients are reviewed and offered referral for support to services eg carer resilience assessment direct, VAR, and Alzheimer’s society.

    Flag patients records to indicate when a patient has Dementia and memory problems – smaller practices may consider new employees

    Provide after diagnosis support ,collaboratively working with all relevent services   

    Any other third parties  who are working toward ensuring that People with Dementia live well as they are able                                                                                                                                                                                       Ensure Carers of PWD are registered as a carer and support is offered .Referals Referrals are made to Social Prescribing and Carers Resilience and BME links are made                                                      


    Being implemented
  • Dementia Awareness ,Dementia Friends and Front Facing Customer Care

    Ensure all staff in the practice have Dementia awareness training – this is built in to training plans as essential

    Ensure all staff are signed up as Dementia Friends                                                                                               

    Include concepts and guidance relating to Customer  care from

     AZ Customer front  facing guidance booklet

    We need to improve Front facing customer care. I plan to encourage the enthusiastic reception staff and the patient participation group to work on this aspect.


  • Provision of Information

    Provision of topical notice boards including areas featuring signposting points for People and cares living with dementia

    Create an information pack for newly diagnosed PWD and their carers – including details about the Carers information and support programme  

    Put AZ society and other support services on practice website to give

    Make Dementia Awareness part of the range of features that feature on the television

    Have Dementia Messages on the red screens .

    Worried about your memory ,Dementia Friends ,Support services   

  • Dementia Friendly Physical enviroments

    Have knowledge of good design in relation to dementia – consider designed concepts when changes are made.

    Coloured toilet seats ,ensure signage is a the correct level and dementia friendly.

     .Avoid shinny surfaces and be aware that breaks in carpets and dark spaces can  look like steps and holes

    Consideration given to Dementia Friendly environment’s  when any refurbishment/ re decorating  work is carried out

  • Promotion and Knowledge about RDAA

    Ensure all staff have knowledge of Dementia Action Alliance Rotherham

  • Impove promotion of Sensory Care

    Ensure patients have been advise about eye hearing and dental checks

    Recommend /organise that anyone newly diagnosed to undergo a sight ,hearing and dental check to maximise the person sensory ability and comfort