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University College London Hospital NHS FT

University College London Hospitals NHS Foundation Trust (UCLH) is one of the most complex NHS trusts in the UK, serving a large and diverse population. In July 2004, we were one of the first NHS trusts to achieve Foundation Trust status.We provide academically-led acute and specialist services, to people from the local area, from throughout the United Kingdom and overseas. UCLH is committed to delivering top-quality patient care, excellent education and world class research.

Updated:
13 March 2014
Location:
London
Sectors:
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?

University College London Hospital NHS FT is committed to delivering and improving excellence in the care we provide for patients living with dementia, including their carers and families. The trust is working hard to improve and implement all seven of the DAA outcomes.

Within the trust we have already started to make progress in the following ways-

Team-

  • Within the trust we have a nurse consultant Vicki Leah who is our dementia lead, and works very closely with the older adult assessment team.
  • The trusts older adult assessment team, is made up of two Clinical nurse specialists (CNS), and an occupational therapist. This new team has been successful in achieving then National Dementia CQUIN targets, however, their success has been far more reaching. Their constant presence on wards and in departments has raised the profile of this patient group and their different needs. An excellent example comes for our pre-assessment clinics both on the UCLH sit and at The Heart Hospital. Here all patients over the age of 74 have a memory test using the 4AD tool, firstly to identify anyone with a potential undiagnosed dementia and secondly to help identify those more at risk of post operative delirium.

Environment-

  • The trust has already made some significant changes to the environment. This includes clear signage for people with dementia to find their way around an unfamiliar environment. These can be found in the outpatient department, ward areas, including the care of the elderly wards, and other departments.
  • The trust have implemented dementia friendly bays, currently we have a male and female bay on the care of the elderly ward, and hope to achieve the same in other departments in the trust.
  • Our new minors area in the ED is dementia friendly
  • New dementia friendly bays in the Acute Medical Unit

 Training-

  • We now have 8 nurse dementia trainers running a number of courses care across the trust.
  • Three day and one day dementia course are run monthly for all staff. All nurses working on the older peoples ward, acute medical unit and orthopaedic are encouraged to attend the 3-day course. Uptake is excellent.
  • The older adult CNS team run a number of small one hour sessions that are department specific, aimed for clinical and non clinical staff members.
  • We are working with University College Partners to achieve their target of providing 12,000 health care staff with dementia awareness training. Our target is 1000 by March 2014. We are well on our way with this.
  • Safe guarding vulnerable adult’s e-learning is now part of the mandatory induction.
  • We have recently run a Making specialing special study day for our Pulse bank nursing assistance to enhance the therapeutic effect of their care.

Influencing change-

  • Within the trust we provide a number of documents to help drive patient centre care and ensure that we know the person behind the dementia. We use a Forget-me-not sign to identify people with dementia; these are displayed behind the patient bed and on patient’s notes. We use an adapted ‘This is me’ document along side an activities of daily living document.
  • All patients over the age of 74 (emergency or elective admissions and in out-patients) are asked about their memory
  • We also value carers and family input and use their knowledge and experience when caring for patient with dementia.
  • Each ward and department have dementia champions to influence change within their work area.

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

  • University Collage London HospitalNHS FT provides specialised services and care for patients across seven different hospitals. One challenge will be to implement and influence change across all the UCLH sites.
  • Meeting the National Dementia CQUINN targets, even though the older adult CNS team are on target to achieve the standards set, their time has been taken up with data collection. Our challenge is to ensure targets are accomplished whilst releasing time to improve other areas of dementia care.
  • The trust has a number of trained dementia trainers that run training sessions across the trust, the challenge still remains being able to release staff from the ward and departments to attend the sessions.
  • There are constant barriers when implementing any changes that involve the hospital environment and the main building work. This is due to the hospital being owned by a private financial investor and the process to change the hospital environment can be extensive.

2. Actions

  • Making a difference in timely diagnosis of early stage dementia

    As the National Dementia CQUINN continues this year we look to achieve the targets, whilst making a difference in timely diagnosis of early stage dementia. We aim to support the patient through this, as well as their carers and families.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Continue to educate and train all UCLH staff

    To utilise the role of the older adult CNS to influence change, continue to educate and train all UCLH staff. We hope the older adult CNS will play a key role in ensuring patients within our trust receive personal and individual care they require, always listening and including patient, carers and families.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Dementia Champions

    Using the dementia champions to influence change on a ward and department level. Champions need to have completed the 3-day dementia course and shown they demonstrate the Trust values and have influencing skills. Very quickly one can see to work of the ward champions. Well-being assessments are completed on our gastric ward where due to complex medical and surgical condition patients may need to be in hospital a long time, knowing how they are fairing psychologically is very important. On our acute stroke unit the champion noted that all patients with dementia had “end stage dementia” written in their notes, she did a quick pieces of work to find out how best to stage dementia for her patients and is currently trying to educate and influence her medical teams in the FAST assessment tool.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • Continue to raise money to make a difference for people living with dementia.

    The Dementia Care Charity has been set up to raise awareness and funds to help support and care for people living with dementia and their families. We hope we can continue to raise money to make a difference for people living with dementia.

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • To continue making changes to accomplish our dementia friendly environment

    To continue making changes to accomplish our dementia friendly environment. We hope to make improvements to the current dementia bays already in place by having dining areas for patients and their families to improve their meal time experience. Along side this we aim to set up quiet day rooms for patients with dementia and their families so they can escape the busy ward areas. We hope to achieve this by putting in a bid for dementia friendly hospitals. 

    Status:
    Implementation

    Update - First Quarter

    Nothing to report - new DAA member

    Update - Second Quarter

    N/A

    Update - Third Quarter

    N/A

  • A greater emphasis on raising staff awareness of the needs of family and friends of people with dementia

    A greater emphasis will be placed on raising staff awareness of the needs of family and friends of people with dementia and how they can help us deliver the care the patients needs. To achieve this we have run two 2-day development days for the nurses on the older people ward and used role players to help develop their communication sills with family and friends who are in a state ff worry about their loved ones.

    Status:
    Implementation

    Update - First Quarter

    New Member

    Update - Second Quarter

    New Member

    Update - Third Quarter

    New Member