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Blackford House Medical Centre

Our Practice is based in Bury. We have over 8000 patients looked after by 4 full time GP’s, 2 Practice Nurses and a team of 22 staff members. We are a teaching Practice, therefore we have a potential capacity for 6 GP trainees, with an average of 4 at any time. Our premises are very easily accessible in terms of transport, with ample parking spaces and a bus line that stops right next to our building. Our waiting area is very specious and all our patients are sat facing the reception area. The staff are able to keep an eye on everybody and they are very good at spotting if somebody is upset or getting anxious. We also have a bathroom next to reception and the staff are always happy to assist if anybody ever needed help. There is always an empty room available where staff would accommodate any patient who is in distress. Our appointment system is run in a way that everybody who needs to be seen on the day has a granted consultation. We also have telephone consultations and we make sure that everybody who needs a home visit is seen on the day.

25 May 2016
North West
Local Alliances:
Bury 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?

The National Dementia Declaration for England has identified 7 outcomes to improve quality of care. These include the right to personal choices, availability of services, support, making patients and carers aware of information, making our environment friendly, home safety and research.

Our role is to assist to all these outcomes and improve quality of care. We are committed to increasing our awareness by providing GP’s and staff with dementia training. The location and facilities in our Practice are already focused on making life easier for patients. We have ample parking and a good reception area. We need to improve on signage and we also need to make information more accessible and easy to understand for our dementia patients. We have a dementia diagnosis and management protocol which is followed by clinicians and ensures quality of care.

We are committed to exploring initiatives to improve psychological support for the patients and carers. We have rooms available and we are looking to liaise with our local 2nd care to provide necessary therapies. As we are in the heart of a very well established small community, we know our patients and relatives very well and we think that we can provide an excellent level of care with the help of our dementia support workers.

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

Although we have already received some training for GP’s and staff, we are aware that dementia care is still far from achieving excellence. We still need more training and need to make sure that our allocated lead GP and staff deliver an adequate support to the rest of the team.

We need a lot of help from partners to make sure that our Practice is fully recognized as dementia friendly and we are willing to any suggestions for improvement. One of our actions is on prescribing monitoring and auditing which is time consuming and we need help from Medicines Management for guidance.

Providing good psychological support to patients and carers involves a lot of effort and liaising with 2nd care and Psychology Departments. We are not sure yet if there is enough staff trained on Psychology Therapies but we are committed to exploring this and taking it forward. We need to make sure that our dementia lead staff is fully supported and able to attend community sessions in order to improve services available for our patients and carers.


2. Actions

  • Full dementia education program for doctors and staff.

    In order to provide the best possible care for our dementia patients and their relatives, we are undergoing a full education program.

    We have allocated a GP lead, Dr C Alier, who has been attending a full education programme on dementia run by our local CCG. This consists of a number of workshops led by two old age psychiatrists. The workshops include diagnosis and management of dementia, prescribing policies, necessary investigations and follow-ups. Dr Alier has shared the information available with his colleagues and he has produced a dementia management protocol. We also have had several learning time sessions on managing behavioural problems. The staff have also received a dementia awareness training session, run by Making Space and lead by Sheelagh Machin and John Pearcey. As a result of this we allocated a member of staff, Olivia, who will be attending some sessions in the community and will be a link person for people with dementia and their carers.


    2016 - Second Quarter Update

    New member - March 2016

  • Identification of people with dementia on the Practice register and identification of their carers. Making sure nobody misses out.

    There are approximately 800,000 people living with dementia in the UK and there are also approximately 670,000 carers of people living with dementia.

    We have already set up a dementia register for the Practice which is being updated all the time as we make new diagnoses in our clinical practice. Our staff are very good at identifying potential dementia patients by noticing changes in behaviour, repetitive questioning, missing prescriptions etc. Once somebody is identified, we follow our protocol diagnosis and enter them in the register. This ensures that they and their carers are seen regularly and that they receive the appropriate level of care. We have full Care Plans in place and make sure that the carers receive a full medical assessment. Once all this is in place we make sure that we have a recall system so that people are reviewed on a regular basis.


    2016 - Second Quarter Update

    New member - March 2016

  • Becoming a dementia friendly GP Practice. Making sure our premises are up to scratch for people affected by dementia using our services

    Our premises are placed in a very accessible area near the M66. We have a regular bus stopping very nearby and parking space is very ample.

    We pride ourselves on a friendly waiting area and the staff try to be approachable and always ready to help. We do have a TV screen in the waiting area and also spaces designated for posters and leaflets. With the help of Making Space we are planning to have dementia awareness slides for the video screen.

    We are also hoping that our dementia staff link, Olivia, will be attending further community events. In this way she will be able to produce an activities programme for patients. This will be shared with our patients through leaflets and our website. We will make sure that the carers are well aware of these events so patients don’t miss out. We are also planning to improve the signage in our Practice with the help of some patients. By a prompt referral to the Dementia Advisory Service we make sure that all our patients receive all the support needed without any delay.



    2016 - Second Quarter Update

    March 2016 - New Member

  • We are committed to good practice prescribing policies and working closely with Medicines Management ensures good level of care.

    We will make sure that our patients receive good care by closely monitoring our prescribing. We already have a protocol in place for managing dementia which shows very clear steps on when and how to prescribe and it is followed by all the Clinicians, GP’s and trainees. We keep ourselves updated by:

          a)Attending ongoing CCG dementia training workshops

          b)In house LTI’s and a regular Journal Club where we discuss current papers

          c)Yearly meetings with Medicines Management

    In order to implement changes, Dr Alier monitors prescribing by auditing. He has already produced an audit on referrals to 2nd care which shows a dramatic reduction. He is currently auditing antipsychotic prescribing and working with our local Consultant Psychiatrist in order to improve outcomes. In this way we make sure that we minimise adverse effects and risks to patients, audits are available on demand.

    Delivery, Implementation

    2016 - Second Quarter Update

    March 2016 - New member

  • People living with dementia and their carers deserve a good quality of life and we are committed to providing the best psychological support available.

    This is perhaps the most ambitious project yet and it is aimed to provide the best psychological support available for carers to improve quality of life for them and their relatives. We have identified different coping strategies to reduced distress of carers.

    These include: Positive approach

    • Solution – focused
    • Positive reappraisal and affective regulation
    • Manual-based coping strategies

    Dr Alier has looked at them in detail and has concluded that manual-based is the preferable strategy. This is provided by trained psychologists in a series of sessions including psyche-education, behaviour management, promoting acceptance, communication skills and future planning. Dr Alier has already contacted Prof. Gill Livingston and Penny Rapaport from University College in London who have trained psychologists in the North West as part of the START programme. Prof. Livingston is happy for us to provide these sessions in our Practice and we will be liaising with our local IAPT to do so.



    2016 - Second Quarter Update

    New Member - March 2016