Bramingham Park Medical Centre
We are a small suburban general practice providing primary care services to nearly 6,000 patients.
- 10 June 2016
- East of England
- Clinical Commissioning Group, Community organisations, Health, Medical
- Local Alliances:
- Luton 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?
Our organisation is already involved in supporting patients and their support networks with dementia. We encounter the issue before diagnosis, during the initial presentation and diagnosis and then beyond.
If organisations such as ours can improve how we support people affected by dementia and help us to better deliver the better outcomes declared by the National Dementia Declaration then the positive impact for the hundreds of patients we have (and then their relatives and carers) could be huge. Should other GP practices be able to improve then the cumulative impact across a region, or country, could be massive.
The presence of support services like the Alzheimer’s Society in the practice could be powerful, as we are so contained in the time we can provide to any one patient and having this source of support in an environment that is familiar for the patients and easy to attend is a huge asset.
2. What are the challenges to delivering these outcomes from the perspective of your organisation?
As a medium sized general practice we have limited direct influence over how wider services are designed and delivered. For instance, we continually try to improve our in-house systems so that they are more tailored and flexible for our patients with dementia but may not be able to influence other services they will likely need to become involved with. Nevertheless, we are actively involved with our Clinical Comissioning Group and have regular Multi-Disciplinary Team meetings, which help in this issue.
We are also limited at times by the availability of carers and family members, who are key at each and every stage of the illness from presentation and diagnosis to the on-going management and support. We rely hugely on their input, information and support and there will inevitably be times when they cannot be there. We therefore strive to communicate effectively with relatives and carers when they are not available.
Another realistic difficulty is that, as well as providing care to people with dementia, we have many other demands to meet and manage as a surgery and we are bound by time constraints and the resources available to us.
Increase dementia awareness with staff and patients
A Dementia Friends information session to be delivered to Bramingham practice staff 12:00 on Weds 16th March during protected learning time
By informing all staff about the holistic issues relating to our patients with dementia, we will be able to offer a more sensitive service to them.
Appointment Management to reflect the needs of people affected by dementia
We keep an up to date list of patients with additional needs and publish a list for all staff to be aware. Patients with dementia to be included on this list, with reminders to have afternoon double appointments.
- Being implemented
Dementia Friendly Environment
We will review the dementia friendly environments check list http://www.dementiaaction.org.uk/dementia_friendly_environments_checklist.pdf
We will request a person living with dementia and their carer “walk through” the practice and feedback their opinions on the environment to enable us to include their views.
- Initial Scoping
Encourage early and accurate diagnosis in primary care, especially in the high risk groups
To refer to the guide “Helping you to assess cognition: A practical toolkit for clinicians”
Support for carers of patients with Dementia
We will identify the carers of our dementia patients and ensure they too are invited for flu vaccines. We will need to check whether the current search criteria includes them.
The set-up of a monthly Alzheimer’s Society Dementia Support Worker clinic will also greatly benefit carers in practical and emotional support. We will write to all patients on our dementia register informing them once this service has been scheduled.
Ensure that practice staff are able to identify and support patients who have Dementia and care for them with dignity and respect
I believe a combination of
- Better signage/environment
- Alerts / awareness of affected patients
Will automatically lead to better support for patients at the surgery. The layout of the reception means the view of the front door is obscured for confidentiality reasons – and so patients would not be immediately visible on arrival, which is a disadvantage.
Training for doctors to deliver on the action “ I will die free from pain, fear and with dignity, cared for by people who are trained and supported in high quality palliative care. “
Increasing clinician’s and other professional’s confidence in palliative care for dementia patients is vital to foster dignity and respect at the end of life. There is a lot of anxiety/uncertainty about when to say ‘this is the end’ or when to ACTIVELY move to pain management above any curative intent. Confidence to have early discussions is key. We plan to arrange a training event in our CPD club on palliative care. This will be a joint meeting between professionals across all of our sites. I hope to secure attendance form the palliative teams involved in community care.
Access to Dementia Support Services
We will offer patients with a diagnosis of dementia and their carers appointments with a Dementia Support Worker based in an available meeting room within the practise to enable them to have ease of access to emotional and practical support on half a day per month.