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Mid Essex Clinical Commissioning Group

Mid Essex Clinical Commissioning Group is part of the NHS and brings together 45 GP Practices in the mid Essex area. We are responsible for the planning and buying of local health services and have a budget of approximately £420 million to spend on healthcare for people living in the districts of Maldon, Braintree and the City of Chelmsford. The health services that we buy consist of hospital care, medicines and prescribing, mental health services, urgent care, community care and ambulance services. We know that the population in mid Essex is growing at a higher rate than national average; that our population is ageing and more people have long term illness. To help people stay well in mid Essex, we are focusing on developing plans that will create services to follow phases of life; startwell; bewell; staywell; agewell; diewell

2 October 2017
East of England
Commissioners Sector
Local Alliances:
Braintree 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?

Mid Essex CCG has a key role in delivering better outcomes for people living with dementia including carers. The CCG is responsible for commissioning the relevant health care service to facilitate the diagnosing of people suspected to have dementia and in addition the CCG works closely with Essex County Council, in ensuring the post diagnostic support services are available and within resource without duplication.

The current key focus for the CCG is to undertake cross working with a number of organisations to allow a dementia diagnosis pathway that is seamless for the patient, quick and efficient to allow early care planning and empowers people to take control of their future. The CCG aims to work with primary care, the Memory Assessment and Support Service and Care Homes to ensure accessibility to services and that the correct support functions are put in place which is determined by each individual’s needs as this has a positive impact on not only the person and carer, but families, the community and the service provision of local authorities.

 As part of this focus and to better outcomes the CCG also has the ambition of ensuring health care environments are dementia friendly inclusive of raising awareness and providing a greater understanding of dementia across services.

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

There are a number of challenges to ensure the correct outcomes for people and these primarily exist around the essential requirement to increase the awareness and understanding of dementia from primary care services through to care homes and the community itself.

A culture change is required to recognise that a dementia diagnosis is not a negative label but instead a positive step which presents opportunities for those diagnosed to empower themselves and make their own decisions for the future.

In order to achieve this the current services both health and social care require a level of integration in line with the Southend, Essex and Thurrock Dementia Strategy nine priorities which include Prevention, Finding Information, Diagnosis and Assessment, Living Well with Dementia, Supporting Carers, Reducing the Risk of Crisis, Living Well in Long Term Care, End of Life and A knowledgeable and Skilled Workforce.

2. Actions

  • The CCG recognises the importance of Primary Care taking a key role in people’s journey to a dementia diagnosis and accessing support functions.

    1)       Ensuring that diagnosis data from the Memory Clinics is accurately shared with GPs and recorded in a timely fashion to enable support functions to operate for those diagnosed.

     2)       Target GP practices that are struggling to achieve the expected diagnosis rate for the associated prevalence against practice list size and offer support to ensure increased awareness of symptoms and subsequently diagnosis

     3)       The CCG has an ambition of increasing the number of CCG localities GP Practices Dementia Friendly by March 2018.

  • The CCG is aware that education and awareness of dementia and the associated support available is critical to enable community resilience and those with dementia live well.

    Roll out of a training programme utilising the GERT Suite and Virtual Dementia Tour to be targeted at Primary Care, Community Nurses and Care Homes to provide education and increase awareness of the importance in having a dementia diagnosis, symptom identification and support functions accessible across the community.

     The aim of the programme is to increase the number of people diagnosed and to ensure those that have been, access the relevant support. This in turn should increase the diagnosis rate, ensure suitable care is accessed, strengthen the community and subsequently reduce the number of emergency admissions that are dementia related and reduce the chances of either the person with dementia or carer ending up in crisis.

     There is also the opportunity to further promote organisations to become Dementia Friendly and in particular care homes.

  • Working with the locality Memory Clinics to ensure a quick diagnosis from referral and ease of access to support functions.

    The CCG is aware of the importance in a timely dementia diagnosis and access to support particularly if early onset dementia is recognised. The CCG’s ambition is to implement a six week pathway by 2020 in line with the Five Year Forward View and a number of actions have been derived to facilitate:

    1. Encourage Primary Care colleagues where possible to diagnose and link directly with support functions.

    2. Move a number of onerous functions in Primary Care to the Memory Clinics to support GPs and prevent delays. I.e. undertake ECGs in the memory clinic, GPs no longer needing to complete the MRI patient safety questionnaires.

    3. To increase awareness within general hospitals and create direct referral links with the memory clinic for patients identified with possible dementia