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Friary House Surgery

Friary House Surgery is a busy city centre General Practice, covering most parts of the city from Tamerton Foliot to Devonport to Plympton. We currently have 10,746 patients and are a multidisciplinary team composing of G.P's , Paramedics, Nurse Practitioners, Nurses, HCA's and a Phlebotomist. We have a supporting team of managers and administration staff and we offer extra services to our patients such as bereavement advice, midwives appointments and lifestyle support. We offer a telephone triage system, as we feel this is the most effective way of supporting our patient caseload. Each general practice partner is allocated their own patients whom they monitor, to ensure safe patient- centred continuity of care where possible. However, any patient can speak to/see any G.P's when requested. Friary House Surgery plays an active role in the education and support of medical, paramedic and nursing students from Plymouth University;offering placements and mentors. We are also involved in apprenticeship schemes with the local college and are a Research practice.

23 April 2019
Local Alliances:
Plymouth 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?

  • Through online training and access to dementia training sessions, we aim to develop all staff's current knowledge and awareness in the field, so we can support our  patients with dementia  most appropriately.
  • Following a recent environmental audit of the surgery, w3 are continuing to make changes to the surgery's environment to make it 'Dementia Friendly'. this includes: improved signage. providing reminiscence boxes and twiddle muffs for the patients to ease anxiety and frustration in the waiting rooms.
  • We offer double appointment slots to all our patients  with dementia and have alert boxes to inform staff of their diagnosis when the patient makes contact with the surgery. This means staff can help the patient most appropriately in a person-centred manner.
  • We would like to send a representative from the surgery to attend Plymouth Dementia Action Alliance meetings to keep our knowledge up to date.
  • We shall soon be sending out letters to our patients with dementia to request up to date information regarding whether or not they have a designated carer. This means we can offer extra support and information regarding accessing local services to help both our patients with dementia and their carers.

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

  • New staff will need time to complete online training or attend dementia awareness sessions. Learning guidance and online resources will assist with this as well as compulsory training during induction. Our practice offers training through Bluestream Academy as well as sessions held by Claire Puckey (Dementia Friendly City Coordinator, Plymouth City Council).
  • Financial budgets may limit the environmental changes we can make to the practice. for example, some of our carpets are patterned which can be disorientating for some patients with dementia. However, financial restraints mean it is unreasonable and impractical to change the carpets at present. However, when they do need changing, we will be more sympathetic towards what settles our patients with dementia.
  • We are reliant on donations of twiddle muffs from our patients or staff.
  • Clinic time: it is not always possible to fit patients with dementia into busy clinics with double allocated time. However, we try and accommodate as best as possible.

2. Actions

  • To ensure the surgery is dementia friendly.

    With the support of Claire Puckey (Dementia Friendly City Coordinator, Plymouth City Council), a member of staff will gradually improve the surgery's environment in aid of becoming more dementia friendly.This includes: signage changes so patients with dementia can more easily find their way around the surgery.Signs are being put up to signpost essential areas such as toilet facilities, waiting rooms and the lift. We are also creating reminiscence boxes/twiddle muffs so patients with dementia have something to interact with whilst waiting for appointments.

  • To improve awareness of dementia across the whole team (clinical and non-clinical) and extend to the Patient Participation Group and surgery patients.

    All staff will have or will be completing online training through Bluestream Academy, they shall also be given the opportunity to attend dementia awareness sessions delivered by Claire Puckey (Dementia Friendly City Coordinator, Plymouth City Council). Learning guidance and online resources will be offered to staff to assist with this as well as compulsory training during induction.

    Input will be given from a local older person's mental health consultant to ensure staff knowledge meets the latest guidelines on on diagnosis of dementia and initiating treatment (this will be arranged when required via Claire Puckey).

    We will also put up displays in waiting rooms, informing patients of up to date and relevant information regarding dementia as a  disease and educating patients about local appropriate supporting organisations, for both the patient and their carers, such as: Alzheimer's Society. Carer's Hub, Age UK Plymouth, Moments Cafe and Hub etc.

    Dementia awareness sessions will be offered to the Patient Participation Group throughout the year (Claire Puckey has offered to help with this).

    We can cover dementia in our newsletter, on our Facebook page and on the website to help raise awareness of the disease. This can include information regarding symptoms and how we can screen patients who feel they may be symptomatic.

  • Ensure patients are easily identifiable as living with dementia and supported appropriately.

    A member of surgery staff will regularly screen for newly diagnosed patients. These patients will have alert boxes to state that they have dementia so staff can put their skills and knowledge appropriately into practice when communicating with the patients.

    They will be offered double appointment slots and be sent letters to communicate any important information regarding their care.

    All patients with dementia will be sent forms requesting contact details regarding their carers and be asked to complete a 'This is Me' form from The Alzheimer's Society, so we can provide person centred care for these patients in accordance with their wishes. Where possible, patients will be offered appointment and telephone consultations to suit their needs, for example: when they are with their carers.

    Doctors will encourage and promote discussion on advanced care planning to prevent future crises regarding both health and welfare matters. Carers will be offered annual health checks.