East Midlands Ambulance Service NHS Trust
EMAS provides emergency 999, urgent care and patient transport services for 4.8 million people within Derbyshire, Leicestershire, Rutland, Lincolnshire (including north and northeast Lincolnshire), Northamptonshire and Nottinghamshire. We employ over 3200 staff at more than 70 locations, including two control rooms at Nottingham and Lincoln, with the largest staff group being accident and emergency personnel Our accident and emergency crews respond to over 670000 emergency calls every year. Our communicate paramedic sand emergency care practitioners have enhanced skills, meaning that more an more people can be treated in their own homes if a hospital visit is not required. EMAS are dedicated to continuous improvements in the treatment of patients and their experience with the service. A working group has developed EMAS values that define the EMAS culture and our future goals.
- 8 October 2015
- East Midlands
- Health, Care, Hospitals and Hospital Trusts, Transport Sector, Emergency Services Sector
- Local Alliances:
- East Midlands Regional Board
1. Action Plan
1. The National Dementia Declaration lists a number of outcomes that we 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?
EMAS continues to work in partnership to safeguard the community and those in their care including people living with dementia. EMAS have developed and delivered a Dementia Education Module. The module was developed in conjunction with partner agencies and service users and carers, and mapped to national competency standards. The module was delivered throughout 2011/12 as part of the mandatory ‘Think! Family Think! Consequence’ Essential Education Training for all EMAS staff. Over 90% of staff attended the module. Enhanced knowledge and skills has improved the recognition of potential indicators of dementia. EMAS utilise the Abbey Non-Verbal Pain Score to assist with management of pain. EMAS staff have access to a 24-hour safeguarding referral line. The referral line is used for staff to report any safeguariding or care concerns that they may have identified whilst attending to treat a patient, this could include a review of medication, carers assessment or a Social Care Needs Assessment. Enhancing the dignity and care of older people is a key priority within EMAS. EMAS issigned up to the dept of hleath diginity in care challenge and has over 500 Dignity Champions of which over 80% have direct patient contact.
2. What are the challenges to delivering these outcomes from the perspective of your organisation?
No dedicated dementia lead.
EMAS do not case-hold and may have limited information about the patient, depending upon whether the patient is in their own home or a residential care setting.
EMAS are continually balancing priorities to ensure we meet our response time standards and provide high quality clinical care to all of our patients.
The dementia agenda
The dementia agenda is encompassed throughout the safeguarding agenda with the divisional responsibility to support local arrangements.
2014 - Fourth Quarter Update
2014 - Yearly Update
EMAS continue to be involved with the dementia agenda. EMAS sit on the DAA at regional level and now have divisional level attendance also. Education on dementia has been delivered to 100% frontline staff and EMAS continune to engage with the national agenda, developing prokects, auditting staff knowledge as well as signposting information available within stations.
Safeguarding and Care concerns
Safeguarding and Care concerns (including early indicators of patients who may be living with dementia or concerns with regards to a carer requiring additional support) are raised through the 24/7 dedicated referral line.
2014 - Yearly Update
Safeguarding referrals and care concerns around elderly care and people with dementia continue to be raised by frontline staff supporting with early diagnosis and supporting people to stay in the community rather than going into hospital. The number of referrals made by staff continues to increase, identifying that EMAS education and audit around dementia insures that staff are engaged with the agenda. Dementia is an ongoing item within the safeguarding workplan. The referral form has been adapted to recognise the role of the carer and highlight when a carers assessment is required.
Supporting early identification
EMAS are actively looking to support early diagnosis of dementia and have a Cquin agreed with commisioners to support this.
2014 In progress
EMAS have redesigne the leaflet again and have a staged roll out across the entire trust. the leaflet is currenlty being used in four division with the final division rolling out in January.
In 2013 - PILOT completed.
To support early diagnosis of Dementia, EMAS are aiming to ask every over 75 who is not conveyed whether they have suffered memory problems within the last six months. EMAS only ask this of individuals not conveyed as those taken to hospital will be accessing acute services who have standard questioning. If they have had problems they will be reffered to their GP for memory assessment. The pilot was completed during Q3 of 2013 with 25% compliance and is being rolled out across EMAS in 2014.
The Safeguarding Team will be the Trust’s Dementia Champions with support of the Divisional Clinical Quality Managers and Senior Management Teams.
Dementia is an associated agenda with the safeguarding team and is an active part of the safeguarding work plan on a basis. The safeguarding Lead for adults attends the regional forum for the DAA and has arranged for attendance at the local DAA boards to ensure EMAS are aware of local initiatives they can share regionally.
The safeguarding team provide feedback on the dementia forum to staff and provide them with information and tools to support their patient care delivery. The team provide the board with national updates.
The Safeguarding team lead on application and development of the mental capacity act within EMAS and ensure that this is being utilised appropriately to support patient and crews
Exploring the provision of communication tools
EMAS are exploring the provision of communication tools for frontline staff to utilise to promote effective communication; seeking consent and making reasonable adjustments.
EMAS used funding provided by charitable funds for a communication booklet to be provided for every vehicle, that include signs and symbols as well as general advice on communication. It also provides information around language line for the staff if English is not the individuals first language. The guide has information within it that service users can use to communitcare with staff for lots of different attendance reasons. These books are now on all EMAS ambulances.
Following delivery of Dementia Awareness Education dementia education materials continue to be available to staff with signposting to the Trust’s Intranet Dementia Awareness Training will continue to be delivered to new staff during induction Any new information/updates to be provided in the EMAS NHS Trust Essential Education Resource Book for 2013-14. Dementia face-to-face education will be part of a rolling safeguarding education programme (including Mental Capacity Act).
Dementia continues to be weaved into education for all our staff. With the need for core education reviewed on a yearly basis. Skills associated with dementia education such as safeguarding, CRT and communication also form part of the key skills EMAS staff are taught.