Services for Later LifeA Clinical Commissioning Group Perspective Professor Chris Drinkwater Independent Chair Newcastle Bridges Commissioning Group www.newcastlebridges.net
Newcastle JSNA Older People Preparation for Old Age Active Old Age Vulnerable Old Age Dependent Old Age
Preparation for Old Age Obese people in their 40s Are 74% more likely to develop dementia compared to those of normal weight. US National Institute of Health (2011)
Active Old Age Those who volunteer have lower mortality rates, greater functional ability, and lower rates of depression later in life than those who do not volunteer
Corporation for National & Community Service 2007
Government should offset volunteering against long term care insurance costs
Vulnerable Old Age Vulnerability increases with age. Better case finding and systematic interventions to prevent vulnerability becoming expensive dependency Staying Steady Group
Joining the Dots/Communities4Health Practices identify vulnerability – 4 or more medications, living alone, recent bereavement. Referral to V&CS provider for assessment Menu of activities – knit & natter, nordic walking, gym, arts, aromatherapy, cooking group. Local supportive social network with link to healthcare provision. Savings on prescribing and other healthcare costs
Dependent Old AgeCare Home Project 3 emergency admissions per day Median duration of admission 1 day 20% die within 5 days of admission Falls, respiratory and urinary infections commonest conditions Dementia and confusion a significant underlying problem Similar issues for people on full home care packages
Progress to date 80% of homes now have a named link GP. Joint GP and care home training programme on falls and end of life care planning. Guidance and tools developed and being tested. Excellent feedback ? Role for Community Care of the Elderly specialists/adult social care.
Final thoughts Clinical Commissioning Groups need to develop and work with local assets in V&CS. Dangers of tokenism – Newcastle Bridges has 3 V&CS members, DPH and Adult Service Transformation Lead. Think through life stages approach and link to JSNA and local health strategy. Health & Wellbeing Board pooled budget to drive integration and joint working.