Raising Awareness of Dementia, prepared by the Thames Valley Knowledge Team. This document will be of interest to those wishing the raise the awareness of dementia amongst non-specialist health and social care staff. The document describes projects taking place across the South of England and provides links to existing on-line resources that may be of use.
North Tyneside NHS Tripartite primary care strategy v1 7Minney org Ltd
North Tyneside developed a Primary Care Strategy which represents the future of community and GP-led healthcare in the area, covering 215,000 population.
Our objective is to enhance the health and happiness of our population, which we'll do by improving appropriate access to Primary Care (GPs etc); expanding the range of clinics and services you can receive in primary care, improving specialist support, and maximising Prevention and Self-Management.
This document is endorsed by the three main organisations - the GP Federation (TyneHealth - for General Practitioners/ Family physicians); Clinical Commissioning Group CCG, and Local Medical Committee LMC
Guidance for commissioners of community specialist mental health servicesJCP MH
This guide is about the commissioning of specialist community mental health services. It explores the role of Community Mental Health Teams (CMHTs), Assertive Outreach Teams and Early Intervention Teams among others.
Guidance for commissioners of financially, environmentally, and socially sust...JCP MH
This guide supports commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.
Sustainable commissioning involves making sure services make the most effective use of financial, environmental and social resources. This includes commissioning services that support secondary (reducing relapse) and tertiary (improving rehabilitation) prevention. It is these aspects, rather than primary preventative measures, that are the focus for this guide. The issue of primary prevention is discussed in the Guidance for commissioning public mental health services.
This guide has been written by a group of experts in mental health and sustainability, in consultation with service users and patients, and strengthened by input from a local government and public health perspective. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
By the end of this guide, readers should:
- understand the concept of sustainability in mental health care, and how using this commissioning framework can create sustainable services
- be aware of the legislation relating to sustainability that the NHS is required to meet
- understand what sustainable commissioning looks like in practice
- understand how and why improving the sustainability of mental health interventions will contribute to achieving the aims of both the mental health, public health, NHS, and social care strategies, as well as improving quality and productivity
- be able to commission sustainable mental health services and interventions.
Find out more and download all the guides published by the Joint Commissioning Panel for Mental Health at http://www.jcpmh.info.
This report published by the South West Strategic Clinical Network for Mental Health has been developed to support commissioners in leading and shaping the transformation of child and adolescent mental health service (CAMHS) in the South West.
Around 10% of children aged between five and 16 have a mental health condition. Too often though these children, young people, their families and carers, find that the services they need are not available to them at the right time or place, are fragmented, or are well meaning but poorly organised.
This guide was written by young people, clinicians, service providers and commissioners. They describe what a good service looks like, pulling together innovative service models from across the region, which have been found to improve outcomes for children, young people and their families. The aim is to maximise treatment options within community settings, which play to the geography of the region and also make economic sense by avoiding hospital care where appropriate and possible. In addition, this guide describes the services which already exist in the region across a range of agencies.
Find out more at http://mentalhealthpartnerships.com/resource/commissioning-better-camhs-in-the-south-west
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
North Tyneside NHS Tripartite primary care strategy v1 7Minney org Ltd
North Tyneside developed a Primary Care Strategy which represents the future of community and GP-led healthcare in the area, covering 215,000 population.
Our objective is to enhance the health and happiness of our population, which we'll do by improving appropriate access to Primary Care (GPs etc); expanding the range of clinics and services you can receive in primary care, improving specialist support, and maximising Prevention and Self-Management.
This document is endorsed by the three main organisations - the GP Federation (TyneHealth - for General Practitioners/ Family physicians); Clinical Commissioning Group CCG, and Local Medical Committee LMC
Guidance for commissioners of community specialist mental health servicesJCP MH
This guide is about the commissioning of specialist community mental health services. It explores the role of Community Mental Health Teams (CMHTs), Assertive Outreach Teams and Early Intervention Teams among others.
Guidance for commissioners of financially, environmentally, and socially sust...JCP MH
This guide supports commissioners, local health authorities and providers to think broadly, but practically, about building sustainable, resilient communities that have the potential, over time, to reduce mental ill health.
Sustainable commissioning involves making sure services make the most effective use of financial, environmental and social resources. This includes commissioning services that support secondary (reducing relapse) and tertiary (improving rehabilitation) prevention. It is these aspects, rather than primary preventative measures, that are the focus for this guide. The issue of primary prevention is discussed in the Guidance for commissioning public mental health services.
This guide has been written by a group of experts in mental health and sustainability, in consultation with service users and patients, and strengthened by input from a local government and public health perspective. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
By the end of this guide, readers should:
- understand the concept of sustainability in mental health care, and how using this commissioning framework can create sustainable services
- be aware of the legislation relating to sustainability that the NHS is required to meet
- understand what sustainable commissioning looks like in practice
- understand how and why improving the sustainability of mental health interventions will contribute to achieving the aims of both the mental health, public health, NHS, and social care strategies, as well as improving quality and productivity
- be able to commission sustainable mental health services and interventions.
Find out more and download all the guides published by the Joint Commissioning Panel for Mental Health at http://www.jcpmh.info.
This report published by the South West Strategic Clinical Network for Mental Health has been developed to support commissioners in leading and shaping the transformation of child and adolescent mental health service (CAMHS) in the South West.
Around 10% of children aged between five and 16 have a mental health condition. Too often though these children, young people, their families and carers, find that the services they need are not available to them at the right time or place, are fragmented, or are well meaning but poorly organised.
This guide was written by young people, clinicians, service providers and commissioners. They describe what a good service looks like, pulling together innovative service models from across the region, which have been found to improve outcomes for children, young people and their families. The aim is to maximise treatment options within community settings, which play to the geography of the region and also make economic sense by avoiding hospital care where appropriate and possible. In addition, this guide describes the services which already exist in the region across a range of agencies.
Find out more at http://mentalhealthpartnerships.com/resource/commissioning-better-camhs-in-the-south-west
Guidance for commissioners of rehabilitation servicesJCP MH
This guide is about the commissioning of good quality mental health interventions and services for people with complex and longer term problems to support them in their recovery.
What your organisation needs to know about personal health budgets, communica...CharityComms
Jaimee Lewis, Think Local, Act Personal
Changing the game: positioning your charity to succeed in the new health service market conference
www.charitycomms.org.uk/events
Guidance for commissioners of services for people with medically unexplained ...JCP MH
This guide is about the commissioning of comprehensive MUS services across the healthcare system. In developing this guide, we recognise that ‘medically unexplained symptoms’ is an unsatisfactory term for a complex range of conditions.
MUS refers to persistent bodily complaints for which adequate examination does not reveal suf ciently explanatory structural or other specified pathology. The term MUS is commonly used to describe people presenting with pain, discomfort, fatigue and a variety of other symptoms in general practice and specialist care. Whilst recognising that the phrase ‘medically unexplained symptoms’ can be problematic, it is nonetheless widely used, and an appropriate term to use in this guide.
This guide aims to: describe MUS and the associated outcomes: outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and highlight the importance of commissioning comprehensive MUS services.
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of older people’s mental health servicesJCP MH
This guide is about the commissioning of mental health services which can improve the mental health and wellbeing of older people.
This guide has been developed by a group of older people’s mental health professionals, people with mental health problems, and carers. The content is primarily evidence and literature-based, but ideas deemed to be best practice by expert consensus have also been included.
Dr Leon Le Roux - Introducing the framework for community mental health suppo...Innovation Agency
Presentation by Dr Leon Le Roux, Clinical Director/ Consultant Psychiatrist, Lancashire Care NHS Foundation Trust: Introducing the framework for community mental health support, care & treatment on Wednesday 13 March at Haydock Park Racecourse.
Joint Commissioning Panel for Mental Health briefingJCP MH
This briefing describes the Joint Commissioning Panel for Mental Health (JCP-MH), a collaborative co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. The collaboration includes seventeen leading organisations, inspiring commissioners to improve mental health and wellbeing, using a values based commissioning model. It brings together service users, carers, clinicians, commissioners, managers and others to deliver the best possible commissioning for mental health and wellbeing.
The JCP-MH publishes briefings on the key values for effective mental health commissioning. It also provides practical guidance and a framework for mental health commissioning and supports commissioners in commissioning mental health care that delivers the best possible outcomes for health and well being
Guidance for commissioners of dementia servicesJCP MH
This guide describes what a good quality, modern dementia service looks like. It has primarily been written for Clinical Commissioning Groups, local authorities, and Health and Wellbeing Boards. It will also be of interest to patients, carers and voluntary sector and provider organisations.
Guidance for commissioners of mental health services for people with learning...JCP MH
This guide is about the commissioning of mental health services for people with learning disabilities, enabling them to live full and rewarding lives as part of their local communities.
This guide is aimed at all commissioners responsible for mental health services for people with learning disabilities including young people in transition to adulthood. The guide will also be helpful for providers of mental health services and for family carers.
This guide describes what we know about mental health services for adults with learning disabilities, and what effective and accessible services look like based on current policy, the law and best practice.
While this guide does make reference to autistic spectrum disorders and ‘behaviours that challenge’ (which people with learning disabilities who have mental health problems may also experience), the primary focus of this guide is on people with learning disabilities who have mental health problems.
Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
What Does Commissioning and Quality Improvement Mean to Me?Sarah Amani
This was a good question which got me thinking: there are so many buzz words in healthcare sometimes its good to unpack what we mean. As one of the areas I cover, Cornwall and the Isles of Scilly are of huge importantance and interest to me so I was really happy to be invited to meet with their impressive commissioning and quality improvement team to discuss this topic
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Guidance for commissioners of mental health services for people from black an...JCP MH
This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic (BME) communities look like.
While all of the JCP-MH commissioning guides apply to all communities, there are good reasons (see P9) why additional guidance is required on commissioning mental health services for people from BME communities.
This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.
Guidance for commissioners of primary mental health servicesJCP MH
This guide describes what good quality, modern, primary mental health care services look like. It has been written by a group of primary mental health care experts, in consultation with patients and carers. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
North Tyneside NHS Tripartite primary care strategyMinney org Ltd
North Tyneside developed a Primary Care Strategy which represents the future of community and GP-led healthcare in the area, covering 215,000 population. This is endorsed by the three main organisations - the GP Federation (TyneHealth - for General Practitioners/ Family physicians); Clinical Commissioning Group CCG, and Local Medical Committee LMC
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Guidance for commissioners of liaison mental health services to acute hospitalsJCP MH
This guide describes what ‘good looks like’ for a modern acute liaison service. It should be of value to Clinical Commissioning Groups (who will be commissioning secondary services, both specialist mental and acute).
Case Study Three: Dementia Reablement Service for Cheshire East
An example of a how integrated care is working across Eastern Cheshire.
Presented at the Caring Together stakeholder event at Poynton Civic Centre 20July 2015
www.caringtogether.info
Guidance for commissioners of services for people with medically unexplained ...JCP MH
This guide is about the commissioning of comprehensive MUS services across the healthcare system. In developing this guide, we recognise that ‘medically unexplained symptoms’ is an unsatisfactory term for a complex range of conditions.
MUS refers to persistent bodily complaints for which adequate examination does not reveal suf ciently explanatory structural or other specified pathology. The term MUS is commonly used to describe people presenting with pain, discomfort, fatigue and a variety of other symptoms in general practice and specialist care. Whilst recognising that the phrase ‘medically unexplained symptoms’ can be problematic, it is nonetheless widely used, and an appropriate term to use in this guide.
This guide aims to: describe MUS and the associated outcomes: outline current service provision for MUS and detail the components of a high quality comprehensive MUS service, and highlight the importance of commissioning comprehensive MUS services.
Guidance for commissioners of mental health services for young people in tran...JCP MH
This guide describes good quality mental health transitions services for young people making the transition from child and adolescent to adult services.
It also describes the benefits of transitions services and explains why a transitions service is important for the commissioners of specialist mental health services.
Guidance for commissioners of older people’s mental health servicesJCP MH
This guide is about the commissioning of mental health services which can improve the mental health and wellbeing of older people.
This guide has been developed by a group of older people’s mental health professionals, people with mental health problems, and carers. The content is primarily evidence and literature-based, but ideas deemed to be best practice by expert consensus have also been included.
Dr Leon Le Roux - Introducing the framework for community mental health suppo...Innovation Agency
Presentation by Dr Leon Le Roux, Clinical Director/ Consultant Psychiatrist, Lancashire Care NHS Foundation Trust: Introducing the framework for community mental health support, care & treatment on Wednesday 13 March at Haydock Park Racecourse.
Joint Commissioning Panel for Mental Health briefingJCP MH
This briefing describes the Joint Commissioning Panel for Mental Health (JCP-MH), a collaborative co-chaired by the Royal College of Psychiatrists and the Royal College of General Practitioners. The collaboration includes seventeen leading organisations, inspiring commissioners to improve mental health and wellbeing, using a values based commissioning model. It brings together service users, carers, clinicians, commissioners, managers and others to deliver the best possible commissioning for mental health and wellbeing.
The JCP-MH publishes briefings on the key values for effective mental health commissioning. It also provides practical guidance and a framework for mental health commissioning and supports commissioners in commissioning mental health care that delivers the best possible outcomes for health and well being
Guidance for commissioners of dementia servicesJCP MH
This guide describes what a good quality, modern dementia service looks like. It has primarily been written for Clinical Commissioning Groups, local authorities, and Health and Wellbeing Boards. It will also be of interest to patients, carers and voluntary sector and provider organisations.
Guidance for commissioners of mental health services for people with learning...JCP MH
This guide is about the commissioning of mental health services for people with learning disabilities, enabling them to live full and rewarding lives as part of their local communities.
This guide is aimed at all commissioners responsible for mental health services for people with learning disabilities including young people in transition to adulthood. The guide will also be helpful for providers of mental health services and for family carers.
This guide describes what we know about mental health services for adults with learning disabilities, and what effective and accessible services look like based on current policy, the law and best practice.
While this guide does make reference to autistic spectrum disorders and ‘behaviours that challenge’ (which people with learning disabilities who have mental health problems may also experience), the primary focus of this guide is on people with learning disabilities who have mental health problems.
Guidance for commissioners of child and adolescent mental health servicesJCP MH
This guide describes what ‘good looks like’ for a modern child and adolescent mental health service (CAMHS). It should be of value to Clinical Commissioning Groups (CCGs) and NHS England.
By the end of this guide, readers should be more familiar with the concept of CAMHS and better equipped to understand:
what a good quality, modern, service looks like
why a good CAMHS delivers the mental health strategy and the Quality Innovation Productivity and Prevention initiative – not only in itself but also by enabling changes in other parts of the system
the benefits of CAMHS to children, young people, their families and carers, and
why CAMHS are important for commissioners.
What Does Commissioning and Quality Improvement Mean to Me?Sarah Amani
This was a good question which got me thinking: there are so many buzz words in healthcare sometimes its good to unpack what we mean. As one of the areas I cover, Cornwall and the Isles of Scilly are of huge importantance and interest to me so I was really happy to be invited to meet with their impressive commissioning and quality improvement team to discuss this topic
Guidance for commissioners of acute care – inpatient and crisis home treatmentJCP MH
This guide is about commissioning services for people with acute mental health needs. It explains the purpose, characteristics and components of acute care so that commissioners can commission good quality services that are therapeutic, safe and support recovery.
Guidance for commissioners of mental health services for people from black an...JCP MH
This guide describes what ‘good’ mental health services for people from Black and Minority Ethnic (BME) communities look like.
While all of the JCP-MH commissioning guides apply to all communities, there are good reasons (see P9) why additional guidance is required on commissioning mental health services for people from BME communities.
This guide focuses on services for working age adults. However, it could also be interpreted for commissioning specialist mental health services, such as CAMHS, secure psychiatric care, and services for older adults.
Guidance for commissioners of primary mental health servicesJCP MH
This guide describes what good quality, modern, primary mental health care services look like. It has been written by a group of primary mental health care experts, in consultation with patients and carers. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included.
North Tyneside NHS Tripartite primary care strategyMinney org Ltd
North Tyneside developed a Primary Care Strategy which represents the future of community and GP-led healthcare in the area, covering 215,000 population. This is endorsed by the three main organisations - the GP Federation (TyneHealth - for General Practitioners/ Family physicians); Clinical Commissioning Group CCG, and Local Medical Committee LMC
Integrated data to support service redesign decision making 19 01 2016 finalNHS Improving Quality
Integrated data to support service redesign decision making
Leeds LTC Year of Care Commissioning Early Implementer Site
Tricia Cable, Year of Care Lead
Alison Phiri, Business Intelligence Manager
Mohini Chauhan, Year of Care Commissioning Manager
Guidance for commissioners of liaison mental health services to acute hospitalsJCP MH
This guide describes what ‘good looks like’ for a modern acute liaison service. It should be of value to Clinical Commissioning Groups (who will be commissioning secondary services, both specialist mental and acute).
Case Study Three: Dementia Reablement Service for Cheshire East
An example of a how integrated care is working across Eastern Cheshire.
Presented at the Caring Together stakeholder event at Poynton Civic Centre 20July 2015
www.caringtogether.info
A guide to workforce development to support social care and health workers to apply the common core principles and competences for end of life care
23 February 2012 - National End of Life Care Programme / Skills for Care / Skills for Health
The National End of Life Care Programme has worked alongside Skills for Health and Skills for Care to ensure that workers involved in supporting someone who is at the end of their life are properly trained to be able to undertake their work effectively and appropriately.
Each section gives an explanation of the area of work and includes important links to further information and resources. There is also a 'practice scenario' to show how the competences are connected and how they can be used to help in developing services and ensuring that workers are appropriately trained and skilled.
This guide completely replaces the 2010 A framework of National Occupational Standards to support common core principles for health and social care workers working with adults at the end of life and should be read alongside the Common Core Competences and Principles: A guide for health and social care workers working with adults at the end of life.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Palliative care in the United States has experienced tremendous growth and visibility over the past decade. Integrating palliative care principles into mainstream health care systems is becoming increasingly common in both acute care and community-based programs. The Center to Advance Palliative Care (CAPC) has played a key role in advancing this field by providing resources, education and training to healthcare providers.
How to make care and support planning a two-way dynamic - presentation from webinar held on 1 October 2014
This relates to the first NHS IQ Long Term Conditions Improvement Programmes Wednesday Lunch & Learn Webinar Series. How to make care and support planning a 2 way dynamic hosted by Dr Alan Nye & Brook Howells from AQuA. This webinar discussed how to encourage patients, carers and the public to work alongside (in equal partnership) with clinicians and managers
Primary Health Care Strategy:
Key Directions for the Information Environment. Case study report and composite success model.
Steve Creed & Philip Gander
Innovation in commissioning and provisioning of community healthcare - Counti...Clever Together
Benedict Hefford is Director of Primary and Community Services at Counties Manukau Health, where he is also the executive lead for integrated care:
http://www.countiesmanukau.health.nz/AchievingBalance/System-Integration/system-integration-home.htm. As Director, Benedict is responsible for both operational delivery and commissioning of health and social care services in South Auckland – a culturally diverse and economically deprived area of New Zealand with over 500,000 residents.
Benedict has 20 years healthcare experience encompassing senior management, commissioning, and strategic roles in both New Zealand and the UK. Prior to joining CM Health, he was Director of Commissioning (Social Care and Health) in central London. Benedict’s previous experience also includes re-designing community care services at Hammersmith and Fulham PCT and Capital Coast Health, as well as developing national health strategies as a Senior Policy Analyst with the NZ Ministry of Health. Benedict holds an MSc in Public Services Policy & Management from King’s College London; a Postgraduate Diploma in Health Services Management; and a BSW (Hons).
La voz de los pacientes en los proyectos de integracion de servicios del nhs ...Societat Gestió Sanitària
Ponencia a cargo del director de politicas y colaboraciones del National Voices en el National Health Service inglés, en el marco de la VI Jornada Right Care sobre Modelos avanzados en integración de servicios sociales y sanitarios, organizada por la Societat Catalana de Gestió Sanitària el 24 de mayo de 2019.
Exploring the potential for using predictive modelling in identifying end of life care needs - 15 February 2013 - National End of Life Care Programme / Whole Systems Partnership
This report, produced in partnership with Whole Systems Partnership, is based on a project which reviewed the literature on predictive modelling, canvassed views and engaged with interested parties to formulate an initial response to the opportunities presented by predictive modelling approaches in identifying people likely to be nearing the end of life.
Predictive modelling involves the interrogation of datasets to inform professional judgement about potential needs. It is hoped that the findings of this report will be used to enable commissioners and providers of services to better understand and meet people's end of life care preferences and wishes, supporting more people to live and die well in their preferred place.
Publication by the National End of Life Programme which became part of NHS Improving Quality in May 2013
Innovations conference 2014 catherine adams integrating a multidisciplinary...Cancer Institute NSW
Catherine Adams - Integrating a Multidisciplinary Stepped Care Model of Psychosocial Care for Cancer Survivors and Families into routine Clinical Practice in Rural and Remote Regions
Improving quality, safety and lives - the Patient Safety Collaborative Programme 2014-2019
Presentation from Chief Nursing Officer for England's Summit 2014
26 November 2014
Explore our infographic on 'Essential Metrics for Palliative Care Management' which highlights key performance indicators crucial for enhancing the quality and efficiency of palliative care services.
This visual guide breaks down important metrics across four categories: Patient-Centered Metrics, Care Efficiency Metrics, Quality of Life Metrics, and Staff Metrics. Each section is designed to help healthcare professionals monitor and improve care delivery for patients facing serious illnesses. Understand how to implement these metrics in your palliative care practices for better outcomes and higher satisfaction levels.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Deep Leg Vein Thrombosis (DVT): Meaning, Causes, Symptoms, Treatment, and Mor...The Lifesciences Magazine
Deep Leg Vein Thrombosis occurs when a blood clot forms in one or more of the deep veins in the legs. These clots can impede blood flow, leading to severe complications.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
2. 2
Introduction.
Raising the awareness of and knowledge and expertise relating to dementia amongst non-specialist health and social care staff is both a national and
local priority.
This document has been prepared by the Thames Valley Knowledge Team. Its purpose is to support this agenda by sharing information about
initiatives that focus on increasing dementia awareness amongst professional health and social care staff (both private and public sectors) and by
drawing attention to existing on-line resources that might be utilised locally
There are two distinct sections:
Section 1 (pages 3-15)
Summaries of some projects taking place in the south of England where the focus has been on raising dementia awareness and expertise.
Summaries are deliberately brief with just enough information for the reader to assess whether obtaining further information would be of value to
them. Lead names are provided where possible so that, where a summary resonates with the reader, contact can be made and the possibility of
sharing practice can then be explored.
Section 2 (pages 16- 20)
1. A series of links to resources that can be accessed on line and available to both organisations and individuals that could enhance the knowledge
and practice of those caring for people living with dementia.
Using this document
This document is intended to be read on-screen by a reader with internet access and as much as is possible is populated with hyper-links that allow
the reader to click through to obtain more detailed information. (all links checked and live on the date of publication).
3. 3
Section 1
South of England Projects that focus on delivering benefits through raising awareness of
dementia and up-skilling non-specialist staff
The project
The aim of this project is to improve the quality and consistency of domiciliary care delivered to people affected by dementia. By ensuring that
domiciliary staff are adequately trained in dementia better outcomes for people affected by dementia will be achieved. The focus will be on domiciliary
care staff delivering care using a relationship and person centred approach.
A project worker will link with domiciliary care agencies in the three local authorities to establish current training provision, identify training needs
through a training needs analysis and to identify how these might be met. In addition they will arrange for dementia awareness workshops to be
delivered to a number of agency staff (i.e. Managers and Senior Carers) who would then act as “champions” to raise awareness of dementia and of
the benefit of training to other staff.
Dementia champions within the domiciliary care agencies will help promote an agency led dementia training blueprint for moving forward and
ultimately a blueprint of excellence that can be shared throughout the South of England.
The training needs analysis will be aggregated and made known to the CCGs and Local Authorities as part of their responsibility for market
development. Currently both Health and Social care offer low cost training around dementia but there is a variable take up within domiciliary care
agencies. This aggregated analysis would both enable health and social care to tailor these courses based on local need and to more target those
agencies who wish to become market leaders.
Contacts for further information
julie.eden@reading.gov.uk
Alain.Wilkes@wokingham.gov.uk
Training Domiciliary Care Workers – Berkshire West Confederation
4. 4
The aim of this project is to establish a care home in-reach team which will work alongside providers to improve the quality of care delivered to people
with dementia living in residential care homes and nursing homes across West Berkshire. The team will improve the health, well-being and
independence of residents with dementia and provide professional guidance and motivation to care home staff.
The team will comprise two experienced and credible nurses in each of the three local authority areas working in 3-4 homes per locality. There would
be one RGN and one RMN in each locality. The team will provide proactive specialist assessments for each resident with dementia, reviewing their
mental health and physical health needs and their care plans.
Team members will spend a high proportion of their time in the homes working alongside staff, reviewing residents, modeling good practice,
supporting staff dealing with difficult situations and introducing new tools to assist with the effective management of long term conditions. They will
provide support to carers of the residents and involve residents and their relatives in anticipatory planning for end of life care. Formal training sessions
may be delivered but it is envisaged that much of the learning will come about through observation and the adoption of new ways of working. Staff will
be trained to recognize the early signs of deterioration and advised about measures that can prevent the further worsening of the condition. Psycho-
social strategies for managing behaviours that are considered challenging would be introduced and modelled.
Progress update
In May the team started working with the first 6 homes spread across the West of Berkshire. In August they moved on to another 6 homes but will
maintain contact with the first homes in order to continue to give support and training.
The team has reviewed the mental and physical health of all the residents and given advice re: care and management of their needs. They have
linked with family members to ensure they are involved with decisions especially where the resident is no longer able to make decisions for
themselves.
Working with the managers and care home staff, training needs have been identified and appropriate training delivered.
The team has built strong links with partner agencies and colleagues who also work in the homes. This includes GPs, community geriatricians, district
nurses, CPNs and local authority staff.
Work around End of Life care plans was always part of the team’s objectives. They have now identified a need for advance care plans as well. It is
hoped these will help reduce the number of unplanned admissions.
Contact for further information
Dr Helen Single, Head of Older Peoples commissioning support - helen.single@berkshire.nhs.uk
Care Home In-reach Team – Berkshire West Confederation
5. 5
Introduction
The aim is to adopt the Gnosall primary care based memory assessment approach (see below) to improve dementia diagnosis in harder to reach,
particularly rural, communities in Buckinghamshire.
A new primary care based memory assessment function will focus on providing:
Improved access for hard to reach groups
Assessment closer to home within familiar surroundings
Rapid referral for specialist diagnosis and advice
Post diagnosis support
Training for GP practice teams on identifying dementia
Increased awareness of dementia within wider community health teams and care providers
The Gnosall service
The award winning Gnosall dementia service is a primary care based older people’s mental health service that is designed to improve access, to
speed diagnosis and improve care for patients with dementia. Based in a rural, primary care setting, outreach consultant-led clinics provide rapid
diagnosis and cost-effective medical care.
Anticipated outcomes
Diagnostic rates to reach 70% of anticipated prevalence by 2015
Time between suspicion and diagnosis to be reduced to 6 weeks
A reduction in general hospital bed days for people with dementia (informed by Whole System Partnership modeling)
County wide uptake of the Bucks primary care dementia protocol
Reduced use of antipsychotic medication
Contact for further information
Ojalae Jenkins, Joint Commissioning Manager - ojenkins@buckscc.gov.uk
Closer to Home Memory Assessment – Buckinghamshire
6. 6
More opportunities for people with dementia to remain living in their own home for longer through greater community support
This is a collaborative project between primary and secondary care which will establish the role of primary care in the diagnosis and management of
dementia.
The drivers of the project are:
The need to improve diagnostic rates: the Prime Minister’s Challenge on Dementia requires CCGs to have a quantified ambition for diagnosis
rates
The current pathway relies entirely on diagnosis within secondary care setting. There is an ambition to bring diagnostic capability closer to the
patient and into primary care
There is a need to increase capacity and reduce waiting times for first time assessments in some localities.
The project involves a collaborative model which increases the skill of GPs in diagnosing cases of dementia, thereby creating extra capacity at
primary care level. This will release the secondary care capacity for the more complex diagnoses and follow-up thereby maximising the benefit of this
specialist service. A jointly agreed protocol will be developed between primary and secondary care outlining the criteria for :-
the diagnosis of appropriate cases in primary care
identifying cases appropriate for referral to secondary care.
Because diagnosis should be a gateway to support services, it also requires the identification of equivalent support services in primary care to those
available in secondary care memory clinics.
Expected Outcomes
A primary and secondary care jointly agreed protocol (and algorithm) as above.
Increased rate of timely diagnosis and with corresponding support plans.
Those people deemed appropriate for primary care diagnosis will receive the same quality of diagnosis and follow up in their familiar primary
care setting as they would in secondary care.
Increased dementia awareness and on-the-job-learning for GPs and their staff.
New capacity for dementia diagnosis in Primary Care.
Maximisation of secondary care capacity for cases of appropriate complexity or diagnostic uncertainty
Contact for further Information
Fenella.Trevillion@oxfordshireccg.nhs.uk
Collaborative Primary and Secondary Care Management – Oxfordshire
7. 7
The aim of this project is to accelerate the pace of improvement in the pathway of care for people with dementia and their carers living by providing a
programme of training and education for health and social care staff.
Project Objectives
Better awareness amongst paid staff/professionals.
Increased identification and early diagnosis of people with dementia facilitating appropriate support at the right times and in the right places.
Develop a competent and sustainable workforce across sectors so people with dementia can have person-centred and dignified care
wherever they are being cared for.
Effective treatment that enables people with dementia to remain independent and in the community for as long as possible.
For carers to feel supported in providing care for as long as they choose.
People with dementia live independently for as long as possible.
Reduction in crisis admission, delayed transfer of care and care home placements.
Improved quality of care in care homes.
Anticipated outcomes
A competent workforce across statutory, independent and voluntary sectors delivering sensitive, appropriate and personalized care to people
living with dementia.
Improved quality of care measured through care standards. Improved patient satisfaction.
Carers of people with dementia report feeling equipped to care and are adequately supported.
Reduced care home admissions and lengths of stay
Reduced admissions to secondary care services.
Reduction in anti-psychotic prescribing.
Contact for further Information
Fenella.Trevillion@oxfordshireccg.nhs.uk
Creating a Sustainable Workforce – Oxfordshire
8. 8
The aim of this project is to achieve excellence in end of life care for people with dementia living in nursing homes. This will be facilitated by a
Specialist Palliative Care Clinical Nurse Specialist (SPC CNS) educating and supporting care home staff. The SPC CNS will also work in a ‘hands on’
in nursing homes to model good practice and mentor staff. Nursing home staff will be offered the opportunity for ‘hands on’ experience within the
hospice in patient unit. The project will focus on experiential learning across the two care settings and the mentorship of nursing home staff in
palliative care, focusing on needs assessment, symptom management and quality end of life care; as well as specific skill development identified by
the individual practitioner / nursing home and mutually agreed with the hospice.
Anticipated outcomes
Improved advanced care planning for all patients with dementia with opportunities for open conversations which allow patients and carers to
communicate their preferences and wishes.
Improved assessment and management of palliative care needs of all patients with advanced dementia in care homes.
Improved recognition of pain, through use of dementia specific pain tools
Better deaths as evidenced through use LCP tools and audit of outcomes.
Improved carer and relative experience of the end stages of the illness.
Positive anticipatory grief work for carers.
Reducing the risk of complex bereavement.
Improved confidence in palliative care delivery by nursing home staff.
Progress update
This project made a significant difference to the care homes involved. It encouraged behavioural change and improved personalised hospice
standard of care for people with dementia. The nurses and carers have reported positively on their experience and enhanced practice.
This project has confirmed the need for specialist palliative care support and practice development in nursing homes. Even within the limited time
frame available, significant improvements in the quality of end of life care for residents and the knowledge and confidence of staff was achieved.
Contact for further Information
Dr Nicola Decker: nicoladecker@nhs.net
Achieving excellence in end of life care for people with dementia in Care homes in North Hampshire
9. 9
The aim of this project is to enhance the skills of health and social care staff in Hampshire so they are better equipped to support people with
dementia and their carers to achieve their care preferences to the very end of their lives. The project will provide training through a voluntary sector
provider for GPs, Primary Health and Acute Hospital Staff and Care Home Staff . This will enable them to better identify care needs, initiate
discussions, undertake advance care planning and share information amongst relevant teams so that people affected by dementia are cared for in
their place of choice with the interventions they choose. The project will support the improvement of dementia care and ensure both patient and carer
access to appropriate services.
Deliverables
The project will address the current inequality in service provision for people with dementia and will:
Adopt and adapt the National Council for Palliative Care (NCPC) evaluated model of GP training to be dementia specific
Include people with personal experience of dementia in the training sessions to motivate and educate staff
The training will:
build on current communication skills training for health and social care staff and will be developed jointly with the End of Life Care Programme
and North Hampshire End of Life Care Strategy Group ensuring an integrated approach building on, rather than replicating current
achievements
Communicate the learning at all levels including feeding into national working groups as well as local networks
Ensure a good cross section of staff including 1 GP from each of the 22 GP practices (aimed at those who liaise with care homes as a priority),
care home managers and clinical staff from acute elderly care and community services + a range of staff delivering care on the ground
Achieve and evaluate sustained behaviour change
Act as an evaluated model of good practice to be replicated in other CCG areas
Progress update
The scheme has involved the implementation of a variety of training methods to develop dementia specific communication skills and embed core
principles of good end of life care. This has included working with the National Council of Palliative Care with workshops based in GP surgeries. This
has enabled GPs a chance to discuss and work through many of the challenges and obstacles in delivering excellent care for Dementia patients.
Contact for further Information
Dr Nicola Decker: nicoladecker@nhs.net
Dementia: From difficult conversations to better outcomes - North Hampshire
10. 10
The project is using an evidence based methodology to improve the knowledge, attitude and competencies of front line health staff in the care of
people with dementia.
The project which aims to reach 20,000 front line staff working within the NHS and independent healthcare organisations across Southampton,
Hampshire, Isle of Wight and Portsmouth (SHIP) will bring together commissioners/Clinical Commissioning Groups, providers, Skills for Health,
Wessex Academic Health Science Network and the emerging Local Education and Training Board with the common aim of equipping and building
confidence in the key workforce who care for people with dementia in a variety of health settings.
The project builds on innovations developed and adopted in the Oxfordshire health community which has been working with Skills for Health by using
national competency frameworks to address practice in the care of people with dementia. Also, work developed by the University of Worcester to
develop Dementia Leadership Champions. By drawing on the learning from these areas we will be able to rapidly introduce our project, knowing that
the approach has been tested elsewhere and thus the benefits to people living with dementia and their carers can be achieved more quickly.
The project addresses the priority identified in the Dementia Challenge for driving improvements in health and care. In particular, the knowledge that
will be built in front line staff should lead to earlier identification of symptoms and diagnosis. The training programme for front line staff will build on
direct feedback from the Andover MIND Dementia Group on the issues people living with dementia and their carers face when admitted to hospital or
other care settings. The project will improve care in hospitals and maximize the benefits for use of financial rewards to hospitals through CQUIN. The
innovative approach to developing Dementia Leadership Champions will facilitate improvement in standards in care homes through the partnership
with the NHS.
Contact for further Information
Dr Edward Wernick, GP, Dementia Lead, NHS North East Hampshire and Farnham CCG - e.wernick@nhs.net
At scale adoption of skills in dementia care across Southampton, Hampshire, Isle of Wight
and Portsmouth
11. 11
This project will provide the capacity and expertise to maximise the effectiveness and extend the impact of the multi-disciplinary Community Care
Teams in Fareham and Gosport. Older people often have inter-related complex difficulties requiring support and interventions for physical and mental
health, and social care needs. The aim of the Integrated Community Care Team is to address this wide-ranging need.
This project will ensure that mental health is fundamental to the delivery of integrated care in South Eastern Hampshire and to enable the coherent
‘joining-up’ of services to deliver comprehensive care.
Deliverables
The project will deliver:
Training and awareness raising about dementia skills for generic staff
Early detection and diagnosis in the community, linking with memory services and the new Dementia Advisor service (starting in October
2012);
Reducti0on in inappropriate use of antipsychotic medication
Enhanced end of life care, recognising the particular needs of people with dementia
Support for carers.
Services that are designed and delivered around individual needs;
Increased personal choice and control
Care and support that is delivered with dignity and respect.
support with advanced care planning and care towards the end of life for both the person with dementia and their carers; and
speedy and timely access to specialist mental health care and support.
Staff in the Community Care Teams and other related services, for example the voluntary agencies providing meals on wheels, will gain core
skills in dementia care.
Contact for further Information
Victoria McDonald, NHS South East Hampshire CCG - victoria.mcdonald-woods@hampshire.nhs.uk
Holistic care for people with dementia in Fareham and Gosport
12. 12
This project will use enhanced training professional support for care home, community and primary care staff as a vehicle for ensuring that people
living with dementia in Kent and Medway can remain in their usual place of residence, avoid unnecessary admission to hospital and not receive
unnecessary anti-psychotic drugs.
Deliverables
Training to care homes across Kent and Medway
Newcastle Model training recruit a band 7 registered metal health nurse to provide training to the Community Mental Health Teams .
Training to intermediate care teams recruit 3 clinical practitioners who will be embedded in intermediate care services to increase the
competence of intermediate care/rapid response teams to support people at home, preventing crisis (including support for the carer)
Geriatrician outreach support will be targeted to those care homes or areas with the highest level of need. The role will include medication
reviews and provision of urgent geriatric assessments. End of life issues will also be addressed as these areas are very often neglected in people
with dementia, in particular advanced care plans, anticipatory care plans and palliative care. There will also be an opportunity to provide training
to care home staff.
Anticipated outcomes
People with dementia living in care homes will be treated with dignity and respect.
There will be reduction in anxiety for people with dementia and a reduction in the prescription of antipsychotic drugs.
Residential care home and community staff have the skills and values to work with people with dementia. They understand dementia; what can
help alleviate distress; how to manage different behaviours and prevent crisis.
Staff know how to get expert advice, and are able to access help and advice when they need it.
Independence will be maintained for longer.
Leadership will be improved in care homes.
Staff will have greater job satisfaction.
Contact for further Information
Sue Gratton, Deputy Associate Director, Integrated Commissioning, NHS Kent and Medway - sue.gratton@eastcoastkent.nhs.uk
Improving community care and reducing anti-psychotic prescribing in Kent and Medway
13. 13
This project aims to increase awareness as well as improving the implementation of the Gold Standards Framework for Care Homes (GSFCH) in care
homes where patients with dementia reside.
Implementation of the GSFCH will support:
Reduction in repeated and inappropriate hospital admission at the end of life
Provide good quality end of life care, which puts the patient and their family and carer first.
Good patient outcomes in line with their needs and preferences about end of life care and choices around treatment and preferred place of
death
Families and carers of patients with dementia when making difficult decisions about end of life care when under pressure, because these
discussions will already have taken place with the patient at an earlier time and will be recorded and referred to when necessary
Deliverables
Development of a training package, delivered by a fully qualified and competent EOLC Dementia Facilitator. The guidance and resource pack will
include a DVD, and an online After Death Analysis (ADA) audit tool.
The process will begin with 4 interactive workshops, using a variety of teaching methods to implement the key GSF standards into practice, monitored
and supported by the GSFCH national team.
Subsequently, after 6 to 12 months care homes can register for GSFCH accreditation on the production of a portfolio. A facilitator will be key in
providing support to the individual care homes to enable them to implement the GSFCH and assemble the required evidence of the development
necessary to pass the accreditation inspection which will be conducted by the national GSFCH team.
Anticipated outcomes
Increased patient choice.
Reduction in inappropriate admissions to hospital.
Improved care planning, with better attention to, and anticipation of, end of life care needs and a structured system for offering bereavement support
Increase in number of deaths in care homes as opposed to in the acute hospital setting.
Contact for further Information
Jane Berg, Project Lead and Head of Education, Princess Alice Hospice - janeberg@PAH.org.uk
Improving end of life care for people living with dementia in Surrey Downs
14. 14
This project will to provide a new pathway of care for people with dementia admitted to the Royal United Hospital Bath, which puts carers and patients
in the ‘driving seat’, improving discharge and reducing unnecessary admissions in future. We have already introduced an innovative charter mark for
our wards, and the National Dementia “CQUIN” 2012 aims to improve the identification of patients with dementia in hospital, to ensure that they are
assessed and referred on. Our aim is to take these initiatives much further by ensuring it is embedded in a whole system pathway that incorporates
innovations that have been shown to be effective.
The project will redesign, implement and evaluate an innovative pathway of care based on best practice for patients admitted to (and discharged
from) hospital with possible/definite dementia. There will be 5 elements:
1. The right staff and skills 7 days per week: including a coordinator, a mental health liaison service and rapid assessment teams
2. Clear monitored timeframes for assessment and intervention; i.e. day 1, day 2 etc
3. Best information and signposting for carers in hospital and then at home
4. Optimal therapeutic environment across our wards using e.g. care bundles (standardised optimal care) and technological solutions
5. Follow up pathways which are timely, robust, support carers and avoid readmission
Objectives
To make sure there is a service every day of the year that gives the right care at the right time:
To agree detailed care plans with carers within 24 hours of admission
To make sure every ward provides excellent care using a “care bundle” to provide a safe environment, whichever ward the person goes to
To use new technologies that will help patients on wards and after discharge: such as “telecare”
To make sure the plan for discharge is clear and care in the community is there when it is needed
Anticipated outcomes
We will reduce unnecessary time in hospital, freeing up 8000 bed days per year
We will involve carers every step of the way
Carers will be reassured that the hospital is listening to their views
By planning the discharge better, and by getting better support at home, there will be 50% fewer people readmitted to hospital
Contact for further Information
Dr Christopher Dyer, Consultant Geriatrician and Clinical Lead OPU, Royal United Hospital Bath NHS Trust - chris.dyer1@nhs.net
Integrating hospital and community care pathways in Bath
15. 15
This project will utilise a team of Dementia Learning Facilitators hosted by Devon Partnership NHS Trust to work with care homes to identify, train and
support a care worker to be a Dementia Champion in their work place. They will be networked with other care home Dementia Champions to share
learning with facilitated monthly meetings/teleconferences. There will also be a monthly team award and newsletter highlighting successful practice
and an annual conference showcasing successful improvements made in the quality of care for people with dementia in local care homes
participating in the scheme. The training and facilitation would be free for care homes.
Over 6 weeks the Learning Facilitators will work alongside the Dementia Champions in a consultative way to help them develop leadership skills,
develop clarity of staff roles and align their attitudes, behaviours and skills to best practice, improve person centred care and care planning and
improve environments (all factors identified as key to the quality of care in research conducted by the SW Dementia Partnership in 2009, and in key
research). The Learning Facilitator will use an educational programme, simple audit, change management theory and improvement and spread
methodology to introduce, embed and sustain positive changes in dementia care and support the Dementia Champions throughout the project. The
facilitated network meetings will help to sustain improvements and support the work of the Dementia Champions.
Objectives and planned outcomes
To establish a cost effective and sustainable solution to improve the quality of life for people with dementia living in the large numbers of care
homes in South Devon and Torbay
To improve the job satisfaction, confidence and knowledge of care home staff working with people with dementia and hence staff retention
To reduce antipsychotic prescribing for people with dementia living in care homes – National target
To reduce acute hospital admission for people with dementia living in care homes
Improved quality of life for people with dementia living in care homes – use dementia care mapping
Improved carer/family feedback – carer satisfaction questionnaire, semi-structured interviews/focus group
Improved satisfaction, confidence and knowledge of care home staff working with people with dementia
Reduced safeguarding incidents and falls
Reduced antipsychotic prescribing for people with dementia living in care homes
To reduce hospital admission rates for people with dementia living in care homes -
Reduction in referrals to Older People Mental Health Team from care homes
Contact for further Information
David Somerfield, Consultant Psychiatrist, Medical Director, Devon Partnership NHS Trust - d.somerfield@nhs.net
The Torbay and South Devon dementia care home learning community
16. 16
Section 2
On-line resources for raising dementia awareness
Alzheimer’s Society
Alzheimer's Society: Multimedia
People with dementia, their partners, families and carers share stories about what it's like to live with dementia.
Alzheimer's Society: Training courses
The Alzheimer's Society has developed a training pathway which offers those working with people with dementia the opportunity to access training
and education. Modules on the pathway range from basic dementia awareness through to higher lever study
Brain Tour
The Alzheimer’s Society UK has produced a series of nine videos, called the ‘dementia brain tour’. These give an accessible overview of how the
brain works and the way it is affected by various types of dementia, including Alzheimer's disease, Poste-rior Cortical Atrophy, Vascular Dementia,
Dementia with Lewy bodies and Fronto-Temporal Dementia.
NHS England
e-LfH: e-Dementia
eLfH is a Department of Health Programme which provides free-of-charge training materials for the NHS workforce across the UK. This is an
interactive e-learning resource to support the training of all health and social care staff in recognising, assessing and managing dementia, and in
providing high-quality dementia care. It consists of ten sessions covering a wide range of issues relevant to dementia. To access the resource in full
you will need to register with an NHS or equivalent email address.
Health Education England: e-Learning for Healthcare – Dementia
An online training resource aimed at ensuring all staff in the NHS and in social care can be dementia-aware. The e-learning sessions in dementia
have been developed by e-Learning for Healthcare, part of Health Education England (HEE)
17. 17
NHS Scotland
NHS Education for Scotland
NHS Education for Scotland (NES) has worked with Scotland Social Services Council (SSSC), Alzheimer's Scotland and the academic sector to
produce material to support professional development of staff engaged in dementia care: Educational resources and guidance on mental health
and learning disability: Dementia.
NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC) (2012) Promoting excellence: Informed about dementia
This DVD has been produced as an educational resource for the entire health and social services workforce in Scotland to support the
implementation of the National Dementia Strategy. It demonstrates that staff are likely to interact with people with dementia in a wide variety of
settings and are encouraged to recognise the rights and abilities of people with dementia. There are also "some simple steps they can take to apply
this learning in a way that can make a huge difference in improving the experience of people with dementia and their families, friends and carers in
health and social services". The DVD is in six chapters.
NHS Education for Scotland (2012) Dementia skilled - improving practice
This is a comprehensive learning resource which has been designed to be of use to a wide range of individuals and organisations. The learning
resource has five modules: Understanding dementia; Promoting person and family centred care and community connections; Promoting health and
well being; Meeting the needs of the person with dementia who is distressed and Supporting and protecting peoples rights.
NHS Education for Scotland (2011): Acute care dementia learning resource
An interactive on-line educational resource for staff working in the acute care environment to help identify and care for patients suffering with
dementia. The resource is in five sections: coming into the ward; recognising and assessing care needs; the care experience; meeting the needs of
the person who is distressed; and leaving the ward - transition.
NHS Education for Scotland (2011) Dementia care in the emergency department
An interactive on-line educational resource aimed at those working in the emergency department to recognise and provide appropriate care to meet
the needs of those with dementia. The resource consists of four sections: initial contact; assessment; intervention; and resolution.
Scottish Government (2011) Promoting excellence: a framework for all health and social services staff working with people with dementia,
their families and carers
This framework, developed by NHS Education for Scotland (NES) and the Scottish Social Services Council (SSSC), supplements existing
frameworks and applies to all health and social services staff who have contact with, and provide support, care, treatment and services for people
who have dementia, and their families and carers. It can be used as a learning tool and to identify individual skills and gaps in knowledge and as an
organisational tool to ensure staff have the skills to meet the needs of people with dementia, their families and carers.
18. 18
Skills for Care
The publications offer a comprehensive framework for the social care workforce to provide consistent high quality social care and support which
promotes the mental health and well-being of people who need care and support. The guide to good practice follows in the best traditions of work
from the Foundation in providing practical support and solutions and is based on real life examples that have been developed by getting the views
and experiences of people with care and support needs, carers, and people working in social care. The publications can be downloaded here:
Common Core principles to support good mental health and wellbeing in adult social care & Principles to practice - implementing the common core
principles
Social Care Institute for Excellence
Social Care Institute for Excellence: Dementia Gateway
This gateway is aimed at health and social care practitioners who work with people with dementia in nursing, residential or domiciliary settings. It is
organised into different sections which bring together written information, films, activities and e-learning. New sections are added on regular basis.
SCIE E-learning (2011) Mental Capacity Act
These e-learning resources bring together audio, video and interactive technology to explore many areas of the Mental Capacity Act such as
assessing a person’s capacity to make their own day-to-day and more complex decisions and when best interests decisions need to be made.
SCIE Social Care TV
Social Care TV has a series of short films which can be used for awareness raising or as part of training modules. They use real situations to illustrate
case studies.
University Based Resources
Bradford Dementia Group at the University of Bradford
This multi-disciplinary and multi-professional group is committed to making a difference to policy and practice in dementia care, through excellence in
research, education and training. Training is delivered through a variety of formats, including face-face short courses and a flexible range of
accredited programmes delivered by distance learning.
The Bradford Dementia Group has been sponsored by Yorkshire and Humber Strategic Health Authority to undertake development and evaluation of
a sustainable model of workforce development for acute hospitals. The work focuses on the development of dementia champions who facilitate
training at foundation level for all staff, and intermediate level for clinical staff. Materials have been developed that reflect the needs of staff working
within an acute hospital setting and which focus on a person-centred approach to dementia care. This work will be evaluated using dementia care
mapping, and the dementia champions training model will be offered to NHS organisations throughout the UK from 2013.
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Dementia Services Development Centre, University of Stirling
This centre provides comprehensive dementia education and training, consultancy and research services designed to support dementia care in a
range of settings. The Centre’s flagship Iris Murdoch Building is a model for dementia friendly design.
The Centre has also developed a practical resource The care of people with dementia in acute hospital settings: Evidence-based practice, innovation
and collaboration. A resource pack for staff. For details see the Centre's catalogue of publications on acute care.
The Centre also provides facilitator training for healthcare assistants and a range of courses relevant to staff working in hospital settings.
Dementia Services Development Centre: Library and Information Service The Library and Information Service at the Centre has an extensive
collection of dementia related material. Services include an online catalogue, dynamic links to current library holdings on a range of topics, a blog
responding to recent enquiries as well as loan and document supply services. Also available is Dementia Now a free downloadable ejournal
containing research information, web links and news stories. Each issue tackles a different topic relating to dementia care.
Dementia Friendly Design - a virtual tour of dementia friendly hospital environments
RCN accredited courses:
Best practice in dementia care: a six part study course for health care assistants
The Dementia Services Development Centre, University of Stirling.
Best practice in dementia care: A six part study course for care home and day care staff
The Dementia Services Development Centre, University of Stirling.
University of Worcester: Association of Dementia Studies (ADS)
The University of Worcester ADS staff have experience in developing care for people with dementia in hospitals. They have been engaged in
research and development on an NHS West Midlands programme with the Royal Wolverhampton Hospitals NHS Trust in developing services of
excellence in the acute hospital from 2009 to 2011.
A range of courses are available up to degree level.
The Association has developed, as part of a collaborative project, DVD assisted training on good communication between health care staff and
people living with dementia and their families which includes a section on hospital care. For more information and details of how to obtain see Stand
by me training resource.
Improving Dementia Education and Awareness (IDEA - Nottingham University) IDEA is a free online resource aimed at improving the care and
quality of life of people with dementia. Whether you are a care worker, carer, or health professional, IDEA provides quality resources about dementia.
The website directs users to relevant online and face to face courses, and there are discussion areas which are open to everyone who registers.
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Other
Royal College of General Practitioners (RCGP): e-GP, e-Learning for General Practice - Dementia
This e-learning resource has two modules, 'Memory Problems in Older People' and 'Care of People with Dementia'. They are written by experienced
clinicians, and the e-learning uses case studies, animation and interactive exercises. Each session takes around 20 minutes to complete. Access to
e-GP is available free to UK NHS General Practitioners, GP Specialty Trainees and GP educators.
Dementia Partnerships
The Dementia Partnerships website, sponsored originally by NHS South of England, is "a resource for people, partnerships and networks working to
improve outcomes for people living with dementia". It aims to share local news and resources and learning on particular topics which include:
commissioning; improving diagnosis and support after diagnosis; hospital care; better prescribing; workforce; the arts and dementia. One of the
resources is a positive practice compendium which brings together a selection of developments and initiatives to improve the quality of dementia care
in hospitals across the South West of England - see Positive practice compendium.
Dementia Training Centre
Offers a range of courses from face to face training programmes, tailored to the meet the needs of your organisation, free e-learning packages
designed by experts, to a Master’s degree offering specialist dementia training.
Hardwick CCG
Has produced a Primary Care Dementia ‘Toolbox’ for use by GPs and practice nurses. The toolbox called ‘Dementia the view from Primary Care’
can be downloaded.
Yorkshire Ambulance Service has published a guide for staff about caring for people with dementia. The Dementia Learning Resource for
Ambulance staff gives basic information and sign-posts further reading.
Thames Valley HIEC
A suite of resources for those involved in Dementia Care. Sign-up to receive regular information digests and notice of news and events. This team
produced this document