The following disclosures were made in the interest of transparency:

(i)            Councillor A Ahmed disclosed that she was the Council’s Dementia Champion and a Governor of Bradford District Care NHS Foundation Trust in relation to the Post Diagnosis Support for People with Dementia item (Minute 87).

(ii)          Councillor Gibbons disclosed that he was a Governor of Bradford District Care NHS Foundation Trust in relation to the Post Diagnosis Support for People with Dementia item (Minute 87).

(iii)         During consideration of the Airedale and Partners Enhanced Health in Care Homes Telemedicine Vanguard report (Minute 88), Councillor A Ahmed disclosed that she employed by the Yorkshire Ambulance Service NHS Trust.

ACTION: City Solicitor

Recommended –

That the minutes of the meetings held on 25 January 2018 and 1 March adjourned to 22 March 2018 be signed as a correct record (previously circulated).

(Palbinder Sandhu – 01274 432269)

Resolved –

That the minutes of the meetings held on 25 January 2018 and 1 March adjourned to 22 March 2018 be signed as a correct record.

There were no appeals submitted by the public to review decisions to restrict documents.

Any referrals that have been made to this Committee up to and including the date of publication of this agenda will be reported at the meeting.

No referrals had been submitted to the Committee.

The Strategic Director, Health and Wellbeing will present a report (Document “AD”), as requested at the Health and Social Care Overview and Scrutiny Committee in January 2017, which provides an annual update report from the Bradford District Dementia Strategy Group focusing on the services provided in the District to support people with dementia and their carers post diagnosis.

Recommended –

(1)       That Members are asked to comment on the update report.

(2)       That a further update report be provided in 2019.

(Rose Dunlop – 01274 431915)

Previous reference: Minute 62 (2016/2017)

The Strategic Director, Health and Wellbeing presented a report (Document “AD”), as requested at the Health and Social Care Overview and Scrutiny Committee meeting in January 2017, which provided an annual update report from the Bradford District Dementia Strategy Group focusing on the services provided in the District to support people with dementia and their carers post diagnosis.

Members were provided with a presentation which included the following information:

The National Picture

·         850,000 people are estimated to be living with dementia in the UK.

•      This figure is expected to rise to 1.15 million by 2025.

•      There are 517,426 people in the UK with a dementia diagnosis.

·         One in 14 people over 65 have dementia and approximately 40% of them are in their 80’s.

•      1 in 3 people born in the UK this year will develop dementia in their lifetime.

·         66% of people with dementia live in their own home.

•      Half of these live on their own.

•      80% of care home residents are people with dementia.

The Local Picture

·         There are 5000+ people in the district with dementia.

•         This figure is expected to rise to 6000 by 2020.

•         There are approximately 4000 with a diagnosis and 1000 undiagnosed.

·         1000 new cases are expected each year.

•         There were 1750 new referrals for Memory Assessment in 2015-16

·         25% of all hospital beds are occupied by people with dementia.

•         80% of care home residents are people with dementia.

·         66% of people with dementia still live at home.

Priorities in 2018

NHS England has published a new dementia guide that sets out what good quality assessment, diagnosis and care looks like.  The guide is shaped by the framework set by the NHS mandate and has two clear requirements to enhance dementia care, through:

·         increasing the number of people being diagnosed with dementia, and starting treatment, within six weeks from referral; and

·         improving the quality of post-diagnostic treatment and support for people with dementia and their carers.

Post-diagnostic support aims:

•      To provide a named co-ordinator of care.

•      To facilitate choice, independence and person-centred care.

•      To signpost to local support services and ensuring continuity of care.

•      To jointly develop and review a care plan.

•      To ensure the person’s physical and mental health are monitored.

•      To ensure access to treatment.

Current types of Support:

•      Specialist Health Services

•      Post-Diagnostic Support

•      Social Care

•      Community-based Support (voluntary sector)

•      Self-Care

•      Carer-Focused Support

At the conclusion of the presentation, it was acknowledged that, going forward, there may need to be more focus on the gap between diagnosis and specialist dementia care services.

In response to Members’ questions, it was reported that:

•      With the aid of new technology, there were ways of ensuring a safer environment for people with dementia who lived alone.

•      In the future, there were expected to be fewer high crisis patients referred to services due to more people being diagnosed  ...  view the full minutes text for item 87.

This report (Document “AI”) provides an update on the progress and changes to the Airedale and Partners Telemedicine Vanguard since 2016.  The Vanguard programme has now reached its conclusion and this report also includes the findings of the evaluation of the Telemedicine part of the Vanguard Programme.

Recommended –

That the findings of the evaluations be noted.

(Rose Dunlop – 01274 431915)

A report was submitted (Document “AI”) which provided an update on the progress and changes to the Airedale and Partners Telemedicine Vanguard since 2016.  The Vanguard Programme has now reached its conclusion and the report also included the findings of the evaluation of the telemedicine part of the Vanguard Programme.

Members were reminded that, in March 2015, Airedale and Partners was one of six ‘enhanced health in care homes’ Vanguards selected by NHS England as part of its New Care Models Programme.  The programme aimed to scale up the existing delivery of telemedicine to care homes in four CCG areas (Bradford City, Bradford District, Airedale, Wharfedale and Craven and East Lancashire).

A detailed presentation was provided to Members of information contained in Document “AI”.  In conclusion, Members were informed of the limitations of the data collected as part of the evaluation process which had reduced the number of care homes that could be analysed from over 200 to 141 and due to some of the small numbers used for the analysis, the findings were unlikely to have any statistical significance.  The evaluation of the 141 care homes, in the year following installation of telemedicine, showed a reduction in emergency hospital admissions of 3%, a small increase of 2% in the use of out of hours services and a reduction in the use of 111 calls by 4%.  The varying service models and local issues affecting the way in which telemedicine was used, as well as the inconsistencies of its usage across care homes, were also factors which needed to be taken into account when considering the findings.

The following responses were provided to Members’ questions:

·         Airedale and Partners had only evaluated the telemedicine aspect of the Vanguard Programme, which was one of the seven intervention areas.  Following a request from NHS England in 2016 to widen the delivery scope to include the full range of activity, it was decided that this should be undertaken by one CCG partner and was therefore led by East Lancashire CCG.  An evaluation of their findings was due to be produced.

·         The Vanguard Programme had not been decommissioned.

·         The evaluator had experienced difficulties in accessing care homes to discuss the use of telemedicine with staff.

·         East Lancashire, as part of their evaluation, would be able to demonstrate cost savings as they were replacing a whole system, but this had not been possible as part of the telemedicine evaluation.

·         The use of telemedicine had raised challenges around losing the personal touch for some patients.

·         The evaluation had not included tests to review how primary care was impacted by telemedicine.

·         When the partners had met to share learning, all commissioners took away learning about how to improve the use of telemedicine.

During the discussion, Members recognised that two years was a short timeframe for the evaluation but hailed the concept of telemedicine as a good way of incorporating technology to help deliver services.  Telemedicine was also considered a new way of working which would take  ...  view the full minutes text for item 88.

The Overview and Scrutiny Lead will give a verbal update tracking the outcomes of the Committee’s resolutions over the last two municipal years.

(Caroline Coombes – 01274 432313)

The Overview and Scrutiny Lead was due to give a verbal update on tracking the outcomes of the Committee’s resolutions over the last two municipal years.

Resolved –

That consideration of this item be deferred to a future meeting of the Committee.

ACTION:       Overview and Scrutiny Lead

The Chair, on behalf of the Committee, thanked Councillor Val Slater for her invaluable input into the work of this Committee during her time as Portfolio Holder for Health and Wellbeing.  She wished her well for the future as she was stepping down from her Councillor role.