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 at an earlier stage.

•      No single part of the service could resolve everything for people with dementia; partnership working was crucial between health and social care services and the voluntary sector.

•      The NHS Bradford City CCG area had a high dementia diagnosis rate (81%) in comparison to other CCG areas across West Yorkshire and this was partly due to the high population of young people in that area.

•      Providing services that catered for different community groups across the district was taken into account when forward planning service provision.

•      The onus to disclose a dementia diagnosis to employers rests with the patient.  Support was available for people with dementia to advise patients on this matter.

•      It was acknowledged that there was work to do to de-stigmatise a dementia diagnosis.

•      The Alzheimer’s Society aimed to make telephone contact with a person with dementia within a week of their diagnosis; people could self refer at anytime.

A Member spoke of the stigma around dementia within the Asian community and asked what could be done to encourage earlier diagnosis.  In response, it was stated that a leaflet was being developed, specifically aimed at the BME (black and minority ethnic) population and that evidence showed that being more informed reduced stigma and increased diagnosis rates. The Services Manager for the Alzheimer's Society in Bradford also added that this was an area of work that would be picked up, in terms of community engagement, with Councillors in those wards where gaps were identified, after the upcoming local elections.

A Member stated that he had recently attended a carers support event at which carers had stated they would welcome more practical help e.g. moving and handling the person they were caring for.  The Assistant Director, Operational Services (who was in attendance at the meeting for the Strategic Director, Health and Wellbeing) stated that there were a number of advice sheets available from the Alzheimer’s Society.  She stated that the local authority would offer practical support in homes and agreed that this was invaluable support to carers.  The Dementia Lead for Bradford District Care NHS Foundation Trust added that, whilst there was good social support and post diagnosis guidance available, practical help on ‘how’ to support someone was a possible gap in service provision.

The Services Manager for the Alzheimer's Society in Bradford informed Members that there were an increasing number of different initiatives for newly diagnosed people with dementia, but the uptake was not always good.  He also stated that Bradford had an Admiral Nurse Service available through the Royal British Legion.

The Head of Commissioning at NHS Bradford Districts Clinical Commissioning Group informed Members that an updated Integrated Care Strategy was due to be submitted to the Commissioning Board on 22 April 2018.

The Assistant Director, Operational Services spoke of the links to the Council’s ‘Great Places to Grow Old’ housing strategy for the over 50’s, given that80% of care home residents were people with dementia.  She touched upon providing services differently with 24/7 access to support and the need to ensure funding was being spent in the right way to support people living with dementia due to the expected rise in numbers.

Resolved –

That a further update report be provided in the 2018/19 municipal year with a focus on finance and housing issues around dementia.

ACTION:       Strategic Director, Health and Wellbeing