- 10 April 2017
- Posted in: Health & Social Care
The Prime Minister’s Challenge on Dementia 2020: Implementation Plan (DoH 2016) showcased a case study for Personal Assistants: Dementia (p34). These are a group of experienced dementia workers who offer to support everyone who is diagnosed with dementia in Walsall. It does not matter whether a person receives a diagnosis at the acute hospital, from their GP, the Memory Assessment Service or indeed from learning disability colleagues.
The important thing is that people are offered post diagnostic support and experience a seamless pathway where services work together as one.
NHS England’s Next Steps on the Five Year Forward View (2017) maintains the emphasis on good post diagnostic support, “We will also continue to maintain focus on diagnosis and post-diagnostic support for people with dementia and their carers. These are key drivers to keeping in their own homes, preventing crises and avoiding unnecessary admission to hospital” (p45). What this should look like will be detailed in the long awaited evidence based clinical pathway for dementia the Department of Health are due to publish, which is likely to place an expectation on CCGs to achieve a referral to diagnosis and treatment time of six weeks and a review of post-diagnostic support 12 months after diagnosis.
Services in Walsall are commissioned to be person centred and not centred on the service delivering that particular element. For the person with dementia and their family, support is offered from a team and that team consists of NHS staff working alongside staff from Pathways4Life (Age UK Walsall and Accord). The model is used in our acute hospital specialist liaison team, working with groups who do not find accessing services easy, improving care in care homes and end of life care. The latter incorporates the specialist skills of St Giles Hospice.
Partnership working is a vital constituent to commissioning in a whole systems way. It is fundamental to the success of all of our services.
It can overcome a range of obstacles, red tape and ‘can’t do’ attitudes, which are un-necessary and lead to poorer outcomes for the people we, are all here to serve. Indeed this partnership working formed the foundations of a more formal transition to an integrated approach entitled, ‘Walsall Together’.
In times of limited funding, it is an opportunity to be innovative and design services with others to benefit the local population, rather than sail with the prevailing wind and try and make someone else’s model fit. It allows one to improve on the quality of care and in doing so, make services more efficient so that new models can be invested in and tried out; sometimes as a pilot in the first instance to gather evidence of their efficacy. The Walsall whole systems approach was featured as a case study by NICE’s Dementia Care: Commissioning Guidance (2013) (p16).
For providers, this level of emphasis and support for formal and informal partnership working has delivered a diverse platform from which providers gain knowledge, shared experiences and greater joined-up working. Walsall now has numerous case examples which highlight the service user benefit to such a high level of cohesive service delivery.
Our most recent example of partnership working at its best was redesigning a traditional older people mental health and dementia day hospital into a peripatetic service.
The Therapy and Liaison Community Service utilises room space in Age UK Walsall’s Community Engagement Centre and Link Line’s base. Link Line is a local voluntary organisation which receives free training for its volunteers in dementia and end of life training. They also provide tea parties in the acute hospital to improve nutrition, hydration and wellbeing. The mental health nurses in the Therapy and Liaison Community Service are training Pathways4Life staff to deliver their own therapies at the Community Engagement Centre, so that after the NHS intervention, people can remain in the same buildings receiving long term support.
Partnership working allows for a pooling of resources without formal contracts. For example, there are a range of training modules which have operated for a number of years and are free to anyone who works or lives in Walsall. It is the backbone to a successful Dementia Friendly Communities Programme. Indeed seeing the Walsall sunflower logo appear more and more in organisations and businesses’ windows is a reward in itself and in particular, on the side of a fire engine racing past on its way to an emergency call, knowing that the crew are all dementia friendly.