Implementing national priorities next steps

Sir Ian Carruthers, Chief Executive of NHS South West, recently wrote to South West Chief Executives and South West Directors of Adult Social Care outlining the next steps on implementing the four national priorities set out in Quality outcomes in dementia.

1. Good quality early diagnosis and intervention for all

Commissioning memory services is an important component of this work and this year, not all the contracts specified activity levels and waiting times nor were able to show that volumes were sufficient to meet need. The Department of Health is preparing a commissioning pack on dementia services that will be available in the next financial year. In advance of this, the South West Dementia Partnership has produced information to help specifically with the commissioning of memory services.

2. Improved quality of care in general hospitals

The Royal College of Physicians interim report on their national audit of dementia care in hospitals highlights a general lack of focus from general hospitals on improving the services for people with dementia despite the significant numbers of patients in acute hospitals.

To complement the national audit the South West Expert Reference Group has developed a set of common standards for improving care and services in community and general hospitals across the South West for patients admitted for elective or emergency treatment and care. The standards will support providers and commissioners to assure high quality care and enable patients, their relatives or carers to call the service to account. For each standard listed there are clear measures or indicators described to inform the monitoring of the implementation of the standard. Some standards will be directly within the control of ward staff, others may require resources to be identified to support implementation.

3. Living well with dementia in care homes

A “Dementia Quality Mark” for care homes is being developed, and will be piloted in the South West. Councils in BANES, Wiltshire, Plymouth, Bristol and Dorset have agreed with local independent sector providers to be early adopters and it is hoped then to roll out the scheme to other areas.

4. Reduced use of antipsychotic medication

Read the letter about a piece of work to reduce antipsychotic prescribing and improve the management of challenging behaviours in people with dementia.

All the SHAs have met and are looking at producing further materials by February 2011 that will build on the local audits that are being undertaken in primary care and the region-wide secondary care audit. This work has highlighted the need to ensure that practice in general and community hospitals is included in your work as a proportion of patients have prescribing initiated while a hospital in-patient.

The DH has allocated £154,000 and NHS South West will be making the necessary arrangements in January 2011 to allocate this to PCTs using the weighted capitation formula. This money is for PCTs and partners to agree how to spend in driving down inappropriate prescribing – for example, it may facilitate audit or help with work on managing challenging behaviours.

5. Implementation progress

Finally there is the requirement in the Revision to the Operating Framework 2010-11 for PCTs to publish progress on their implementation of the National Dementia Strategy. The South West Dementia Partnership have produced a suggested template to help PCTs with this task.