25.1 The Board
considered a report providing information about local arrangements
for diagnosis and post diagnosis support for people with dementia
in the East Sussex Better Together (ESBT) area of East Sussex.
25.2 The Board was
informed that a new Dementia Post Diagnostic Support
Service will be provided from April 2018 to replace the Dementia
Advisors programme. The Service will include 10.5 whole time
equivalent (wte), Dementia Community
Development Workers (DCDW), delivering practical support to carers
and patients across the ESBT area. One additional wte DCDW will be commissioned to support those
individuals and families where an early onset dementia has been
identified. The new contract is expected to be awarded at the end
of the week.
25.3 The following
additional information was provided in response to questions from
Members:
-
All GPs running the Memory Assessment Services (MAS)
Clinics complete a part-time, one year post-graduate certificate in
dementia.
-
MAS Clinic GPs would not diagnose urgent or severely
complicated cases of dementia, and would refer patients who are
acutely ill with dementia, or displaying disturbed behaviour, to
secondary care specialists for diagnosis. There is also recourse to refer these patients to
a dementia specialist who runs a monthly tertiary clinic in
Polegate. In total, 97% of patients
with suspected dementia are referred to the MAS clinic for
diagnosis, and 95% of those who are referred to a MAS clinic are
diagnosed by the MAS GPs – with 5% being referred to
secondary care specialists.
-
People with learning difficulties and suspected
dementia will typically be referred to the Learning Disability
Service unless the individual prefers to be seen by a MAS Clinic
GP.
-
The recommissioning of the Dementia Post Diagnostic
Support Service was not carried out as a cost saving measure. The
previous Dementia Advisors Service contract involved a minimum
payment to the Alzheimer’s Society and additional funding
paid out for additional work on top, however, the additional
capacity was not being utilised. The 10.5 wte Dementia Community Development Workers
currently employed in the Dementia Advisors Service will be
redeployed to make more effective use of the funding envelope, and
the admiral nurse will be employed as an additional
spend.
-
Whilst the MAS Clinic GPs are drawn from the pool of
existing GPs and there is a continued shortage of GPs, particularly
in the Hastings area, there are several practice nurses who have
the postgraduate certificate and take part in the MAS Clinics. This
means that further practice nurses could be upskilled if necessary
to fill future gaps in MAS clinic staff if GPs are not available to
fill them.
-
The current referral time from GP to MAS Clinic is 5
weeks. NHS England is to introduce a new standard of 6 week’s
referral time, so the MAS is already meeting the
target.
-
Examples of how the voluntary sector is involved in
the MAS include:
-
ESBT Community Link Workers help identify
appropriate voluntary agencies and inform GP Practices.
-
GP practices are developing care navigators to
proactively search for voluntary agencies.
-
The new Dementia Post Diagnostic Support Service
contract includes a responsibility to ensure that dementia patients
are assisted with accessing a wide range of voluntary
sector-provided support.
25.4 The Board
RESOLVED to note the report.