Agenda item

Support for people with dementia in the East Sussex Better Together area

·         A Report by the Director of Adult Social Care and Health


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.

Supporting documents: