Meeting documents

To receive a presentation from the Chiltern Clinical Commissioning Group - Dr Sian Roberts, Clinical Director and Caroline Hart, Joint Commissioner.

Dr Sian Roberts, GP Dementia Lead and Maxine Foster Commissioning Manager, from Buckinghamshire Clinical Commissioning Group (CCG) (Aylesbury and Chiltern formally merged in April 2018) gave a presentation on dementia.

During the presentation the main points were noted by Members:-

·       Dementia was defined as a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities.

·       There are 850,000 living with dementia and this was expected to rise to over 1 million by 2025.

·       The Prime Minister challenge on dementia 2020 is to maintain a diagnosis rate of at least two thirds, increase the numbers of people receiving a dementia diagnosis within six weeks of a GP referral and improve the quality of post-diagnosis treatment and support for people with dementia and their carers.

·       A dementia diagnosis will aid the understanding of care workers, family members and friends, leading to better support of the person with dementia. It can lead to more appropriate care and support, may give the person with dementia the opportunity to plan for the future and depending on the type and stage of dementia specific treatments or interventions may be available.

·       6,500 people over 65 in Bucks are probably living with dementia.

·       Diagnosis can be undertaken through the Memory Clinic at Amersham Hospital, memory assessment closer to home (Denham Medical Centre) or screening in care homes.

·       A Memory Support Service was offered via Alzheimers Society. There was also support from Carers Bucks, GPs, Older Adults Community Mental Health Teams and the Dementia road map.

·       There was a my life my memories project which was focusing on dementia in the different communities within the Buckinghamshire area.

·       There was a mobile virtual dementia tour and living with joy workshops.

Members discussed the following points:-

·       A Member referred to a local example where it was very difficult to get a referral. Another Member referred to another example and also commented that the trigger mechanism for a referral did not work. Having clarified the timescale for these issues Dr Roberts reassured Members that dementia services had changed significantly and it was much easier to get a referral. GPs now had received training on dementia diagnosis and with the help of the screening tool, the memory clinic and accessibility of services across localities this should no longer be an issue.

·       In answer to a question on monitoring, Dr Roberts informed Members that the CCG commission Oxford Health Foundation Trust ( OHFT) to provide Memory Assessment Services. The contract with OHFT was monitored monthly with key performance indicators ( KPIs).

·       They received detailed information for monitoring purposes, including on providers of services such as Older Adults Community Mental Health Teams  and also looked at patient choice. Referrals were prioritised according to need but they worked towards the target of six weeks. Innovative work was being undertaken to get people to ask for help. If a patient was having difficulty in obtaining a referral they should contact their GP.

·       A Member expressed concern about carers receiving information from GPs because of confidentiality. GPs were able to confirm what services had been put in place but could not disclose any personal information without the patient’s consent. Reference was made to the need to obtain power of attorney in certain situations.

·       In terms of the Government campaign there was recognition around the difficulties with dementia and to destigmatise the illness and raise awareness. Ideally dementia would be diagnosed and supported from an early stage – assessment was key. If patients had to be hospitalised this was undertaken locally where possible. A Member referred to the Annual Review carried out by GP surgeries and the opportunity to help identify any issues at this appointment.

·       Reference was made to a project on dementia partnered by Carers Bucks which looked at the impact of their unique family intervention service on carers and families of those suffering from dementia.

·       GPs in the past had felt helpless in treating dementia however there was now an education programme and support available so GPs were more confident in diagnosing dementia and referring to support services.

·       BME patients were less likely to be diagnosed as some families in different cultures were more reluctant to ask for help.

·       A Member referred patients not being able to attend an appointment and there being a difficulty in rebooking appointments. There could sometimes be a disconnect between hospital and GP services and it was important that one organisation took ownership of the patient’s care. Dr Roberts reassured Members that hospital appointments could be rebooked online but would clarify the rebooking of appointments with the Mental Health teams.

Members thanked Dr Roberts and Maxine Foster for attending the meeting and welcomed the excellent presentation and discussion. They asked Dr Roberts to attend a future SBDC Council meeting so that all Members could hear the presentation.

RESOLVED that the report be noted.