Agenda item

To receive a presentation by Dr Andrew Ellis, Consultant Psychiatrist.

Dr Andrew Ellis, Consultant Psychiatrist, made a presentation to Members outlining the Dementia Care Pathway whose aim was to focus on patient-related outcomes to ensure that patients could live well with dementia.

The presentation covered:

      the statistical information in respect of the number of people with dementia and the expected rise in dementia by 2030. It was noted that the number of people with dementia currently was 700,000 in the UK, costing an estimated £17b per annum.  The number of sufferers was likely to rise to 1,400,000 by 2030, with a consequential increase in cost to £51b.

Dementia in under 65 years of age was rare. 1 in 14 of dementia sufferers were, over 65 years of age, with 1 in 6 over 80 years of age.

      the cost of treating patients with dementia.  In the previous year, a sum of £160m had been allocated under the National Dementia Strategy, but as the funding had not been “ring-fenced” it had been used in other areas of patient care.

      the use of anti-psychotic drugs in treatment of dementia.

      etection/Assessment:  Early detection was important in improving the outcome for sufferers. A television advert, piloted in the North-West, encouraged close relatives or carers to seek GP diagnosis where relatives were exhibiting memory loss.

      Challenges presented by NICE HTA, and issues surrounding drug costs and service capacity.

      Dementia pathways:

-                      detection

-                      initial assessment

-                      initial management

-                      specialist referral

-                      specialist assessment

-                      specialist management

-                      discharge

      The Committee was informed that in Wirral, more people with dementia were admitted to hospital than in other areas (1,000 per annum).  In the absence of other prevailing health conditions, this was not appropriate.

      CWP initiatives, including –

o                   new in-patient wards

o       Anti-psyocotics in dementia – project with PCT                            awareness pilot in four care homes and four GP practices

o       Memory Assessment Scheme: nurse-led working with partner   organisations focusing on early diagnosis and support

o       Local initiatives:

                       (West)

                                   Advanced nurse practitioner

                                   Intensive home treatment team

                                   Accreditation Cedar Ward

                                   Memory clinic Accreditation

                                   Service redesign

                       (East)

                                   Advanced nurse practioner

                                   Care Services Efficiency Delivery (CSED) Project

                                   Acute care consultant

o       Introduction of acute care model

      Future Challenges

o       Increasing demand for services

o       Move to patient-related outcomes

o       Impact on partnership organisations such as Social Services    and Acute Hospital Trusts

Dr Ellis was thanked for his presentation and Members were able to ask questions –

      Was research into dementia being undertaken? 

Members were informed that there had been no major breakthroughs for approximately 10 years.  Dementia was a progressive deterioration in the brain and could take up to 20 years to manifest itself. The current focus was on the quality of care and support which could be provided to ensure, as far as possible, that dementia sufferers could remain independent.

      In response to a question about dementia statistics, Members were informed that there were no specific areas where there were significantly high or low incidences of dementia. 

      Training of GPs.

Training on psychiatric disorders formed only 6 weeks training for GPs.  Members commented that this appeared to be inadequate in view of the new role of GPs who would be able to commission health services under the Health and Social Care Bill.

It was suggested that at a future meeting, the Committee examine the staffing structure in respect of dementia services.

RESOLVED:  That the presentation be noted.