There are around 80,000 people with dementia in the UK and the numbers of people affected is expected to double by 2040 with economic costs likely to treble from the current estimated costs of £26 billion a year (Alzheimer’s disease Society 2014).
The North West of England has approximately 89,000 people affected with dementia, the second highest in the country, with projected increases of more than 101,000 people in the region by 2021 (Alzheimer’s Society 2014). Within care homes one in three adults die from dementia with the majority living in care homes at the time of their death.
With these statistics there is, without doubt, a real need to ensure the workforce is appropriately educated to manage the demands of this rising health problem and this has prompted the development of the Dementia Academy and Dementia MasterClasses through the existing Neurology Academy. This innovative programme builds on 14 years of success in Parkinson’s disease education and extends this widely acclaimed and unique model of education to an area that is impacting significantly on health and social care services.
Spearheaded by Dr Ira Leroi, Clinical Senior Lecturer and Honorary Consultant in Psychiatry, University of Manchester Mental Health and Social Care Trust Institute of Brain, Behaviour and Mental Health, Sue Thomas, Chief Executive of NHiS Commissioning Excellence, and Tony Burch GP Trainer London, Manchester is an appropriate place to launch the Dementia Academy and first Dementia MasterClass. The aim of the Dementia Academy is to increase awareness, provide training opportunities and ensure competence for clinicians working with people who will have or develop dementia. The first meeting held on 2 March focused principally on GPs and provided education on how to diagnose, treat and manage dementia from ‘forgetting my keys’ to advanced care needs.
The meeting was opened by ex- Greater Manchester Chief Constable Sir Peter Fahy, who spoke of his personal experiences of his mother who had dementia. He highlighted that dementia is everyone’s business and that we will need to work in an integrated way to manage the impact this condition brings.
Professor Alistair Burn, NHS England National Clinical Director for Dementia provided a keynote address outlining the fact that the interest in dementia was ignited by the publication of the National Dementia Strategy in 2009, energised by the first Prime Minister’s challenge on dementia in 2012 and fuelled by a raft of developments such as the hospital dementia scheme, the primary care detection initiative, the creation of Dementia Action Alliances across the country, reduction in the prescription of antipsychotic drugs by 50% and the creation of one million dementia friends. He said support for people with dementia was rated in the top five in importance by the NHS Citizen’s Jury in 2015.
For NHS England, the prevailing focus for the last year has been the fulfilment of the ambition that two thirds of the estimated number of people with dementia have a formal diagnosis and post-diagnostic support.
The ready availability of the national diagnosis rate coupled with the absence of a corresponding simple metric for post-diagnostic support have inevitably resulted in a focus on the former. The successful achievement of the diagnosis rate of 67% at the end of November 2015 has allowed conversations to move to post-diagnostic support and beyond.
He stated much of the focus to date has been toward primary care, emphasising the long-term nature of dementia, the need to get things right for patients in primary care – including prompt assessment and treatment – and the issue of whether GPs should be empowered to initiate anti-Alzheimer medication. He outlined the acronym DEMENTIA which should be used to guide dementia reviews (see www.england.nhs.uk).
The next speaker, Dr Ross Overshott, gave a very enlightening interactive overview of dementia outlining diagnostic issues. Small group work followed highlighting through three differing stages of dementia potential management scenarios. During the meeting the ‘Wall of inspiration’ allowed sharing of resources to support better management of dementia and included resources from the voluntary sector, local clinical commissioning group pathways and guidelines as well as phone apps that could assist crisis issues.
Further group work in the afternoon focused on issues like driving, legal issues, carer support and the Memory Assessment Service.
Rounding up the meeting a panel presentation from Greater Manchester police, Manchester ambulance service and an acute hospital liaison clinician clarified for attendees what issues each of these services found most pressing and outlined how GPs might prevent or better support some of these issues from arising. For example, PC Adele Owen highlighted issues of people with dementia getting lost had prompted the purchase of bracelets which revealed a person’s first name and an emergency contact phone number when scanned with an NFC enabled phone. Dan Smith from the ambulance service highlighted their most important need was for a baseline measure of patients as when they received a 111 call they were often unsure if the person was in a crisis situation requiring hospital admission or just needed extra home support.
Throughout the day, Sue Thomas collated information on the dementia pathway process as one of the main outputs for the meeting will be an interactive integrated dementia pathway.
The next meeting will be for secondary care clinicians to gain education on holistic dementia management as well as contributing to elements of the integrated care pathway.
The next meeting will be held on 15 June 2016 for secondary care clinicians to gain education on holistic dementia management as well as contributing to elements of the integrated care pathway. To participate in further meetings visit the Dementia Academy webpage; alternatively you can access presentations and reports from previous meetings on the Dementia Resources page.
To participate in further meetings or access presentations and reports see Dementia Resources.
ACNR 2015;16(2):23. Published online 14/6/16