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					Appendix 4:

Summary of Progress made to date on local Norfolk Dementia Priorities – NDS Objectives 1, 2, 6, 7, 8, 11 and 13.

Local Priority                PROGRESS
1: Improving public &           Awareness about Dementia’ road shows held across the county.
professional awareness          Stakeholder Event in September 2009 attended by over 100 people.
and understanding of            Public consultation about the draft joint Norfolk commissioning strategy for dementia including:
dementia                            o 6 public events across the county
                                    o Media engagement by health and social care commissioners and professionals leading the
                                         Norfolk dementia project.
                                Event in March 2010 attended by GP’s & supported by Secondary Care Clinical Consultants to better
                                 understand the role of primary care in dementia.

2: Good quality early             NWMHFT are working jointly with NCH&C to develop a community based model to deliver care for the
diagnosis & intervention           frail elderly including those with dementia.
                                  NWMHFT run 'memory treatment' services in each locality giving knowledge, experience and practical
                                   insight available to help the Dementia Project formulate services specification.
                                  Trial/pilot in South Norfolk (run by the NWMHP FT CMHT)) of a primary care link worker for older people
                                   working successfully with designated surgeries.
                                  DoH sponsored Dementia Advisor (DA) pilot across all Norfolk localities. DA's employed by Alzheimer’s
                                   Society but each attached to the community mental health team

6: Improved community             N&WMH FT in partnership with local GP Practices have successfully piloted a Primary Care Dementia
personal support services          Worker (PCDW) role which will undertake initial review of GP referrals for assessment.
                                  The PCDW approach advocates non-pharmacological approaches to the management of challenging
                                   behaviour and is trained in the use of person centred care and dementia care mapping (DCM).
                                  This approach has helped reduce falls and other physiological complications of drugs used to manage
                                   challenging behaviour, resulting in reduced admissions to Acute Hospitals (e.g. NNUH, Julian Hospital).
7: Implementing the      Development of the draft strategy for carers in Norfolk reflects the following principles consistent with the
Carer’s Strategy          joint Norfolk dementia strategy:
                              o Improved health and well being
                              o Improved quality of life
                              o Making a positive contribution
                              o Choice and control
                              o Freedom from discrimination
                              o Economic well being
                              o Personal dignity
                         The views those caring for people with dementia and the general public in Norfolk have informed the
                          Norfolk carer strategy. The important development areas are:
                              o Information on services and support
                              o Having a life of our own
                              o Income - the opportunity to work if carers wish to do so or to have information on benefits
                              o Health and well being of carer
                              o Having a say in service provision
                              o Practical Support to assist in the caring role
                              o Services that support the cared for person
                              o Emergency Support
                              o Having a break
                         The Norfolk carer strategy will concentrate on developing these areas for the next 3 years – and will
                          therefore be the focus for ensuring delivery of service requirements for carers of people with dementia.
                         Produced a yearly publication to inform Carers of the services and support available for Carers in Norfolk
                          and ensured that this is widely distributed
                         Provided a Carers Helpline 8-8 Monday – Friday that gives information and support to Carers
                         Produced a quarterly magazine of information for Carers
                         Developed services with Carers Agencies to provide information
                         Developed an Information Officer post specifically for Carers
                         Publicised support for Carers at the Norfolk Show and during Carers Week and at other events
                         Ensured that Assessors and contact points give all Carers that contact them information about services
                          for Carers in Norfolk
                         Supported the Alzheimer Society to develop support and information groups for Carers of people with
                         Commissioned organisations like Norwich and District Carers Forum and West Norfolk Carers to provide
                          information and support
                         Norfolk Adult Community Services personalisation objective at only an earlier stage of development for
                          Carers but there is a commitment to achieve this in Norfolk especially as Carers have indicated that they
                          would value this opportunity.
                         NHS Norfolk and NHS Great Yarmouth and Waveney have also made a commitment to supporting
                          Carers through our commitment to the personalisation agenda.
8: Improved Care in      Each of the Acute General Hospitals has:
General Hospitals             o a nominated lead clinician for dementia who is the focus for leading their developments to
                                 services and care.
                              o formed working groups which are reviewing dementia care pathways for services in the acute
                                 hospital and expect this work to be completed in the next 3 – 6 months.
                              o introduced the use of ‘This is me’ booklets – and to extend the usage to all wards in the Trusts
                                 they are their steering groups to include surgical and orthopaedics champions.
                              o appointed a mental health liaison nurse (MHLN) and are considering the opportunity for other
                                 similar roles
                              o introduced protected meal times on all wards and the NNUH has introduced regular audits of
                                 practise. This audit tool has been shared with other acute hospitals following our recent
                                 Stakeholder event.
                              o introduced separate systems to assist patients receive and complete quality of services with their
                                 foods including usage of ‘colour-coded’ trays for those patients, including those with dementia
                                 needing assistance with feeding; MUST nutrition Tool and allowing relatives to come in to help
                                 with feeding
                         NNUH are using a pre-operation leaflet for patients and carers about how people with dementia may
                          react after their operation. This has led to a decrease in complaints due to lack of communication and
                          knowledge. It is being circulated to other Acute Trusts for information.
11: Living well with         A series of workshops have been launched and two have already taken place in January and April 2010
dementia in Care Homes        with a further one scheduled for July 2010.
                             These are targeted primarily at Care Home Managers across all sectors and aim to identify and spread
                              good practice across Norfolk in caring for people with dementia in Care Homes.
                             The April event attracted 100 participants and was over-subscribed. The next event consists of an
                              independent national provider operating locally presenting the steps it has taken to improve the quality of
                              dementia care in their Care Homes - an example of the participants’ willingness to share knowledge and
                              ideas across the sector.
                             A multi-agency group led by NHS Norfolk Clinic Pharmacists and Medicines Management Technicians
                              has made significant progress at minimising the use of anti-psychotic drugs in Care Homes through an
                              ambitious programme of audit, training and formal guidance notes.
                             The N&W Mental Health Trust have established a Team with a brief to provide in-reach support to Care
                              Homes and this service is being progressed within the development of the dementia strategy cooperative

13: An informed and          SWIFT workforce development has been initiated to develop workforce development plan for mental
effective workforce for       health including dementia and will report back in March 2011
people with dementia         Ongoing dementia workforce training tool being developed in conjunction with NWMH NHS FT
                             HIEC has been established locally to support development of a centre of excellence in the delivery of
                              dementia related training.

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