PCT involvement in the development of Brookside Alex Walker NHS Central Lancashire 20 th June 2012

Integrated working Integration - the act of inter-mixing persons previously segregated (Oxford English dictionary). ‘A single system of service planning and/or provision put in place and managed together by partners who nevertheless remain legally independent’ (Integrated Working: a guide – DH 2004)

No decision about me without me The Government’s ambition is to achieve healthcare outcomes that are among the best in the world. This can only be realised by involving patients fully in their own care, with decisions made in partnership with clinicians, rather than by clinicians alone. (p16 Equity and Excellence)

Working in partnership with carers and people with dementia First piece of work in Lancashire following the publication of the National Dementia Strategy Focussed on an aspiration to address the full pathway Allowed for a common dementia outcomes framework which continues to support more localised work

Key outcomes for people with dementia and their carers 20 outcomes from pre-diagnosis to bereavement - some examples: –I am confident I will receive a timely diagnosis –I feel valued and supported and I am treated as an equal partner in planning and decision making. –I am confident I can get help when things go wrong. –As a carer I feel I am involved, listened to, my needs are understood and met. –I am supported to try new things and live well with dementia.

What are we trying to achieve for dementia care in Central Lancashire? Centres of excellence –Specialist design –Learning environments A therapeutic approach –Improvement and maintenance of skills –Resilience for people with dementia and their carers –Improved quality of life –At all levels of need A shift in culture –Breaking stigma –Changing staff approaches –Normalising dementia –Care planning based on skills not deficits

What are we trying to achieve for dementia care in Central Lancashire? Access to outdoors as the norm –Seeing the whole environment as vital to the delivery of support –Recognising the importance of nature Integration of services –Multi agency Services for all tiers of need

Charnley Fold Resource centre - South Ribble Base for: –MH and Provider Trust –County Council –Age Concern –Alzheimer’s Society –People with Dementia and their carers Services: –Dementia adviser service –Dementia café –Enhanced day care –Memory assessment service –Post diagnosis ‘Positive outcomes project’ –CMHT

Meaningful Places Enhance daily life

The Lodge - Continuing Healthcare facility Shared facilities –Specialist environmental design –Space –Meaningful environment and activity –Apartment living –High quality Innovation so: –Massive cultural shift –Much to learn GP surgery on site Dementia Adviser service on site Opportunity for continued carer involvement

Brookside Resource centre - West Lancashire Wider partnership –RSL –District council –CCG –U3A –Age UK –Alzheimer’s Society –Integrated Care organisation –MH Trust –Bistro provider –Wider community

Brookside Resource centre - West Lancashire Wider range of health services –Memory Assessment –CMHT –Dementia Adviser –Peer supports –Prevention services –Stroke services –Falls and Therapy –Longer term rehabilitation flats for: Stroke Dementia care Intermediate care

Brookside Resource centre - West Lancashire Greater integration of services –Physical and Mental Health care –Health and Social care –Statutory and Voluntary sector supports –Housing as part of the equation Emphasis on changing the quality and environments for support –De-stigmatisation Community ownership Transformational, influential and educational

Challenges Different approach to risk within a housing scheme –Health & Safety – is it balanced? The challenge of integrating –Different cultures –Working together takes time –Leadership is critical The changing provider and commissioner landscape –CCG not PCT –Split of Health providers Procurement v On-going service development

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