Dementia and Oral Health Cllr Graham Jones MRPharmS Chairman of West Berkshire Health and Wellbeing Board gjones@westberks.gov.uk Community pharmacist Leader WBC Clinitian leading a HWB Many of messages similar to those to pharmacy Worked closely with dentisrty in TV

Pharmacy and dentistry have both evolved!

The headlines System under huge pressure = financial, demographic, staff

Challenges Austerity Ageing population Burden of disease Integration Care Act Austerity Ageing population - Burden of disease Integration - HWBs Care Act – prevent, reduce, delay the need for long term intervention. Find the most appropriate level of care Ensure welfare in homes

By 2022 we will only fund care – not roads, waste etc People judge on bins and roads! Public opinion survey

Pressures! Up to 8.5% increase in over 85s in one year Living longer - dying slowly – much longer in ill health. Heart attack 50 years ago – dementia/degenerative disease now Solutions need to be at least cost neutral prevention ‘Fiscal austerity’ is now expected to extend to at least 2018

Golden Rules Key principle of the Care Act (2014) – prevent, reduce, delay the need for long term intervention Always offer tiers 1 and 2 before offering tier 3 No hand-offs, no waiting lists Not about containing costs in reducing, it is about helping people live as independently as possible Never plan long term with people in crisis – stick to people like glue. Always think hard about what will help carers continue caring. 100% of people and families plan their own support. Staff picked up from a waiting list - also people sometimes had to wait a long time. There was patchy knowledge around demand within the teams The implementation of self-directed support was variable, with a low number of direct payments to people long-term decisions were being made at a time of crisis e.g. admissions into residential care straight from hospital Not enough focus on getting people back to previous level of independence Priority to look after careres

Role of Local Government in care Community care Public Health Integration – Health and Wellbeing Board Community care – covered earlier - biggest Public Health Integration – Health and Wellbeing Board

The public health challenge PH – Rescue from the river Prevention Prevention Prevention   – walk from Chievley to Victoria.  -          West Berks primary school kids Ownership of health by councillors.  Council budget challenges

Public Health Now led by local government Integration with other council services Getting into council thinking - walk for health Mental health Dementia friends/Village agents Now led by local government Integration with other council services Getting into council thinking - walk for health Mental health Dementia friends/Village agents

Health and Wellbeing Boards Main players in health Politically led To date no place for pharmacy/dentistry/optometry Bring together main players Council and local govt Also Healthwatch, police (?), PH, CC, CS, Politically led - LOCALISM To date no place for pharmacy/dentistry/optoms Work with the HWB and lobby Who are main players in HWB Use health scrutiny and healthwatch  

Localism Local vs national Local plans Postcode lottery

Newbury Dementia Friendly Community Project Road Safety Public Transport Outside Environment Inside Environment GP surgeries Dementia Friendly Community Road Safety Public Transport Outside Environment Inside Environment GP surgeries – Continuity Quiet waiting areas Explain – acknowledgement is not the same as understanding Signs to toilets

Perspective of a clinician involved in local government and politics Challenges facing the nation in the future

gjones@westberks.gov.uk