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

2. Pharmacy and dentistry have both evolved!

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

4. 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

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. Localism
Local vs national
Local plans
Postcode lottery

13. 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

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