1. ‘Dementia & Northern Ireland ’ Report on the Project 2009-12

2. Impact of DSDC NI project Every GP practice 700 organisations 1624 people newsletters/ ebulletins 70 – 3 day Design 125 design awareness

3. 200 staff in acute care got education and an resource pack

4. Best Practice 106 facilitators educated 848 healthcare assistants over six months in a culture change programme

8. 2010 - International Award

9. What is dementia? Dementia is a term for a set of symptoms that result from various brain illnesses. Memory Communication Relationships Terminal condition

10. Dementia in Northern Ireland 19,000 in 2011 60,000 by 2051 £400m pa inc £150m informal carer costs –Source: DHSSPSNI(2010) - Improving dementia services in Northern Ireland: a regional strategy

11. Drivers for Change Demographics Economics Policy Standards Practice Values People

12. Drivers for change Dementia strategy (pending) Public spending cuts NICE – Dementia Guidelines NICE – Delirium Guidelines NAO – Improving dementia services Time for Action (anti-psychotics) Always a Last Resort (anti-psychotics) Dementia & People with Learning Disabilities

13. Drivers for change........ Counting the Cost Support. Stay. Save. Home from Home National Audit Office – Falls National Audit Office – End of Life Care Death by Indifference Mencap

14. More to come Listening Well.......the voice of people with dementia

15. The £20bn Question UK estimates - 35% increase in costs between 2010 & 2018 NI – now £400m (incl. £150m informal carer costs) NI – 2018 £540m

16. The £20Bn Question Whole systems approach Hospitals Community services Care homes Domiciliary care 2011 – All Party Parliamentary Group report

17. High impact actions Collaboration & integration Sharing expertise Early intervention Improved co-ordination of services Training in dementia care Diagnosis Supporting carers Sharing best practice

18. Case study -Acute care Counting the Cost – 25% beds Average cost bed day £225 Average LoS – 30 days pre-intervention Average LoS – 13.9 post-intervention 54% reduction in LoS £6750 reduced to £3128

19. Case study – Community Care/ Nursing Homes interface Cost of nursing homes - £82m pa in Northern Ireland ( estimate) APPG report estimate 10% saving potential (UK) Postpone admission Improve community & carers support infrastructure Source: Paying for Care

20. Care Options & NI Comparators with UK Higher rate of institutional care Lowest rate receipt of home care Lowest rate receipt of day care –Source: 2007 Dementia UK NI Supplement

21. Big issues for discussion Acute care Environmental design Staff training & best practice Day Care & Home Care Learning Disability Governance, Quality & Efficiency

22. High Impact interventions on offer Training of staff & carers Environmental design Diagnosis & early intervention Information & awareness

23. References Design Council (2011) -Design Challenge: Living well with dementia DHSSPSNI (2010) draft – Improving dementia services in Northern Ireland - a regional strategy NICE (2007) Dementia – The NICE – SCIE Guideline on supporting people with dementia & their carers in Health & Social Care NICE (2010) Clinical Guideline103 Delirium : diagnosis, prevention and management NAO (2007) Improving services and support for people with dementia Bannerjee S ( 2009) Time for Action http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_108302.pdf http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_108302.pdf APPG (2007) Always a Last Resort RC Psych (2009) Dementia & People with Learning Disability Alzheimer Society ( 2009) Counting the Cost Alzheimer Society ( 2010) Support. Stay. Save. Alzheimer Society ( 2007) Home from Home NAO(2009) Falls prevention in the elderly. http://www.patient.co.uk/doctor/Prevention-of-Falls-in-the-Elderly.htmhttp://www.patient.co.uk/doctor/Prevention-of-Falls-in-the-Elderly.htm NAO (2010) End of Life Care Strategy 2 nd Annual Report http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_118810 http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_118810 Mencap (2007) Death by Indifference Alzheimer’s Society ( 2009) Listening Well APPG ( 2011) The £20 billion question