1. General hospital care for people with dementia: mechanisms to effect change Nye Harries DH SW

2. Performance priorities of a typical acute trust Financial balance Effectively managing emergency activity Reducing length of stay

3. Dementia care in acute hospitals Royal College of Psychiatrists 1 identified that on average in a 500-bed district hospital: 330 beds will be occupied by older people 330 beds will be occupied by older people 220 of these will have a mental health disorder 220 of these will have a mental health disorder of which 102 will have dementia of which 102 will have dementia (depression and delirium form most of the remainder) (depression and delirium form most of the remainder) 1. Who Cares Wins: improving the outcome for older people admitted to a general hospital, Royal College of Psychiatrists, 2005

4. Breakdown of RUH Inpatient Bed Days by age cohort, 2008 / 09 Age 0-15 6% Age 16-64 28% Age 65-79 28% Age 80+ 38%

5. RUH inpatient bed days by age for Surgery/Ortho/MAU/Gen Med: 2008/09 Number of Bed Days General Surgery OrthopaedicsA&EGeneral medicine 80+ 65-79 16-64 0-15

6. Improving general hospital care : key challenges Seeing dementia/cognitive impairment as a whole Trust issue, not just elderly care Securing executive sign-up Ensuring good data – eg clinical coding

7. Making the link with the Trust “performance” agenda LoS & the need for measurement Demonstrating the value of effective pathways, input of liaison. Renewed interest in diverting front door activity

8. What levers could help you? Extra focus on LoS reduction in 2010/11 Sharing data from the new national audit C-QUIN, with commissioners Trust Quality Accounts Sharing data from the new audit Patient Related Outcome Measures (PROMs)

9. Who are your potential allies? Director of Nursing & Chief Executive Trust Non-Executives Alzheimer's Society Commissioners

10. plus NHS community services LINKs Council Overview & Scrutiny Committee