1. Creating momentum; building and sustaining leadership Alison Moon Regional Champion, Dementia Care in Hospital Chief Nurse, University Bristol Hospitals NHS Foundation Trust

2. 2009-2010… poor coding; negligible data stigma; and ignorance “not in tariff” silo commissioninginvisibility of dementia complex systems

3. Leadership; partnerships; mandate Moving from engagement to action leadership ‘from the ground up’ engagement within hospitals: staff, managers, commissioners, local stake holders clinical leads in every hospital regional Community Hospitals Network– for all sectors defined, ‘SMART’ work programme resources & support – new Strategic Clinical Network

4. What makes a Network work? What enables it to deliver? learning by doing assertive dissemination & spread sustained, good quality communications & knowledge management conferences, network meetings multidisciplinary, multi-sector, real partnerships; = inclusive top-down and bottom-up leadership – ‘growing leadership’

5. South West Standards of Dementia Care in Hospital An improvement process 1 Development of Standards Publication; expectation; mandate 2 Self assessment – engagement Hospital improvement plans 3 Peer review – ‘leave no bruises’ Are standards embedded? Progress?

6. 1. Respect, dignity and appropriate care 5. Nutrition and hydration needs are well met 7. Ensure quality of care at the end of life 6. Promote the contribution of volunteers 4. A dementia friendly hospital environment; minimising moves 2. Agreed assessment, admission and discharge processes with a needs specific care plan 3. Access to a specialist older people’s mental health liaison service 8. Appropriate training and workforce development

7. About progress, not ‘performance’ 8 Standards self assessment evidence; National Audit positive practice learning opportunities for improvement signposting; support share and spread CEOs, Non-Execs senior teams staff at all levels, in different settings carers; volunteers Third Sector agencies CCGs/commissioners social services local GPs Culture, leadership; sustainability

8. Assets approach - not deficits critical friend appreciative enquiry system change; OD non-hierarchical exchange of learning; ‘buddying’ participative ++ constraints; S.W.O.T. acknowledgement; commitment; culture ‘Peer Review’ ‘Peer Appraisal’

9. What makes a difference? What has impact? change that is about pervasiveness and depth organisation-wide; support for the ‘mavericks’; innovators system-wide: primary care, community, hospitals, intermediate care, end of life care smarter commissioning; smarter delivery: future proofing; strategies; QIPP; dementia CQUIN, integrated services; smarter planning, national ‘Call to Action’

10. Leadership = (clarity + pragmatic action) x commitment what we want to improve, and why what innovations make a difference what we will do, and how how we will make it happen how we will be sure that innovation is an improvement NHS SoE Dementia Portal: www.dementiapartnerships.org.uk/hospital

11. What are the priorities, and opportunities for Community Hospitals? Will the peer review process ‘translate’? Is there an ‘appetite’ for it? Scale, pace, capacity - challenge Focus and approach: provider-to-provider? hospital-to-hospital? Involvement: CCGs, voluntary and community sector, people living with dementia; carers/families