Dementia Care in London

Working Together forBetter Mental Health

29 February 2012

Gordon King

Scale of the challenge• Nearly one in every hundred Londoners has dementia

• 64,600 people in London with dementia including over 1,500 with young onset

• Increase expected by nearly 16% across London to 75,000 by 2021. Wide borough variation

• Up to 65,000 people with substantial or critical care needs in 10 years

• SUS data shows 93% of acute admissions for dementia are unplanned

• Nearly 4000 people with a diagnosis admitted to acute beds 3 times or more

• 41% of people with dementia are on GP dementia registers

How do Health and Social care systems respond to increasing demand in the current climate?

• What new thinking or progress is being made across London?

• National Dementia Strategy (DH, 2009); Dementia Services Guide (CSL/LHP, 2009); Dementia Commissioning Pack (DH, 2011); London Dementia Needs Assessment (NHSL, 2011)

• NHS London clinically led project to improve dementia care and prescribing (established March 2011). Highlights include

• High impact taskforce to reduce antipsychotic training 

• GP skills and awareness programme

• Early diagnosis

• Acute trust training

How do Health and Social care systems respond to increasing demand in the current climate?

• Mental health liaison model for dementia project (NCL cluster with LHP support)• QIPP project to reduce dementia related acute trust

admissions & readmissions, shorten stays & reduce variation through a MH liaison model

• Readiness to grasp problems of fragmented systems with fractures & variation within commissioning, service provision & improvement/redesign

• Model developed now part of cluster contract negotiations for 2012/13

• LHP will produce report with lessons for London - significant potential savings modelled for the health & social care economy in the capital through “whole system” commissioning

How do Health and Social care systems respond to increasing demand in the current climate?

• Joint Improvement Partnership / London Councils• Social care and dementia• How do we begin to robustly commission a new model for

residential care?• Integrated pathways require integrated commissioning• How do we get whole system approach to dementia in

London which has both health and social care drivers & levers working together?

• London-wide opportunities

What can we do next year for

maximum impact?

• Identify up to 3 pieces of work likely to make the most significant impact on the commissioning or provision of dementia services in London over the next year & rank them in priority order (10-12 mins)

• Taking the top priority, what would be the major challenges in delivering this piece of work? (8-10 mins)

• What are the key levers in the system, who needs to be involved or engaged to ensure success & how will that success be measured? (8-10 mins)

• Feedback briefly to whole group (2 mins maximum each group)

Small group work sessions

Thank you