Wessex AHSN Healthy Ageing Programme Community of Practice ... 11-11-19 combined slide de… · 12....
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Wessex AHSN Healthy Ageing Programme Community of Practice – spotlight on Delirium Cheryl Davies Programme Manager Healthy Ageing Wessex AHSN 11th November 2019
Transcript of Wessex AHSN Healthy Ageing Programme Community of Practice ... 11-11-19 combined slide de… · 12....
Wessex AHSN Healthy Ageing ProgrammeCommunity of Practice – spotlight on Delirium
Cheryl Davies Programme Manager Healthy Ageing Wessex AHSN
11th November 2019
Welcome and House Keeping
Keep the frailty conversation going…
@WessexAgeing
#WessexFrailtyFit
Agenda
Wessex AHSN Healthy Ageing Community of Practice Meeting
Networking with the spotlight on Delirium Merley House (Library room), Merley House Lane Wimborne BH21 3AA
Monday 11th November 2019. 9.30-13.00
Time Agenda Item Lead/Speaker
9.00 - 9.30 Registration
9.30 - 9.35 Welcome, Introductions and housekeeping What would you like to take home from today?
Cheryl Davies – Programme Manager Wessex Healthy Ageing team
9.35 - 10.00 Setting the Scene: Delirium Why Should I Care?
Anna Chainey - Health Education England Trainee Consultant Practitioner Older People and Frailty
10.00- 11.00
Delirium Workshop (Facilitator TBC) exploring: 1. What tools are there to assess for delirium – when should these be used and by whom?
2. What is the impact of delirium (e.g. individual, family, cost, length of stay, death, transfer to residential care etc)
3. What are the risk factors for delirium? How do we differentiate Delirium, depression and dementia?
4. What does good care/practice for patients with delirium look like? – give examples of best practice?
5. What are the issues/challenges in implementing a delirium pathways? How could these barriers be overcome? Facilitated by Experts: Julia Barton, Sandy Woodbridge and Stuart Murray – Salisbury Dementia and Delirium team
11.00 – 11.20 Networking and coffee
11.20-11.50 Delirium Pathway, a North Hampshire Experience.
Dr Yasir Al Rawi – Consultant in Elderly and General Medicine Royal Hampshire County Hospital.
11.50-12.10 Collecting a good collateral cognitive history. Mad chimps?
James Lee - Consultant Practitioner Trainee, Older Persons and Frailty Health Education England, Wessex
12.10-12.30 Social Prescribing within Frailty Management
Emma Gardiner – Community Nurse Practitioner Dorset Healthcare University Foundation Trust
12.30 – 13.00 Healthy Ageing Update
Cheryl Davies and Kathy Wallis - Associate Director, Strategic Programmes (Healthy Ageing and Medicines Optimisation) – Wessex AHSN
13.00 Evaluation and close
Objectives of todays’ Community of PracticeThe primary aims of our Community of Practice (CoP) events are to give you:
• a real and virtual Wessex wide network of people interested in, and working in, the healthy ageing/frailty agenda
• This group is integral in informing us on the topics of interest/concern
• The CoP can add value by sharing your experiences and to highlight areas where the Healthy Ageing programme
should prioritise effort
• a platform to network and share projects and best practice on a focused area of frailty
• an update of work in the Healthy Ageing programme
What do we need from you today?
• What does delirium mean to you?
• What would you like to understand/achieve by the end of todays’ session?
• Capturing your feedback on todays event and subsequent events – feedback forms!
Delirium – why should I
care?ANNA CHAINEY
CONSULTANT PRACTITIONER TRAINEE OLDER PEOPLE AND FRAILTY
HEALTH EDUCATION ENGLAND (SOUTH)
What?
Acute onset
Under detected
Usually temporary
Associated with poor outcomes
When?
Medical wards: 20% - 30%
Having surgery: 10% - 50%
Long term care: less than 20%
Community: 1% - 2%
BUT 1 in 3 cases can be prevented
So?
Earliest detection = better
outcomes
Different types affect
patients differently
Malnutrition and
dehydration
Unusually sleepy or active
Pressure ulcers
Weakness, decreased
mobility
Wandering/disorientation
Falls
And…
Agitation and aggressive behavior
Hallucinations, paranoia and abnormal beliefs
Delayed hospital discharge
Delayed recovery full stop
Between forty and sixty per cent of patients are
not fully recovered at the time of discharge.
Why should I care?
Increased hospital stay
Retain distressing memories
Reduced ability to undertake activities of daily living
Increased risk of requiring long-term care
Un-mask dementia
Increased likelihood of reoccurrence
Increased 1 year mortality
References
https://www.alzheimers.org.uk/get-support/daily-living/delirium
https://www.nice.org.uk/guidance/cg103/chapter/Introduction
https://www.bgs.org.uk/resources/14-cga-in-primary-care-settings-patients-presenting-with-confusion-and-delirium#anchor-nav-further-reading
https://www.rcpsych.ac.uk/mental-health/problems-disorders/delirium
McCusker J, Cole M, Abrahamowicz M, Primeau F, Belzile E. Delirium Predicts 12-Month Mortality. Arch Intern Med. 2002;162(4):457–463. doi:10.1001/archinte.162.4.457
https://www.ndph.ox.ac.uk/longer-reads/hospital-or-2018hospital-at-home2019-2013-what2019s-best-for-older-people
https://www.england.nhs.uk/wp-content/uploads/2014/09/dementia-revealed-toolkit.pdf
Wessex AHSN Healthy Ageing Programme
Community of Practice
Delirium Workshop
11th November 2019
Delirium PathwayThe HHFT Experience
How it all began…
2/2/2016Receive email 11/3/2016
HHFT meeting 17/6/2016
CCG meeting 18/8/2016
First pt. discharged
Re-assessment25/3/2019
Pathway starts again
What others have done
• West Hertfordshire
– 3 weeks, live-in care, OT and SW review at home and medical review in hospital
• Norfolk & Norwich
– 12 weeks, nursing home care, Nurse telephone follow-up
• North Derbyshire
– 3 weeks, live-in care, OT and SW review at home and medical review in hospital
The mystery of delirium duration
• DSM III (1980)
– “The duration of an episode of Delirium is usually brief, about one week; it is rare for Delirium to persist for more than a month”
• DSM IV (1994)
– “The delirium may resolve in a few hours to days, or symptoms may persist for weeks to months, particularly in elderly individuals and individuals with coexisting dementia”
• DSM V (2013)
The pathway
• Funded by North Hampshire CCG
• Commissioned by Mental Health and LD Senior Commissioning Manager
• Combined medical and care package
• 3 wk package (extendable to 6 if needed)
• Live-in care
Pathway in practice…
Identify
Mobile, max. Ax1
No night-time needs
Within catchment
Has spare bedroom
1st MDT
• Who:- Family, consultant, nurse specialist, ward therapist, care provider
• What:- Define roles, set goals, manage expectations
R/v
• MOCA at beginning and end
• Home visits
• Taper care as soon as possible
• mid-term MDT (medical team and social worker)
Pt LOS (days) Outcome
87M 108 (GIM) Pathway extended 2 further weeks.Private live-in care started following dischargeDx: AD
91M 21 (Ortho) Discharged at 3/52No care neededDx: MCI
93M 10 (EM) Discharged at 3/52OD care advised but family opted for twice/wk private careDx: LBD
90M 7 (EM) Pathway extended 2 further weeksDifficulties at home. Required SS placementDx: VaD
91F 27 (Surg) Discharged at 3/52SS funded bd careDx: AD
82F 10 (GIM) Discharged at 3/52Private BD care with fall-back plan of placementDx: AD
96M 29 (EM) Ongoing
Benefits
• Clinical outcome
• Costs
– Back of envelope calculations (based on ~£300/d hospital stay)
• aLOS ~16 days
• Overstay for 1st pt cost ~£27000
• Saving on pts 3,4 and 6 ~£4500
Pitfalls & Lessons• MDT essential for expectation management
• Close working relationship with SS, care provider, and family is paramount
• Keep the system flexible
• Evaluate mid point and have a plan B
• Carer diary very valuable
• Increasing the breaks from early on
• Look out for cultural differences
• MOCA more sensitive than MMSE
• Dedicated phone number
For the future…
• Closer working relationship with community OPMH
• Community therapy involvement
• Tailored care
Patient-Centred & Safe FriendlyProfessional Responsive
Quality Improvement Project‘Collateral cognitive history’
James LeeConsultant Practitioner Trainee
Health Education England, Wessex
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An outstanding experience
for every patient
Patient-Centred & Safe FriendlyProfessional Responsive
Background
• Project carried out during placement with Salisbury Hospital Mental Health Liaison team.• Delirium screening tools used inconsistently – shortCAM, 4AT, SQiD.• Not designed for obtaining further collateral history from informants.• Dementia screening and collateral cognitive history taking practice is problematic in the acute
hospital.(1,3)
• Therapy team or MHL team or Dementia ward round collecting collateral history late when it should have been done earlier by someone else.
• No proforma or sticker is used. Practice is very variable.• No formal training on collateral history taking.• Although this is a task requiring a high level of skill and experience, it is often delegated to the most
junior staff.• Complaints from families quote poor communication as a major issue.• It is becoming increasingly difficult to find a good historian with more older people living in isolation.• There is confusion in some cases about a diagnosis of dementia or delirium, and diagnosis is wrongly
recorded in notes and discharge summaries. The consequences can be devastating.
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Patient-Centred & Safe FriendlyProfessional Responsive
Dementia screening and collateral cognitive history taking practice is problematic in the acute hospital.(1,3)
• Up to 40% of older inpatients may have dementia, and only around half of these will already have been diagnosed.
• Delirium affects at least one in eight hospital patients.
• In people without dementia delirium is associated with a greatly increased risk of future dementia.
• However simple ‘point in time’ cognitive screening tools are problematic.
• A note of cognitive impairment without context may at a future date be mistaken for evidence of chronic impairment.
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Patient-Centred & Safe FriendlyProfessional Responsive30
Patients aged 65 years and older admitted to an acute medical team.Over a 2-week period, 257 patient admissions were reviewed.Of these, only 153 (59%) had their cognitive function documented on admission and only 14% had their premorbid cognitive function documented.Delirium was only diagnosed in 8 patients (3%) with at least 10 others having descriptions of delirious states without the formal diagnosis.Prior functional status (in terms of mobility (50%) and sensory disturbance (24.5%) was poorly documented).Past medical history of dementia/cognitive impairment was recorded in only 11.3%.
Patient-Centred & Safe FriendlyProfessional Responsive
Background
• Delirium screening tools used inconsistently – shortCAM, 4AT, SQiD.• Not designed for obtaining further collateral history from informants.• Dementia screening and collateral cognitive history taking practice is problematic in the acute
hospital.(1,3)
• Therapy team or MHL team or Dementia ward round collecting collateral history late when it should have been done earlier by someone else.
• No proforma or sticker is used. Practice is very variable.• No formal training on collateral history taking.• Although this is a task requiring a high level of skill and experience, it is often delegated to the most
junior staff.• Complaints from families quote poor communication as a major issue.• It is becoming increasingly difficult to find a good historian with more older people living in isolation.• There is confusion in some cases about a diagnosis of dementia or delirium, and diagnosis is wrongly
recorded in notes and discharge summaries. The consequences can be devastating.
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Patient-Centred & Safe FriendlyProfessional Responsive
BGS blog.
• It’s a familiar scenario, you are on your Elderly Medicine placement and you are asked: “Can you get collateral history about Mrs Smith´s cognition?” You don´t want to miss anything, but what exactly do they want to know?
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Patient-Centred & Safe FriendlyProfessional Responsive
ED project
• ED are developing a tool to gather key information from relatives who attend with older patients, including some indication of diagnosis and/or previous cognitive function, including history of confusion.
• Designed to capture brief details including cognition at front door.
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Patient-Centred & Safe FriendlyProfessional Responsive
Model for improvement
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• Langley et al. 1996
Patient-Centred & Safe FriendlyProfessional Responsive
PROBLEM STATEMENT
• PROBLEM STATEMENT: collateral histories for older patients with confusion to ascertain background and historical cognitive function, evidence of delirium and dementia are not done well and often forgotten. When they are done they are suboptimal. This can make the information inaccurate leading to incorrect diagnosis and treatment.
• But who cares? Confused older patients with delirium or dementia or confusion of other causes are extremely common in hospital and community settings. Poor care leads to unnecessary acute admission, wrong or missed diagnoses, delayed treatment, prolonged length of stay and consequent increase in morbidity and mortality.
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Patient-Centred & Safe FriendlyProfessional Responsive
Development PLAN
Ascertain current practice:
Literature review of current best practice examples, what does a good collateral cognitive history look like?
Develop retrospective audit tool.
Audit notes on one ward area on current practice.
Interview (questionnaire) staff re experience, skills, knowledge, training.
Ask Twitter.
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Patient-Centred & Safe FriendlyProfessional Responsive
An outstanding experience
for every patient
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James Lee
@lee68_james
Collateral cognitive history in confused patients. Who's
job is it to collect this? Why are we so bad at collecting
this vital info? Any answers appreciated. Thanks Twitter!
“Every clinician who has contact with the patient. I definitely
seek this info from spouses/family/friends/carers etc. It's
absolutely vital to know a cognitive baseline in confused
patients”.“Good question. Really important to engage relatives/ primary
carers from the start. Collateral history informs your clinical
diagnosis/early decision making, so whoever does the initial
assessment.”
“Everyone's? Make the most of every opportunity when family
and friends are visiting. Are people too busy?”“Whoever is assessing the person and who happens to
pick up phone/meet relative on ward. Like many things
it's the responsibility of whole MDT. As soon as we know
what is usual for that person across all aspects of their
life, the sooner we can establish how 2 help their
recovery”
“First contact practitioner gets a great collateral from family-
often before seeing the person, but with their consent, and then
verifies it”“A major deficit in what should be routine practice. It should be
considered as essential as other parts of the history. The
IQCODE-SF is a good tool to operationalise this & works in
delirium and dementia”
Patient-Centred & Safe FriendlyProfessional Responsive
Guidance
• Determining that cognitive impairment or perceptual problems are not due to a prior or progressing dementia can be challenging and requires knowledge of the patient's baseline level of functioning. The diagnosis is made more easily if there has been a prior assessment of cognitive abilities. In other instances, informantsmust be immediately sought to establish chronology. These should include formal caregivers (eg, nursing staff familiar with the patient), family members, and informal caregivers, particularly those who may have observed fluctuations in the patient's mental functions. https://www.uptodate.com
• Similar suggestions in NICE (4) and SIGN(6) guidance.
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Process map
website | qiclearn.com
Need for collateral history identified
Collateral history collected Collateral
history used in determining diagnosis
appropriate treatment started
Patient admitted with confusion
Confusion not recognised as new. Assumed dementia.Need for history not identified.Incorrect assumptions made.Attending family missed.
Job identified but not allocated.Delay in collecting.Family not available.Not known by anyone.Diagnosis already made and treatment started.
History collected by untrained person.Wrong questions asked.History ignored.Same history repeatedly collected.
Potential for wrong diagnosis, wrong treatment, incorrect labelling, patient harm.History ignored.
Patient-Centred & Safe FriendlyProfessional Responsive
Implementation PDSA
• Guided by scoping study develop teaching and guidance for collecting
collateral histories. (P)
• Use one ward area to implement teaching and guidance. (D)
• Redo initial audit.(S)
• Collect feedback from staff on teaching / guidance implementation.(S)
• Adapt and embed good practice in chosen clinical areas.(A)
– Identify collateral champion.
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Patient-Centred & Safe FriendlyProfessional Responsive
Teaching plan
• What is a collateral cognitive history
• How this helps with diagnosis
• Who can and who should collect it (and when)
• How to obtain a collateral history
• What to do with the information
• Are there any tools or guides?
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Patient-Centred & Safe FriendlyProfessional Responsive
An outstanding experience
for every patient
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https://britishgeriatricssociety.wordpress.com/2017/02/15/maple-v-taking-a-collateral-history-for-cognition/
Patient-Centred & Safe FriendlyProfessional Responsive
Collateral cognitive history
Intellectual function – education and employment history.ADL’s (eg. Mobility, transfers, toileting/bathing, aids used, assistance)History of Confusion: Onset, Course and Features (this episode and any previous episodes, acute and chronic)Sensory deficits – hearing, sight, speechPhysical signs and symptoms suggestive of underlying cause (eg.Infection, falls, incontinence, constipation, pain)Medication history including non-prescribed drugs and alcohol.Memory and Dementia (investigations or diagnosis).Depression and other mood or personality changes.
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Patient-Centred & Safe FriendlyProfessional Responsive
MAD CHIMPS!
Memory and Dementia (suspected vs. diagnosed).ADL’s (Change in: Mobility, toileting/bathing, managing finances, independence).Depression and other mood or personality changes.
Confusion History: Onset, Course and Features (this episode and any previous episodes, acute and chronic).Intellectual function – education and employment history.Medication history including non-prescribed drugs and alcohol.Physical signs and symptoms suggestive of underlying cause (eg. Infection, falls, incontinence, constipation, pain).Sensory deficits – hearing, sight, speech.
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Patient-Centred & Safe FriendlyProfessional Responsive
Results of baseline Audit
Nurses and AHPs Medics
Is it your job to investigate Collateral cognitive history?
YES 16/16 100% YES 6/6 100%
If NO who’s job is it N/A N/A
Do you know how to take a collateral cognitive history?
YES 5/16 31.25% YES 6/6 100%
How confident do you feel taking the cognitive history?(1= not confident, 5= very confident)
Avg. 2.50 Avg. 4.17
Would you know what to ask? YES 5/16 31.25% YES 4/6 66.7%
Would a proforma be helpful? YES 15/16 93.75% YES 5/6 83.3%
Previous training on Collateralhistories?
YES 1/16 6.25% YES 3/6 50%
Would you like some training? YES 15/16 93.75% YES 4/6 66.7%
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Patient-Centred & Safe FriendlyProfessional Responsive
The Confused Patient - Collecting a collateral cognitive history - MAD CHIMPS
What is a collateral cognitive history?Factual information about cognition from a relative or carer(informant) that knows the patient well.How this helps with diagnosis:Can help differentiate between delirium, dementia and depression. Can help to identify a physical cause and start corrective treatment early. Will help to provide person-centred care.Who can and Who should collect it (and When)?YOU, YOU (and NOW)!How to obtain a collateral history:Speak to the best informant, use MAD CHIMPSWhat to do with the information:Document clearly in medical notes (use MAD CHIMPS format), inform medical team.Are there any tools or guides?YES – MAD CHIMPS
MAD CHIMPSMemory and Dementia (investigations or diagnosis).ADL’s (eg. Mobility, transfers, toileting/bathing, aids used, assistance – any recent changes)Depression and other mood or personality changes.Confusion History: Onset, Course and Features (this episode and any previous episodes, acute and chronic, BPSD*)Intellectual function – education and employment history.Medication history including non-prescribed drugs and alcohol.Physical signs and symptoms suggestive of underlying cause (eg. Infection, falls, incontinence, constipation, pain)Sensory deficits – hearing, sight, speech
*BPSD = Behavioural and Psychological Symptoms of Dementia/Psychosis.James Lee, Consultant Practitioner Trainee, HEE Wessex, [email protected]
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Patient-Centred & Safe FriendlyProfessional Responsive
References:
References:1. Shenkin et al. 2014 Screening for dementia and other causes of cognitive impairment in general hospital
inpatients. Age and Ageing 43; 166-1682. Jorm AF. 1994 A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE):
development and cross-validation. Psychol Med; 24: 145–153.3. Rodwell et al. 2010 How well is cognitive function documented by medical staff in the over-65 age group at the
time of acute medical admission? New Zealand Medical Journal 123: 13174. NICE quality standard. Delirium in adults Quality standard [QS63] Published date: July 2014
https://www.nice.org.uk/guidance/QS63 accessed online June 2019
5. Galvin JE et al, (2005) The AD8, a brief informant interview to detect dementia, Neurology 2005:65:559-564
6. Scottish Intercollegiate Guidelines Network (SIGN). Risk reduction and management of delirium. Edinburgh: SIGN; March 2019. (SIGN publication no. 157). [cited October 2019]. Available from URL: https://www.sign.ac.uk/sign-157-delirium.html
IQCODE(2) and AD8(5) can both be used to determine a diagnosis of prior dementia in people with suspected cognitive impairment.
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Patient-Centred & Safe FriendlyProfessional Responsive
MAD CHIMPS?
ANY QUESTIONS?
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Social Prescribing within frailty management
Dorset HealthCare
Social Prescribing within frailty management
Social Prescribing within frailty management
Social Prescribing within frailty management
Social Prescribing within frailty management
“What matters most to me”
Wessex AHSN Healthy Ageing Programme2019/2020 Update and Business Planning
Cheryl Davies Programme Manager Healthy Ageing Wessex AHSN
11th November 2019
Nutrition and Hydration Achievements since May 2019
• Formal launch of the Nutrition Wheel on 23rd September 2019 at the annual Malnutrition Task Force conference
• 2000 Nutrition Wheels ordered for the Malnutrition Task Force and 307 circulated across Wessex to date
• Good progress has been made on obtaining data for the Bournemouth University research project, “Pilot testing the feasibility and acceptability of using the ‘Nutrition Wheel’ to identify community-living older people at risk of malnutrition (as undernutrition) and signposting to appropriate nutrition advice and support”
• Work also in progress to evaluate uptake and use of the Nutrition Wheel across the Wessex geography
• Launch of the Hydration at Home in domiciliary care project – Apex Havant and Portsmouth with 35 clients
• In collaboration with Hampshire County Council, the development of content for e-learning hydration material for use in care homes and domiciliary care
Nutrition and Hydration Plans until March 2020
• Exploration of digitalising the Nutrition Wheel with Bournemouth University and stakeholders
• Presentation of the Nutrition Wheel development and approach at • Optimal Nutrition Care for All (European-wide) conference 20th November
2019• BAPEN Annual conference 26-27th November 2019• British Dietetic Association Research Symposium - December 2019
• Hydration at Home domiciliary care project training to be undertaken, focus groups and data analysis of impact
• Finalising write up of the Hampshire care home hydration project• Evaluation and completion of the basic level hydration e-learning tool and
materials and planning of launch and event to promote spread• Publication of a hydration leaflet for use across any setting
Audit Achievements and Plans
Wessex Acute Frailty Audit• Publication of the evaluation report• Active working groups meeting monthly to deliver Wessex wide projects
• Development of gold standard for screening in progress • Board to Porter -Tier 1 Skills for Health Frailty e-learning and resources
updated– pilots November 2019 • Collaboration with Hampshire and IOW Education STP to support rollout of
materials• Trusts working on their own QI projects to support the frailty agenda• In preparation for next years Acute Audit across Wessex and other AHSNs, we
are working with Health Innovation Network (South London) to trial• updated audit questions• Inclusion of additional specialities e.g cardiac, cancer• Older peoples mental health wards
Audit Achievements and PlansCommunity Frailty Audit
• Complementary audit to the Wessex Acute Frailty audit run Autumn 2018• The audit focused on the processes for identification of those people living with
frailty, and the subsequent holistic assessment and care planning, training of staff, and communication with colleagues across the health and social care system at PCN Level
• PCNs are the vehicle for the delivery of the frailty elements long term plan, keeping patients at home and independent for longer = good place to start and create a baseline
• Overall aim to drive up the standards of care for those at risk of, or living with
frailty
• Audit ran during October 2019 – 23 PCNs responded
Focus of the community audit questions
28 questions include the following themes:
1. Screening and sharing of frailty information
2. Frailty knowledge, skills and training
3. Current frailty pathway processes
4. Multi-disciplinary team interactions
5. Service Improvement opportunities
Community Audit Timeline
Timeline Activity StakeholdersApril 2019 Working group set up to design Community
Frailty questions.Representation from Consultant Geriatrician, GP Extensivist, Consultant Frailty Practitioners, Director of Transformation and the University of Southampton
May – August 2019 8 Plan Do Study Act Cycles to review and refine audit questions
Working group
Early September 2019 Engagement with STPs and CCGs – opening letter
STP and CCG leads
Late September 2019 Electronic trial of audit questions with 1 PCN Frailty Lead for 1 PCN
October 2019 Audit open for completion across Wessex PCNs
PCN Clinical Directors/ PCN Frailty Leads
November – December 2019
Analysis of Wessex AHSN Healthy Ageing Community Frailty audit
Centre for Implementation Science
February 2020 Wessex AHSN Healthy Ageing Community Frailty PCN workshop
Community Geriatricians,CCG leads, PCN Clinical Directors, PCN Frailty Leads and members of integrated teams
What’s happening next with the Community Frailty Audit?
• Wessex PCN workshop event February 2020 to identify areas of best practice and opportunities for improvement
• Consideration of a rapid PDSA cycle PCN collaborative to encourage PCNs to work together on making Wessex frailty fit
• 3 x Health Education England (HEE trainee) consultant frailty practitioners supporting 3 PCN service improvement projects
• Wessex AHSN wide PCN Collaborative to support rapid service improvement• Formal evaluation of approach• Publication of our approach Quarter 1 2020/21• Ongoing bi-annual audit to build an in depth picture of frailty provision
Then (March 2018)
Now (Sept 2019)
in the Wessex AHSN region
Business Planning 2020/20201
• Commencing Business Planning process for the Healthy Ageing Programme for 2020/2021
• Alignment to member, STP and Long Term Plan requirements• Continuation of commitment to audits
• Autumn 2020 Wessex Acute Frailty Audit• Collaboration with Health Innovation Network and planning for wider AHSN
rollout• Continuation of commitment to identifying new innovations• Potential new areas of focus for the programme… watch this space!
What can you do to support and promote the Programme?
• Sign up to our Healthy Ageing newsletter – contribute articles (best practice)
• Opportunity to blog to share working with us
• Add your project to the Healthy Ageing healthlineshttps://wessexhealthlines.nhs.uk/health-lines/healthy-ageing-line/
• Share our work within your organisations and feedback to us
• Celebrate and share your great work with us – tweet, call or email!
• Get involved with our work…
• Make frailty everyone’s business..
Events – Dates for your diary
Next Healthy Ageing Community of Practice MeetingDate: 12th May 2020Location: TBC Focus: Frailty Syndromes: Mobility
Healthcare Conferences UK: Delirium Prevention, Assessment and Effective Management’ conference is taking place on Monday 3rd February 2020, London.
@HCUK_Clare #Delirium
Contact details
Contact us to join our mailing list for newsletters or to join our
community of practice
@Wessexageing
https://wessexahsn.org.uk/programmes/35/healthy-ageing
#WessexFrailtyFit
Thank you – safe journey home…. And feedback forms please!
