How the Dementia Demonstrator Sites in Scotland are working to achieve better dementia care

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Ruth Glassborow, National Programme Manager, Mental Health Collaborative, Scottish Government.Presentation from Alzheimer Scotland conference 2011 - Creating Better Dementia Care.

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How the Dementia Demonstrator Sites in

Scotland are working to achieve better dementia care

Context

Dementia StrategyFive Key Challenges

• Diagnosis

• Post diagnostic information and support

• General healthcare and dementia

• Treating people with dignity and respect

• Support for carers

Underpinning ChallengeBetter – More - Less

Better Outcomesfor

More People

for

Same or Less Resource

• We use more resource by doing things wrong or too late (Failure Demand)

• We use resources un-necessarily by providing interventions people don’t want or need (Created Demand)

Redesigning dementia care, our underpinning hypothesis is…

Designing services that meet peoples needs

or

Person Centred Care

The solution to addressing this is…..

The Road to Transformation?Source: Gareth Morgan

QuickTime™ and a decompressor

are needed to see this picture.

Who is doing it?

Our commitment was for…

Onewhole system

dementia pathway

redesign project

Picking the Dementia Demonstrator Sites

Perth and Kinross CHP

North Lanarkshire CHP

Midlothian CHP

Support for Change

Joint Improvement Team

75k

Quality and Efficiency Support Team

Healthcare Improvement Scotland

Improvement Service

Alzheimer Scotland

What are they doing?

•NHS, Local Authority and Voluntary Sector

•Redesigning with focus on intervening earlier

•Testing use of talking points with dementia

•Evaluating financial and non-financial outcomes

All three sites

Understand current health and social care system (map pathways, use data, SWOT existing services, user & carer narratives)

identify opportunities for redesign/improvement

Implement changes

Midlothian

Mapping Pathways

identify opportunities for redesign/improvement

Implement changes

Lanarkshire

• Closed a 12 bed dementia assessment unit - all resources moved into community

• Set up multidisciplinary community team operating 7 days a week and testing a range of service developments through this

Perth and Kinross

How will we share learning?

• Each change initiative – case study which includes economic analysis

• Evaluation of national programme support

• National learning event – 29th Sept

• Developing other mechanisms

Sharing the learning

For each change initiative:

Qualitative Template (why, what did, outcomes, what learnt, key contextual factors)

+

Cost Consequence Analysis Template

Economic Case for ChangeTesting the Cost Consequence Analysis

Economic Case for ChangeCost Consequence Analysis

Cost of service after change

Cost of service prior to change

Recurrent savingsor costs of change- =

Collect data on relevant changes to outcomesof care and changes to the experience of

those receiving care

Collect information on the non-recurrent costs ofmaking the change

CONSEQUENCES

COST

Summary

demonstrating more-better-less

by

redesigning pathways across whole system

and

sharing

outcomes and learning widely

In summary Dementia Demonstrators are

Thank you for listening

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