Catherine Holmes

The Right PrescriptionA Call to Action on the use of

antipsychotic drugs for people with dementia.

Catherine Holmes

Our goalBy 31st March 2012:• all of the estimated 180,000 people with dementia who

are receiving antipsychotic drugs will have undergone a clinical review , to ensure that their care fits with current best practice and guidelines and that alternatives to their prescription have been considered

• People with dementia are not prescribed antipsychotics in future unless their situation fits the guidelines

The challenge

There is a lot of activity and energy for change.......

Unless that energy is translated into appropriate prescribing and appropriate review of medications, it counts for nothing

We want to provide a focus and direction that moves everyone in the same direction

What did we need to agree?

• Who we are calling to action

• What actions we want them to take

• The sources of support and resources that will be made available to help them in their actions

Eight groups to call to action• People with dementia and their carers• Leaders of care homes• GPs and primary care teams• Psychiatrists and mental health teams• Pharmacists • Hospital doctors and their teams• Commissioners of health and social care• Medical Directors and Nurse Directors of acute and

mental health trusts/providers

Undertake audit of accuracy of practice registers. And review of prescribing decisions

Undertake audit of accuracy of practice registers. And review of prescribing decisions

Identify who is on repeat prescriptions and review timescales in place.

Identify who is on repeat prescriptions and review timescales in place.

Script switch messages for use in practices-prescribing software and AP alerts

Script switch messages for use in practices-prescribing software and AP alerts

Prescription guidelines authored and owned by all partners (example available from Medway [email protected]

Prescription guidelines authored and owned by all partners (example available from Medway [email protected]

National standards & recommendations for review and withdrawal of antipsychotic drugs and non-pharmaceutical alternatives.

National standards & recommendations for review and withdrawal of antipsychotic drugs and non-pharmaceutical alternatives.

Develop an understanding of the alternatives, the evidence base for these and their availability locally .Put referral processes in place- e.g. memory clinics

Develop an understanding of the alternatives, the evidence base for these and their availability locally .Put referral processes in place- e.g. memory clinics

Discuss patients/families/carers’ expectations around prescribing – what people think they want.

Discuss patients/families/carers’ expectations around prescribing – what people think they want.

Awards for good practice including Cornwall STAR (challenging antipsychotics and commissioning in dementia, via Martin Freeman) [email protected] )

.

Awards for good practice including Cornwall STAR (challenging antipsychotics and commissioning in dementia, via Martin Freeman) [email protected] )

.

Using practice based communications- leaflets, RCGP good practice with carers

Using practice based communications- leaflets, RCGP good practice with carers

COMMITTMENT FOR GENERAL PRACTICTIONERS AND PRIMARY CARE TEAMSSpecific commitment? Main themes for action? Resources/sources of help?

Work in partnership with other colleagues (psychiatrists, pharmacists, care home leaders) to develop a mutual understanding of the existing issues and develop a planned review for people with dementia who are on antipsychotics –to include specific support around the withdrawal of antipsychotics.

Work in partnership with other colleagues (psychiatrists, pharmacists, care home leaders) to develop a mutual understanding of the existing issues and develop a planned review for people with dementia who are on antipsychotics –to include specific support around the withdrawal of antipsychotics. Link with the Coroner’s office- avoidable

deaths.

Link with the Coroner’s office- avoidable deaths.

Guidelines for Care Homes and Nursing Homes (example from Medway) & Skills for Care guidance.

Guidelines for Care Homes and Nursing Homes (example from Medway) & Skills for Care guidance.

GPs commit to identify and review their patients who have dementia and are on antipsychotics with the purpose of understanding why antipsychotics have been prescribed. Working in partnership with the person with dementia, their family and carers and their medical colleagues in psychiatry to establish whether or notthe use of antipsychotics is inappropriate and whether or not it is safe to begin the process of discontinuing their use and to establish that access to alternative interventions can be secured


Audit who is on Aps-•Diagnosis•Under review

Audit who is on Aps-•Diagnosis•Under review

At risk-Care plan for. people at riskAppropriate use of medicines and alternatives.Focus on admission prevention

At risk-Care plan for. people at riskAppropriate use of medicines and alternatives.Focus on admission prevention

Pharmacy/non pharmacy interventions.Holistic assessment carers/familiesPredictive modelling

Pharmacy/non pharmacy interventions.Holistic assessment carers/familiesPredictive modelling

Appraisal revalidation,QoF,Qipp,CQuin

Appraisal revalidation,QoF,Qipp,CQuin

Environment/co-working.Resources and mapping of non-pharmacy alternatives.Use of personal budgetsBusiness case development for investment in alternatives for commissioners

Environment/co-working.Resources and mapping of non-pharmacy alternatives.Use of personal budgetsBusiness case development for investment in alternatives for commissioners

Community Matrons

Medicines Management Team

Admission prevention teams

Third sector

Social services

)

.

Community Matrons

Medicines Management Team

Admission prevention teams

Third sector

Social services

)

.

Map of medicine Map of medicine

COMMITTMENT FOR GENERAL PRACTICTIONERS AND PRIMARY CARE TEAMS continued…

Main themes for action? Resources/sources of help?

CommunicationSecondary care at discharge-identifying post discharge support.Improved information in community regarding relevant life history to know the pt.Primary to secondary care passport.

CommunicationSecondary care at discharge-identifying post discharge support.Improved information in community regarding relevant life history to know the pt.Primary to secondary care passport.

Holistic assessment -Interia project.

Holistic assessment -Interia project.

Carers/families questionnaireHospital PassportReminiscence.

Carers/families questionnaireHospital PassportReminiscence.



Needs Assessment

Joint Strategy Needs Assessment and Health & Wellbeing Strategy (and wider strategic plans) demonstrate the needs of people with dementia and carers by including residential care standards, workforce capacity & capability, health promotion and prevention and safeguarding protocols.

Needs Assessment

Joint Strategy Needs Assessment and Health & Wellbeing Strategy (and wider strategic plans) demonstrate the needs of people with dementia and carers by including residential care standards, workforce capacity & capability, health promotion and prevention and safeguarding protocols.

I (we) commit to:

1.Improving the quality and experience of care for people with dementia ( and their carers) ,by commissioning a whole systems approach to dementia

2.. Ensure through effective evidence-based commissioning, we support providers to minimise the need for antipsychotic drugs , and in addition to ensure prescribing is in line with NICE guidelines across the health and social care system

I (we) commit to:

1.Improving the quality and experience of care for people with dementia ( and their carers) ,by commissioning a whole systems approach to dementia

2.. Ensure through effective evidence-based commissioning, we support providers to minimise the need for antipsychotic drugs , and in addition to ensure prescribing is in line with NICE guidelines across the health and social care system

Service review/Priority settingEnsure local plans are in place by 31/3/12 to deliver the national dementia strategy specifically anti psychotic prescribing. Publicize and promote this plan and ensure is accessible and understandable by the publicCommissioners to make dementia business as usual across all areas of commissioning. Commissioners to develop and enhance leadership and governance for prescribing.

Service review/Priority settingEnsure local plans are in place by 31/3/12 to deliver the national dementia strategy specifically anti psychotic prescribing. Publicize and promote this plan and ensure is accessible and understandable by the publicCommissioners to make dementia business as usual across all areas of commissioning. Commissioners to develop and enhance leadership and governance for prescribing.

Commissioning pack to include SCIE recommendations

Recommended reading / information prescriptions (see appendix 1)

Audit results and statistics with examples and key questions to ask of the audit data e.g. % prescriptions generated in secondary care, no of pts on anti-psychotics with no diagnosis, what % people in care homes have had no review in last 6 months, what are prescribing stats in primary care, what is the incidence of falls reported from people with dementia on anti-psychotics.

Commissioning pack to include SCIE recommendations

Recommended reading / information prescriptions (see appendix 1)

Audit results and statistics with examples and key questions to ask of the audit data e.g. % prescriptions generated in secondary care, no of pts on anti-psychotics with no diagnosis, what % people in care homes have had no review in last 6 months, what are prescribing stats in primary care, what is the incidence of falls reported from people with dementia on anti-psychotics.

Local and national publications (see appendix 1). Dementia portal / NHS Networks – dementia section

“This is me” Alzheimer's society

“Misspent opportunities” audit commission

Local and national publications (see appendix 1). Dementia portal / NHS Networks – dementia section

“This is me” Alzheimer's society

“Misspent opportunities” audit commission

Service redesign and supplier side reshaping

Enabling providers with MDT to use appropriate alternatives to prescribing by strong evidence based commissioning in all areas ( this is the primary responsibility of the doctors but a part of the commissioning ethos). Ensure ‘in reach ‘ services appropriate to your locality is a priority within commissioning intentions. Incorporate within primary, acute, mental health and care home contracts governance mechanisms for regular audit of anti-psychotic prescribing. Implement NICE compliant protocols between primary and secondary care for the review of anti-psychotic medication on patient transfers.

Service redesign and supplier side reshaping

Enabling providers with MDT to use appropriate alternatives to prescribing by strong evidence based commissioning in all areas ( this is the primary responsibility of the doctors but a part of the commissioning ethos). Ensure ‘in reach ‘ services appropriate to your locality is a priority within commissioning intentions. Incorporate within primary, acute, mental health and care home contracts governance mechanisms for regular audit of anti-psychotic prescribing. Implement NICE compliant protocols between primary and secondary care for the review of anti-psychotic medication on patient transfers.

Clinical Decision making

Monitor and implement an MDT and multi-agency process for serious untoward incidents associated with people with dementia and their carers

Clinical Decision making

Monitor and implement an MDT and multi-agency process for serious untoward incidents associated with people with dementia and their carers

Local QOF data with up to date information Link to QIPP and

QOF data / LES CQuINs. CQC.

Local QOF data with up to date information Link to QIPP and

QOF data / LES CQuINs. CQC.

Examples of good practice include:

SE Collaborative – audit and quality indicators

Surrey – whole systems model inc Telecare

Examples of good practice include:

SE Collaborative – audit and quality indicators

Surrey – whole systems model inc Telecare

COMMITTMENT FOR COMMISSIONERS IN HEATH, SOCIAL CARE AND GP COMMISSIONING Specific commitment Main Themes for action Resources/sources of help?

Workforce developmentEducation commissioned for the public, workforce and managers enabling each to gain key skills to improve outcomes. Setting key educational stds for people in the health & social care , independent sector workforce , working with people with dementia . Enabling provision of training for lay carers

Workforce developmentEducation commissioned for the public, workforce and managers enabling each to gain key skills to improve outcomes. Setting key educational stds for people in the health & social care , independent sector workforce , working with people with dementia . Enabling provision of training for lay carers

Compendium of good practice and success stories/case studies , including those alternative approaches

Set up a steering group to share good practice

Create a central place to collate information – National Field or dementia portal.

Reference and link to websites which contain to partnerships, protocols for good practice.

Compendium of good practice and success stories/case studies , including those alternative approaches

Set up a steering group to share good practice

Create a central place to collate information – National Field or dementia portal.

Reference and link to websites which contain to partnerships, protocols for good practice.

Needs Assessment/Priority setting

All localities to take local audits (using available / shared audit tools) of current practice for antipsychotic prescribing medication for people with dementia which covers the whole health and social care system by 31st March 2012 Commit to change local commissioning plans as appropriate and contracts with all partners to reflect this and to reduce antipsychotic prescribing. measured by:

- the lens of people with dementia and their carers

- professional behaviours/practice

- actions at an organisational/system level

Commissioning specifications and contracts which reflect interventions and functions which deliver outcomes which minimize the need for anti-psychotics.

Needs Assessment/Priority setting

All localities to take local audits (using available / shared audit tools) of current practice for antipsychotic prescribing medication for people with dementia which covers the whole health and social care system by 31st March 2012 Commit to change local commissioning plans as appropriate and contracts with all partners to reflect this and to reduce antipsychotic prescribing. measured by:

- the lens of people with dementia and their carers

- professional behaviours/practice

- actions at an organisational/system level

Commissioning specifications and contracts which reflect interventions and functions which deliver outcomes which minimize the need for anti-psychotics.

Link to specific web pages and key documents which support

commissioning decisions

Link to specific web pages and key documents which support

commissioning decisions

Review processes and infrastructure which may lead to inappropriate prescription of antipsychotics and put in place other systems to support best practice (See slide 2: Sub-themes for action arising from this).

Review processes and infrastructure which may lead to inappropriate prescription of antipsychotics and put in place other systems to support best practice (See slide 2: Sub-themes for action arising from this).

I (we) commit to:

Identifying all people prescribed antipsychotic medication and to documenting and delivering an evidence-based, personalised care-plan developed in partnership with the individual, their family & the multi-disciplinary clinical team

I (we) commit to:

Identifying all people prescribed antipsychotic medication and to documenting and delivering an evidence-based, personalised care-plan developed in partnership with the individual, their family & the multi-disciplinary clinical team

Undertake a home-wide review of prescriptions initially & then establish a system of proactive review for all new residents, upon taking up residence, and thereafter in line with current clinical /best practice guidelines.

Undertake a home-wide review of prescriptions initially & then establish a system of proactive review for all new residents, upon taking up residence, and thereafter in line with current clinical /best practice guidelines.

National Dementia Strategy

Guidelines from Alzheimer’s Society

Guidelines from Dementia Alliance

NICE and SCIE Guidelines

National Dementia Strategy



NICE and SCIE Guidelines

Multi-disciplinary care pathway: management of challenging behaviour

Department of Health: compendium of best practice

(Examples of non-drug alternatives)

BUPA Mental Capacity Act ‘postcard’ for staff

Multi-disciplinary care pathway: management of challenging behaviour

Department of Health: compendium of best practice


BUPA Mental Capacity Act ‘postcard’ for staff

SCIE Dementia Gateway

Social Care TV

Charities Websites

Social Media (e.g. Facebook): BUPA, Dementia UK, possibly others

SCIE Dementia Gateway

Social Care TV

Charities Websites

Social Media (e.g. Facebook): BUPA, Dementia UK, possibly others

Develop clear, systematic protocols to ensure support to care home staff in actively challenging antipsychotic prescribing.

Develop clear, systematic protocols to ensure support to care home staff in actively challenging antipsychotic prescribing.

Establish clear relationships with, and links in to, emerging collaborative partnerships between GPs and Pharmacists - establishing as part of the wider call to action.

Establish clear relationships with, and links in to, emerging collaborative partnerships between GPs and Pharmacists - establishing as part of the wider call to action.

Develop/put in place a proactive, systematic register for maintaining and monitoring all antipsychotic prescriptions, reviews and outcome decisions.

Develop/put in place a proactive, systematic register for maintaining and monitoring all antipsychotic prescriptions, reviews and outcome decisions.

Care UK: Experiential Learning Course (Surry Pilot)

BUPA: How to work with challenging individuals

BUPA: Understanding behaviour (partnered with Bradford University)

Alzheimer’s Society: Focused Intervention Training for Staff (FITS 10-day programme)

Boots: Dementia Medication Training

ElBox, SKIP, MABO, Studio 3 & Edge

Care UK: Experiential Learning Course (Surry Pilot)

BUPA: How to work with challenging individuals

BUPA: Understanding behaviour (partnered with Bradford University)

Alzheimer’s Society: Focused Intervention Training for Staff (FITS 10-day programme)

Boots: Dementia Medication Training

ElBox, SKIP, MABO, Studio 3 & Edge

COMMITTMENT FOR LEADERS OF CARE HOMES: Specific commitment Main themes for action Resources/sources of help

Develop clear, systematic information resources & support for use by the individual, their family and care home staff

Develop clear, systematic information resources & support for use by the individual, their family and care home staff

Provide access to dementia-specific training & development opportunities for all care home staff.

Provide access to dementia-specific training & development opportunities for all care home staff.

Identify a named ‘Dementia Champion’ in each care home, supported through appropriate specialist education and training, with sufficient authority to effect change.

Identify a named ‘Dementia Champion’ in each care home, supported through appropriate specialist education and training, with sufficient authority to effect change.

Identify and utilise personal information resources for use by the individual, their family and care home staff.

Identify and utilise personal information resources for use by the individual, their family and care home staff.

Tools to help in the care environmente.g. Dependency scoring templateFlowchart for recognising problems which could change behavioursObservational toolsSCIE website, gateway &social care TV

Tools to help in the care environmente.g. Dependency scoring templateFlowchart for recognising problems which could change behavioursObservational toolsSCIE website, gateway &social care TV

Training resourcese.g. Training DVDsResident experience trainingMotivational mapping toolsVoluntary sector - Alzheimer’s Society training and resourcesE-learning resourcesMedicines management training

Training resourcese.g. Training DVDsResident experience trainingMotivational mapping toolsVoluntary sector - Alzheimer’s Society training and resourcesE-learning resourcesMedicines management training

Sources of support/service other than antipsychoticse.g. Alternative therapies and activities Local memory clinicsEnvironmental resources - e.g. Eden Journal of dementia care

Sources of support/service other than antipsychoticse.g. Alternative therapies and activities Local memory clinicsEnvironmental resources - e.g. Eden Journal of dementia care

Build relationship with the community to put in place interventions in the care home in line with best practice.

Build relationship with the community to put in place interventions in the care home in line with best practice.

Provide the times and resources for recognised accredited training on good dementia care.

Provide the times and resources for recognised accredited training on good dementia care.

Health and social care professional supportHealth and social care professional support

COMMITTMENT FOR LEADERS OF CARE HOMES: (Continued)Key Theme for Action Sub-themes for action Resources/sources of help

Provide ongoing training and support to staff.Provide ongoing training and support to staff.

Establish and maintain a clear relationship with multidisciplinary team members (e.g. GPs and pharmacists).

Establish and maintain a clear relationship with multidisciplinary team members (e.g. GPs and pharmacists).

Review processes and infrastructure which may lead to inappropriate prescription of antipsychotics and put in place other systems to support best practice

Review processes and infrastructure which may lead to inappropriate prescription of antipsychotics and put in place other systems to support best practice

Care planCare plan

The individual, their family and carerse.g. This is me document/Dementia passport

The individual, their family and carerse.g. This is me document/Dementia passport

Examples of good practicee.g. Nothing ventured, nothing gained DH docDH Compendium of best practice

Examples of good practicee.g. Nothing ventured, nothing gained DH docDH Compendium of best practice

Establish a clear dialogue and agree joint working practices for reviews with all prescribing partners

Establish a clear dialogue and agree joint working practices for reviews with all prescribing partners

Become better informed about best practice guidelines for the prescribing of antipsychotic medication, and alternative interventions, for people with dementia. Provide support and sign-posting to alternative resources for people with dementia and their carers

Become better informed about best practice guidelines for the prescribing of antipsychotic medication, and alternative interventions, for people with dementia. Provide support and sign-posting to alternative resources for people with dementia and their carers

Guidance in Bannerjee report

Source of specific guidance from RCGP

Guidance in Bannerjee report

Source of specific guidance from RCGP

http://www.rcpsych.ac.uk/files/pdfversion/CR138.pdf

http://www.rcpsych.ac.uk/files/pdfversion/cr119.pdf (see section 8 and appendix)

http://www.rcpsych.ac.uk/files/pdfversion/CR138.pdf

http://www.rcpsych.ac.uk/files/pdfversion/cr119.pdf (see section 8 and appendix)



Talking with people with dementia and their families



Talking with people with dementia and their families

NICE and SCIE guidelineNICE and SCIE guideline

Community pharmacists:

Query every prescription for an antipsychotic for people aged 65 years or over and/or those known to have dementia and search for, and audit, all people 65 years and over who have received antipsychotic medication in the last 3 months

Community pharmacists:

Query every prescription for an antipsychotic for people aged 65 years or over and/or those known to have dementia and search for, and audit, all people 65 years and over who have received antipsychotic medication in the last 3 months

Hospital pharmacists:

Query every prescription for an antipsychotic for people aged 65 years and over and ensure that discharge information is up to date regarding the actions GPs should take (in line with NICE guidelines)

All antipsychotic are flagged on transfer documentation with a clearly identifiable review date PCT and commissioning pharmacists:

Include antipsychotic within QOF action plan and QIPP target. Review/challenge high prescribers

Hospital pharmacists:

Query every prescription for an antipsychotic for people aged 65 years and over and ensure that discharge information is up to date regarding the actions GPs should take (in line with NICE guidelines)

All antipsychotic are flagged on transfer documentation with a clearly identifiable review date PCT and commissioning pharmacists:

Include antipsychotic within QOF action plan and QIPP target. Review/challenge high prescribers

Multi-disciplinary care pathway – management of challenging behaviour in dementia

Multi-disciplinary care pathway – management of challenging behaviour in dementia

Department of Health – compendium of best practice


Department of Health – compendium of best practice


Report back on my progress in these activitiesReport back on my progress in these activities

COMMITTMENT FOR PHARMACISTS

Specific commitment? Main themes for action? Resources/sources of help?

I (we) commit to:

Reviewing the people under my care to identify those who are prescribed antipsychotic medication and to work in partnership with my prescribing and other health care colleagues to review each individual by 31st March 2012

I (we) commit to:

Reviewing the people under my care to identify those who are prescribed antipsychotic medication and to work in partnership with my prescribing and other health care colleagues to review each individual by 31st March 2012

To challenge routine practice and update knowledge base using current evidence and best practice

To challenge routine practice and update knowledge base using current evidence and best practice

Utilise clinical governance esp. clinical audit, to provide information on local practice to inform required local action

Utilise clinical governance esp. clinical audit, to provide information on local practice to inform required local action

Annual mtg of Faculty of Old Age Psychiatrists / Royal College (March mtg– but could utilise newsletters)

Annual mtg of Faculty of Old Age Psychiatrists / Royal College (March mtg– but could utilise newsletters)

‘Getting to Know You’ charts – to help identify causes of disturbed behaviour

‘Getting to Know You’ charts – to help identify causes of disturbed behaviour

NICE guides for dementia

Royal College Psychiatrists resource pack

NICE guides for dementia

Royal College Psychiatrists resource pack

Increase links with local GPs esp. identifying and working with GP 'dementia leads’ to review local practice

Increase links with local GPs esp. identifying and working with GP 'dementia leads’ to review local practice

Offer local education opportunities to all psychiatrists and to all hospital doctors

Offer local education opportunities to all psychiatrists and to all hospital doctors

Increase links and offer educational support to Care Homes e.g. 1 day conference with input from psychiatrists and care homes staff

Increase links and offer educational support to Care Homes e.g. 1 day conference with input from psychiatrists and care homes staff

Flowchart for identifying causes of BPSD – Anne Child. [email protected]

RAGE for monitoring

Flowchart for identifying causes of BPSD – Anne Child. [email protected]

RAGE for monitoring

Admission process pathway – North Staffs (audit data to demonstrate benefits)

Admission process pathway – North Staffs (audit data to demonstrate benefits)

COMMITTMENT FOR PSYCHIATRISTS AND MENTAL HEALTH TEAMS

Specific commitment? Main themes for action? Resources/sources of help?

Review the causes(s) of disturbed behaviour before initiating or continuing antipsychotic treatment

Patients discharged on antipsychotic treatment to have a clear management plan and support from the Care Home liaison team

Patients discharged on antipsychotic treatment to have a clear management plan and support from the Care Home liaison team

Joint visits (psychiatrist and GP) to ‘struggling’ care homes (possibly monthly)

Joint visits (psychiatrist and GP) to ‘struggling’ care homes (possibly monthly)

v090511

I (we) commit to: Review the causes(s) of disturbed behaviour before initiating or continuing antipsychotic treatment

I (we) commit to: Review the causes(s) of disturbed behaviour before initiating or continuing antipsychotic treatment

Seek information and support from the voluntary sector and other resources on treatment and care options and seek guidance on how to establish a dialogue with health and social care professionals.

Seek information and support from the voluntary sector and other resources on treatment and care options and seek guidance on how to establish a dialogue with health and social care professionals.

I/We commit to Proactively seeking a conversation with my (our) GP to review care and agree a personalised care plan (in line with best practice)

I/We commit to Proactively seeking a conversation with my (our) GP to review care and agree a personalised care plan (in line with best practice)

Take responsibility for working in partnership with care team to ensure initial and ongoing appropriate review of the care plan.

Take responsibility for working in partnership with care team to ensure initial and ongoing appropriate review of the care plan.

Care plan and ‘who I am‘ document (e.g. This is me, Dementia Passport)

Care plan and ‘who I am‘ document (e.g. This is me, Dementia Passport)

Information from the voluntary sector (e.g. Alzheimer’s Society’s antipsychotics booklet, Alzheimer’s Society website, Age UK website).

Information from the voluntary sector (e.g. Alzheimer’s Society’s antipsychotics booklet, Alzheimer’s Society website, Age UK website).

Local services and peer support networks (e.g. Memory clinic, dementia adviser, support group).

Local services and peer support networks (e.g. Memory clinic, dementia adviser, support group).Take responsibility for sharing insights into who I

am and what I want (who the person I care for is and what they want) to support the development and implementation of an effective, valuable and realistic care plan.

Take responsibility for sharing insights into who I am and what I want (who the person I care for is and what they want) to support the development and implementation of an effective, valuable and realistic care plan. Information from membership

organisations such as UKHCA and ECCA

Information from membership organisations such as UKHCA and ECCA

COMMITTMENT FOR PEOPLE WITH DEMENTIA, THEIR CARERS AND FAMILIES

Specific commitment Main themes for action Resources/sources of help

Non-web information sources (e.g. Alzheimer’s Society help lines, libraries)

Non-web information sources (e.g. Alzheimer’s Society help lines, libraries)

Local and national mediaLocal and national media

Health and social care professionals (e.g. GP, CPN, consultant)

Health and social care professionals (e.g. GP, CPN, consultant)

Help us make it happen

• Pick up a flyer and email us• Visit our website• Join one of our commitment groups• Tell us why this matters to you• Share your resources• Connect a colleague

Join us today!

Catherine Holmes

Documents