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Helping hand for people with dementia in Dartford, Gravesham and Swanley

User AvatarPosted by at 21/05/2013 21:11:22

As people live longer, the number of people with dementia is on the increase.

The Alzheimer’s Society predicts the number of people with dementia in the UK will double in the next 40 years. By 2051 there will be 1.7 million people with dementia.

Across Kent and Medway there are currently 9,000 people diagnosed with dementia, with 1,256 of these in Dartford, Gravesham and Swanley. However, the NHS in Kent and Medway says that only 47.3 per cent of people with dementia in the area are diagnosed.

Steps are underway to encourage more people who may have the condition to seek diagnosis. This, and support services for people with dementia and their carers, are being promoted this week to mark national Dementia Awareness Week (19-25 May).

The first step for many people who think they or a loved one may have dementia is a trip to the GP. A new memory testing system is being piloted in some GP surgeries across Kent this year which will use an iPad app called CANTABmobile to determine whether patients have memory problems which may be linked to dementia.

All acute hospitals in Kent and Medway are now screening everyone aged 75 and above, who is admitted as an emergency and spends more than 72 hours in hospital, for any sign of memory problems.

GPs, practice nurses and other primary care providers are also being trained to look out for the early warning signs.

Dr Bhaskar Bora, Chair of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group (CCG) said: “Dementia is on the increase and we want to make sure that more people with memory problems are diagnosed so that we can offer them the right support. Carers of people with memory problems can also benefit from the support so it’s important that they encourage their loved ones to visit a GP if they’re concerned.”

The support available includes the Kent and Medway Dementia Web. The website provides information and details of support services which are searchable by area. Details of dementia cafes, peer support and mentors can all be found on the site - see www.dementiawebkentandmedway.org.uk

A free 24 hour helpline for people with dementia and their carers also offers advice and emotional support – call 0800 500 3014.

Clinical commissioning groups across Kent and Medway are working on a number of further initiatives to support people with dementia, many of them supported by the Prime Minister’s Dementia Challenge funding. NHS organisations in Kent and Medway received £1.2 million from the challenge fund to support work on dementia, and west Kent received a further £300,000. Other health trusts and councils in Kent and Medway have also invested in services.

The NHS in Kent and Medway works in partnership with Kent County Council, local councils, charities and voluntary organisations to support people with dementia and their carers.

Home Treatment Services are available across east Kent, provided by Kent and Medway NHS and Social Care Partnership Trust. They provide enhanced support and treatment for people with dementia and their carers in response to crises and during periods of transition to prevent unnecessary admission to hospital and to provide support to carers. The teams include mental health nurses, occupational therapists and psychology and support workers.

Support is also available to care homes.  Twelve care homes across Kent and Medway have been selected to participate in a training programme to enable them to provide an even better service for people with dementia. The Excellence in Kent scheme will give the 12 care homes access to intensive training and will involve careful assessment of people with dementia with a system called dementia mapping which aims to see life through the eyes of someone with dementia.

Hospitals are also improving care for patients with dementia. Each acute hospital in Kent and Medway has a specialist dementia nurse. The hospitals are also recruiting dementia champions from their staff to raise awareness of the needs of people with dementia. A buddy scheme has been established in Darent Valley Hospital and similar schemes are being implemented in all other acute hospitals across Kent and Medway. The scheme is delivered by volunteers who provide support to people with dementia and their carers to make their stay a better experience.

Changes are also being made to the environment in hospitals, to make them more dementia friendly. These changes include a memory wall in Medway Maritime Hospital.

In addition, Kent County Council is working with a number of partners to create dementia friendly communities. Work includes the development of more dementia cafes, facilitation of intergenerational work which brings people with dementia together with young people, and also an adult placement scheme called Shared Lives which is similar to fostering but is for adults rather than children.

Dr Bora said:  “It’s important to note that getting forgetful is a natural part of the ageing process, but there are some tell-tale signs that mean it may be time to visit your GP and express your concerns.”

These signs include memory loss, especially problems with short-term memory, increasing difficulties with tasks and activities requiring concentration, depression, changes in personality and mood, periods of mental confusion and difficulty finding the right words.

Case study - Dartford, Gravesham and Swanley - Mental health nurses working with GPs

The number of people living with dementia is steadily rising putting increasing pressure on health services and carers, says a local GP.

Dr Bhaskar Bora, Chairman of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group, said: “Dementia is an illness that predominantly affects older people and, as we are all living longer, it’s inevitable that the number of cases will rise.”

Almost 3,000 people are predicted to live with the degenerative brain disease in the area.

Dr Bora added: “The first step is getting a clear picture of what we are facing.  At present, diagnosis of dementia is relatively poor and we’ve set ourselves a target of increasing detection rates to 50 per cent this year and 60 per cent by 2015.

“What early diagnosis can do is help us with care planning, rapid response and behavioural support and improving the general approach of health care professionals towards dementia patients.”

At present, the CCG is aligning mental health practitioners to GP surgeries where patients can be assessed in familiar surroundings with specialist staff on hand to support GPs.

The CCG is working closely with Kent and Medway NHS and Social Care Partnership Trust and has developed close working arrangements where mental health practitioners are aligned to practices to help assess people who present with memory difficulties. 
The initiative will ensure people receive a diagnosis in the early stages of dementia and get the appropriate advice and support as the condition progresses. 

The government says more than 700,000 people will be living with dementia by 2020 at a cost of £20 billion a year.

Help your GP improve patients' health in Dartford, Gravesham and Swanley

Posted by at 20/05/2013 16:58:55

Help your GP improve patients’ health by joining a patient participation group. Many practices already have their own and those which do not, may appreciate help starting one.
The National Association for Patient Participation (NAPP) is staging its first awareness week from Monday 3 June to encourage more involvement so this is a good time to act.

Rosemary Bolton, the independent member for patient involvement at NHS Dartford, Gravesham and Swanley Clinical Commissioning Group, the area’s new health team, said: “Patient participation groups play a vital role in helping to improve the area’s health by sharing ideas and feedback with surgeries and the CCG.

“They carry out patient surveys, help with health awareness days like winter flu injections, produce newsletters or web pages and act as a critical friend, giving important feedback to the practice.

“Joining a patient participation group allows you to have a direct input in how your practice is run. It ensures patients’ views remain at the heart of local services at a time when the NHS is undergoing significant change.”

Some groups run online virtual versions for those unable to attend meetings but who still want to help.

Sue Creedon, secretary of Patient Voice, the patient participation group at the Oaks Surgery in Nightingale Way, Swanley, said: “Our group has patients, surgery staff and a GP on the committee.

“We have a newsletter, a noticeboard in the waiting room and a dedicated webpage on the practice website to give patients information about the surgery and changes to the NHS, particularly in the local area.  Patients can contact us through our own feedback forms and through our own e-mail address.”

Sue, a former state registered nurse and school teacher who has retired through ill health, added: “I agreed to join our surgery's patient participation group because the practice has been very helpful to me with my own health problems and I wanted to put something back.  We have established a Patient Reference Group, in addition to the patient participation group committee, and that has 230 members. We survey them for their opinions about any decisions or changes taking place and ask for comments and ideas.”

Patient participation group members have designed the annual practice survey for the past two years and this year put a version on the web for patients to complete online. Sue said: “It is very useful to find out about the positive points of the surgery and to hear any concerns patients may have. Patient Voice has put an action plan in place with the surgery to make improvements over the coming year.”

The patient participation group held its first patient event last year in conjunction with Sevenoaks District Council and is planning another in the autumn. Sue said: “We believe health education is an important aspect of patient participation group work.”

Every six to eight weeks the chairs of the area’s patient participation groups meet the clinical commissioning group to exchange ideas and feedback, to raise questions with the CCG and to take information back to their members. The CCG is keen for every practice to be represented at the meetings.

Dr Bhaskar Bora, chairman of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group and who is based at Elmdene Surgery in London Road, Greenhithe, said: “It is great having a patient participation group. It gives feedback about what is needed and helps keep patients up to date with what is happening and alerts them to any special health issues. I would recommend patients enrol in their own patient participation group or help start one.”

A third of the area’s 34 practices now have patient participation groups. To find out if your practice has one, call the surgery or check out the practice website.

GPs appeal to patients on medication

Posted by at 14/05/2013 10:08:46

Patients on more than one type of medication are being reminded to visit their local pharmacist for a free medicines review.

The review will ensure they are taking the most appropriate medication in the best way - at the right time of day, for instance, or not on an empty stomach.

It will give patients a chance to ask questions and check they know what their medication is for, and will provide an opportunity to return any out-of-date medicine that can be safely disposed of.

Dr Bhaskar Bora, chair of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group, said: “It is estimated that more than £300 million is wasted on unused prescriptions every year.

“The review gives patients peace of mind as well as ensuring people aren’t storing up more medication than they need. It may seem like a small measure but if everyone took part in the area it would make a big difference.”

Simple advice includes only ordering the medicines you need, checking how much of your medication is left before ordering more, not automatically ordering all medicines each time your repeat prescription is due and talling to your GP or pharmacist if you are having problems taking medication.

GPs appeal to patients to keep appointments

Posted by at 14/05/2013 10:07:47

GPs are appealing for patients not to put off hospital appointments investigating suspected cases of cancer.

Suspected cases are given priority as part of the local cancer plan and seen within two weeks by specialists.

However, figures from the last recorded three months in Dartford, Gravesham and Swanley show more than 8 per cent of patients are failing to turn up or are putting off their appointments.

Dr Bhaskar Bora, Chair of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group, said: “I can’t stress enough the importance of early diagnosis in improving people’s chance of overcoming cancer.

“The earlier we can identify a problem, the better the chance of recovery.  Ignorance is not bliss and, if there is a problem, we can get to grips with it.

"We are not sure why people in this area are taking such a casual approach to cancer appointments but we would ask them to attend all medical appointments - and particularly ones for cancer.”

The value of early detection is highlighted by bowel cancer where people have a 90 per cent chance of surviving for five or more years if screening picks up cancerous cells.

Dr Bora added: “Keeping your appointment also shows  a little respect to medical staff because a missed appointment costs people’s time when they could be helping others.”

New health team pledges quality for Dartford, Gravesham and Swanley

Posted by at 09/05/2013 16:56:20

GPs have pledged their commitment to improve the quality of health services in Dartford, Gravesham and Swanley at the first meeting in public of the area’s new health commissioners.

Dr Bhaskar Bora, chairman of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group’s governing body, said: “Addressing the quality of services for patients is at the heart of everything we do. That is why we are involved in the CCG. That is what motivates us.”

The CCG, which includes all of the area’s GPs, took over planning and paying for most of the health services for the area’s 249,000 population on 1 April. It has £278 million to spend this year.

The GPs are represented by a governing body which met in public on Tuesday 30 April at the White Oak Indoor Bowls Club, Swanley. The CCG has identified three local priorities for its first year:

  1. To ensure patients with long-term conditions have integrated care plans to help them manage their own health so they are less likely to need emergency treatment in hospital;
  2. To increase the use of end-of-life care registers so people are more likely to die in their place of choice rather than on a hospital ward;
  3. To focus on patients with heart disease, one of the main causes of death in the area.

This area also has a higher than average number of overweight patients and people with high blood pressure, which puts them at risk of stroke and heart attack. The area has higher than average emergency hospital admissions for diabetes.

The governing body also agreed its constitution and complaints policy.

The next meeting in public of the CCG governing body is on Tuesday 21 May from 1-4pm at Gravesend Cricket Club, Bat and Ball Ground, Wrotham Road, Gravesend DA11 0QP. The agenda and papers will be on the website www.dartfordgraveshamswanleyccg.nhs.net  or available to be inspected from Wednesday 15 May. Or call 03000 424903. Any member of the public may ask a question about an agenda item. E-mail your request to dgs.ccg@nhs.net at least three days before the meeting.

Support for people at the end of their life in Dartford, Gravesham and Swanley

Posted by at 09/05/2013 16:55:09

Everyone deserves to be treated with dignity and respect as they approach the end of their life, and to be cared for in a manner and place of their choosing.

Most people want to have a say over the healthcare they receive in their last weeks and days. However, it is not always easy for people who are dying to discuss their thoughts and wishes with those around them. Just thinking about it can make those close to them very upset.

Steps are taking place in Dartford, Gravesham and Swanley to provide better care for patients at the end of their life and these steps are being promoted as part of Dying Matters Week which runs from 13-19 May. Improving end of life care is one of the CCG's top three priorities.

A pilot 24/7 crisis response service which provides support for patients at the end of their life is being continued, following good feedback from the carers and families of those who have received the service.

The service is provided by EllenorLions Hospice, and gives assistance to patients and their carers with emotional support and practical care to enable the patient to die at home if that is their wish. This bridges the gap between the patient’s own informal family/carer support and access to professional input and is available to anyone at the end of life.

Referrals to the crisis response service are made by health professionals, including GPs, community nurses and hospital staff, and the first visit can be made within a few hours of the referral being made, if this is needed. More than 300 people have received the service which has enabled three quarters of them to die at home.

In addition, a new 12 month community case management project will help to ensure more people die where they want to. The pilot project will be led and run as a partnership between the EllenorLions Hospice and Kent Community Health NHS Trust, with two community nurses seconded into the EllenorLions team. The team will work with GP practices to identify people with life limiting illnesses approaching the end of life and to provide support to them in planning their future care and co-ordinating all the services they receive, including times when help is needed outside of normal GP working hours.

Ten GP practices across Dartford, Gravesham and Swanley will be taking part in the pilot project. The project will be launched in the next few months, and will aim to help reduce the number of people going into hospital at the end of their lives and help those cared for in hospital to return home to die if that is their wish and if it’s safe for them to do so.

Dr Bhaskar Bora, Chair of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group (CCG), said: “The thing people fear most about dying is the associated loss of control. By empowering patients to express their wishes, and putting procedures in place to ensure healthcare professionals can support those wishes, that control can be restored.

“It’s important we support people who are at the end of their life. This project will improve end of life care experience for patients and their families. Improving end of life care is one of the top three priorities for NHS Dartford, Gravesham and Swanley CCG."

The CCG is also planning to introduce an improved system for patients at the end of their life to record their wishes for treatment and where they want to die, and for this information to be shared electronically, if a patient consents, among healthcare professionals who may be involved in their care, to ensure that each individual’s wishes can be met.

Additional training in end of life care for nursing and residential care homes staff is also continuing.

*The EllenorLions Hospice is holding an open evening to coincide with Dying Matters Week. The hospice, in Coldharbour Road, Northfleet will be open on 13 May from 6pm to 9pm.

Parents in Dartford, Gravesham and Swanley urged to protect children against measles

Posted by at 02/05/2013 15:19:01
Families of children in Dartford, Gravesham and Swanley and surrounding areas who may have missed out on their measles jabs are being urged to make sure the youngsters are protected against the disease.

Local GP practices are contacting the families of patients aged 10 to 16 who, health records show, have missed out on vaccination against measles, mumps and rubella.

This follows the launch of a campaign to immunise one million children and teenagers across the country against measles, mumps and rubella (MMR) after a national increase in measles cases.

The vast majority of children and teenagers in Kent are up-to-date with their immunisations.

However, several thousand of the 110,000 10 to 16 year olds have not been immunised against MMR or have had only one of the two jabs needed for maximum immunity.

Dr John Rodriguez, Kent and Medway Screening and Immunisation Lead, said: “While there is no immediate cause for concern in this area – in fact there was just one confirmed case of measles in Kent in the first three months of this year - it is a wise precaution for parents to make sure their children have had both MMR vaccinations.

“Take-up rates for MMR immunisation in Kent are higher than the national average but we would like even more children to be protected.

"Both doses of the vaccination are needed to give children maximum protection against these serious diseases, and reduce the risk of outbreaks.

“GP practices will be contacting the families of children who, according to child health records, have not had their immunisations.

“I would urge that all families act on the invitation.”

Experts believe the national rise in measles cases can be mostly attributed to the proportion of unprotected 10 to 16 year olds, who missed out on vaccination in the late 1990s and early 2000s when concern around the discredited link between autism and the vaccine was widespread. After many years of low vaccination uptake, measles became re-established in 2007.

Dr Bhaskar Bora, Chair of NHS Dartford, Gravesham and Swanley Clinical Commissioning Group, said: “Measles is not a mild illness and is extremely infectious. It is very unpleasant and can lead to children becoming very seriously ill, and in very rare cases, to their death.

“Children, teenagers and young adults who have not been vaccinated at all against MMR should urgently seek at least one dose which will give them 95 per cent protection against measles. A second dose is then needed for almost complete protection.

“Although GPs will be contacting families direct, I would urge any parents who think their child may not have had both vaccinations to check their red book, which has the child’s vaccination record or, if they cannot find that, to contact their GP practice.

“Now is the time to catch up on missed vaccinations and ensure their children are protected now and into the future.

“I would also urge all parents of young children, who are being invited for their routine vaccinations, to make sure they take up the offer. More than 100 children in England have been hospitalised with measles so far this year – make sure you give your child the very best protection you can.”

The first MMR immunisation is given to children between the ages of 12 and 13 months. The second dose should be given once they are three years four months and before they are five, or before they start school.

Statement – Dartford, Gravesham and Swanley Clinical Commissioning Group

Posted by at 01/05/2013 09:03:54
Dartford, Gravesham and Swanley Clinical Commissioning Group has announced temporary changes to its leadership.

Clinical Accountable Officer Dr David Woodhead is stepping down for six months due to family illness. He will continue to serve on the governing body in a clinical advisory role. Deputy Accountable Officer Patricia Davies will take the helm on an interim basis.

Dr Liz Lunt, who as a GP and governing body member is Deputy Clinical Accountable Officer, is also taking a break from her role in order to spend more time in clinical practice.

Patricia Davies said: “We completely understand why David needs to take a break and look forward to his return in due course. We will also miss Liz’s involvement, but I am pleased to say she will still be supporting the CCG behind the scenes.

“The CCG has a number of other GPs on the governing body, and also leading workstreams in the wider CCG membership, so our clinical leadership is strong. In recent weeks we have also completed recruitment of our four independent and lay members, so we are in an excellent position to pursue our goals.

“We are building our engagement with the local community to ensure our decisions take account of the views of local people. As we begin to review and commission healthcare services it is essential that we are putting patients at the heart of everything we do – this is important to us and one of the factors that will make the difference in the new system.”