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A Human Rights Based Approach to Care
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Dementia Scotland 2016
A Human Rights Based Approach to Care
14th of September 2016
Dynamic Earth, Edinburgh

 

An estimated 90,000 people in Scotland alone live with dementia, there is no doubt that dementia remains one of the foremost public health challenges worldwide
"While spend on dementia services is difficult to calculate, it is estimated that we spend around £2 billion a year within statutory services on people with both dementia and other co-morbidities”. Geoff Huggins - Director of Health and Social Care Integration
"Our national performance on diagnosis over the last two years has been maintained and remains one of the highest in the world. But we want to improve further.”. Jamie Hepburn - Minister for Sport, Health Improvement and Mental Health
"Our national performance on diagnosis over the last two years has been maintained and remains one of the highest in the world. But we want to improve further.”. Jamie Hepburn - Minister for Sport, Health Improvement and Mental Health

An estimated 90,000 people in Scotland alone live with dementia, there is no doubt that dementia remains one of the foremost public health challenges worldwide. Scotland's second three-year National Dementia Strategy was launched in 2013.

The key priorities included: continuing to improve diagnosis rates and post-diagnostic support; ensuring the highest quality of care and support for people with dementia at every stage of the illness; improving service response in acute care and supporting the growth of dementia-friendly communities.

The Scottish Government is now reviewing the progress of the 2013 strategy and a third National Dementia Strategy for Scotland will be produced in spring 2016.

The Scottish Government’s National Dementia Dialogue 2015 consultation paper submitted on January 29, 2016 identifies the gaps, opportunities and priorities and to help shape the direction of the next strategy.

In 2015 Alzheimer Scotland held across Scotland to allow interested parties to comment on the progress of the strategy to date and the areas outlined in the National Dementia Dialogue.

These events have enabled:

  • People with dementia & carers to talk in small groups to discuss and share with others their views on the quality of services and how they can be improved to meet their needs.
  • All health, social care and other professionals who may have a responsibility for implementing the strategy to discuss issues for implementation and action locally and nationally.
  • Others who have an interest in this area to contribute to these discussions and talk about other aspects of Scotland’s overall approach to dementia, and lessons learnt from throughout UK & EU.
The National Dementia Dialogue 2015 outlines the following 12 key focus areas

  1. Diagnosis and post-diagnostic support
  2. Integrated support at home
  3. Palliative and end of life care
  4. Workforce development
  5. Acute general hospital care
  6. Specialist and continuing NHS dementia care
  7. Care homes
  8. Human rights based approach to dementia care
  9. Prevention
  10. Research
  11. Dementia friendly communities
  12. Improvement support, data and service re-design
Diagnosis and post diagnostic support

The Scottish Government’s national post diagnostic support target is designed to give people time and space to access services and receive high quality support in a way that meets their individual needs over the course of a year, coordinated by a named Link Worker. This target has adopted Alzheimer Scotland’s 5 Pillars approach.

The Scottish Government is now considering enhanced primary care support to help deliver the post diagnostic support guarantee. Two sites will test this new approach, utilising resources from the Primary Care Transformation Fund.

Integrated support at home

Alzheimer Scotland’s policy paper Delivering Integrated Dementia Care: The 8 Pillars Model of Community Support has proposed an integrated care model. This 8 Pillar model focuses specifically on that stage of the illness where more intensive community services are needed to enable people to stay living well and as independently as possible at home for as long as possible. Over the last 18 months 5 areas of Scotland Glasgow City, Midlothian, North Lanarkshire, Moray and Highland have tested the applicability of this model, and our conference will seek to disseminate outcomes and outputs from the many programmes of work which have been covered.

Palliative and end of life care

The Scottish Government is supporting the new Palliative Care Strategic Framework for Action with £3.5 million of funding over the next four years. Launched on December 18, 2015, it builds on many actions and policies already in place and sets out the goals, challenges and direction for future improvement. We will seek to provide further guidance on the framework and funding routes through our main plenary sessions.

Alzheimer Scotland has published the Advanced Dementia Practice Model: understanding and transforming advanced dementia and end of life care. The report is based on an extensive consultation and information gathering process, involving people with dementia, their families and carers, individual professionals and interested organisations, as well as research into best practice and in depth exploration of the available evidence. Through our live event and the supporting online resources we will seek to provide valuable continuous insight into all research and outputs.

The Scottish Government intends to test and evaluate this service model in at least two geographical areas in the next dementia strategy.

Workforce development

Over 500 Dementia Champions are trained to lead improvements at the frontline of NHS hospital care and associated community care settings, with a further 100 graduating in March 2016. In addition over 800 people have chosen to become Dementia Ambassadors and in doing so have taken a lead role in developing the knowledge and skills of 15 other staff in their localities.

Acute general hospital care

The Scottish Government has a three year strategy to improve dementia care in hospitals, including a 10 point action plan to drive up standards of care. Our approach includes development of clear standards, ensuring strong senior and clinical leadership, getting right staff in the right place and giving healthcare staff the support and training they need to provide safe, effective and person centred care to every patient, every time. National reporting from all NHS Boards on all 10 care actions started in March 2015.

Specialist and continuing NHS dementia care

The Mental Welfare Commission (MWC) report Dignity and Respect: Dementia continuing care visits published in June 2014 sought to improve quality of care in general hospitals to other hospitals and NHS settings.

The Quality and Excellence in Specialist Dementia Care programme (QESDC) launched in September 2015 is aimed at supporting NHS boards to implement the recommendations from the MWC report.

Care Homes

Early in 2015, a Scottish Government led Dementia in Care Homes Group was established to help improve dementia care in residential care settings, notably around workforce training and development to support delivery of the Standards of Care for Dementia in these settings, including Promoting Excellence.

Human rights based approach to dementia care

The Charter of Rights for People with Dementia and their Carers is at the heart of Scotland’s National Dementia Strategy. The Charter is intended to empower people with dementia and their carers to assert their rights in every part of their daily lives.

This human rights based approach has informed all aspects of the National Dementia Strategy and is reflected in the Standards of Care for Dementia in Scotland and the Promoting Excellence Framework.

Prevention

Currently, the Scottish Government takes forward an overall programme of public health initiatives, including encouragement of smoking cessation, alcohol reduction, a healthy diet and more exercise. Resources produced by NHS Health Scotland, Alzheimer Scotland and others provide information on the evidence of the benefits of maintaining a healthy lifestyle in reducing the risks of some forms of dementia.

Research

Join Dementia Research is a UK wide platform launched in 2015 to enable people with dementia and cognitive impairment to indicate their willingness to take part in research studies and to be matched to suitable studies in which they can then be invited to participate.

Dementias Platform UK (DPUK) is a £53 million project, largely funded on a UK wide basis by the Medical Research Council; with The University of Edinburgh is one of the 8 academic partners. And the European Prevention of Alzheimer’s Dementia Initiative (EPAD) Involves 35 partners from the academic and private sectors and will initially run for five years with around £50 million funding.

Dementia friendly communities

The Standards of Care for Dementia for Scotland recognise the importance of people with dementia being enabled to take as full and as active a part in their community as possible. There are already a range of national and local activities in train in this area: Alzheimer Scotland’s implementation of the Dementia Friends initiative; The Life Changes Trust’s support for dementia friendly initiatives; and local initiatives in areas such as Edinburgh, Motherwell and Stirling, among others.

Improvement support, data and service re-design

Focus on Dementia is a partnership improvement programme which brings together and maximises the skills, expertise and knowledge of improvement professionals, policy practitioners and the third sector in order to support the continuing redesign, transformation and modernisation of dementia services in Scotland.

2016 will see the beginning of further up scaling of improvement support provided across health, social care and housing within Healthcare Improvement Scotland, and the Focus on Dementia will retain a distinct programme identity within that national improvement support infrastructure.

This conference will examine progress of Scotland’s ongoing National Dementia Strategy, whilst dissecting the aspirations of the New 2016-2019 strategy. The conference website will provide ongoing commentary as the key priorities of the new strategy unfold.

We will provide a platform for the leaders of all of the above mentioned projects and many others to showcase their achievements and ambitions and provide insight on evidence based research and innovations to the leading health and care professionals from across all areas Scotland.

Govconnects experience in delivering communications around other EU driven Dementia strategy’s along with its unique socially focused reinvestment model has enabled us to gain a reputation as one of the UK’s fastest growing social enterprises, with a clear dedication to the promotion of patient focused improvements, world class research, diagnosis and care and financially supporting organisations linked to each individual country’s challenges has placed us in an ideal position to assist the many stakeholders involved in delivering Scotland’s national dementia strategy.

Govconnects inaugural Dementia Scotland Conference aims to develop a community of conference delegates, online users and wider stakeholders who through focussed ongoing debate both at the conference and via the 12 month engagement process, work together towards the achievement of their individual and shared ambitions.

Update: March 2016 - Proposal for Scotland’s National Dementia Strategy 2016-19

This proposal for Scotland's National Dementia Strategy 2016-19 is the outcome of extensive discussion and feedback from the Dementia Dialogue events between November and January and written submissions on the dementia consultation paper. This paper lays out Scottish Government proposals on the major areas of policy and direction on dementia for the next three years, and will form the basis of Scotland's next three-year National Dementia Strategy which will be published later this year, in 2016.

 

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