Annex B - Developing a dementia strategy for York

1.   Introduction

The development of a dementia strategy is a priority of the York Health and Wellbeing Board. A key theme of the York mental health strategy is to ensure that York is both a mental health and dementia friendly city including a priority to develop a joint strategy for improving dementia diagnosis and support services. Both the Health and Wellbeing Board’s Mental Health Partnership and their Ageing Well Partnership are sighted on this work with the Ageing Well Partnership taking the lead.


2.   Purpose of a strategy

It is suggested that the purpose and scope of the dementia strategy is to provide a strategic quality framework within which local services can deliver quality improvements to dementia services and address health inequalities, as well as a guide to services for those affected by dementia and their families.


3.   What has happened to date?

Ø  Reports to Ageing Well Partnership in February and April 2021

Ø  Proposed timescale for a strategy to be developed by September 2021 and concerns about any further delay have been acknowledged

Ø  Multi agency group established to drive essential work still to be done between health and social care, the voluntary and independent sectors and people with dementia and their carers

Ø  Commitment that action is needed before the ink is dry on the strategy to bring about change in dementia care and support

Ø  Draft priorities agreed

Ø  Delivery plan developed

Ø  Task and Finish Groups established and actions underway

Ø  Plans for engagement and consultation from 1 May 2021








4.   Draft priorities

York Dementia Action Allicance Priorities

Identified Gaps

Ø  Establish a post -diagnostic pathway of support

Ø  Improve early identification and accurate diagnosis

Ø  Have a positive campaign about living with dementia

Ø  Better collaboration between services

Ø  Development of carer support

Ø  Prevention

Ø  Young/early onset dementia – is a priority implicit throughout all themes of the strategy

Ø  Care should not be seen as the ‘end game’ and a key priority is for people with dementia to be supported to live well at home and for care in local communities

Ø  Residential care

Ø  Domiciliary care

Ø  Better collaboration is implicit throughout and an outcome of the strategy


5.   Proposed Priorities


Priority Area

Ø  Preventing Well: Risk of dementia is minimised

Ø  Diagnosing Well: Timely, accurate diagnosis, care plan and review within first year

Ø  Supporting Well: Safe high-quality health and social care for people with dementia and carers

Ø  Living Well: To live normally in safe and accepting communities

Ø  Dying Well: To die with dignity in the place of your choosing

Ø  Training Well: Staff training in dementia/personalised care

Ø  Prevention: Public Health promotion

Ø  Improve early identification and accurate diagnosis

Ø  Establish a post diagnostic pathway of support

Ø  Have a positive campaign about living with dementia

Ø  Carer’s support




6.   Some key information about dementia

Ø  There are thought to be 3013 people with dementia in York

Ø  Of these only 1519 have received a formal diagnosis; a rate of 50.5% (NHS Digital February 2021)

Ø  Of the 3013 people it is estimated that two thirds will be living in the community, whilst a third will be living in care


7.   Why is being diagnosed important?

Ø  Because patients and their carers want it

Ø  It gives choice and a say in future care

Ø  The cost of dementia in the UK is rising and people without a formal diagnosis are more likely to present in crisis

Ø  If there is no formal diagnosis health and social care staff will not be aware that a person has dementia, and it will not appear in their care plans


8.   Ongoing work in Task and finish groups

Ø  Referrals from primary care to Dementia Forward pre-referral and at point of referral to provide wrap-around support through diagnostic journey

Ø  Specialist dementia nurse commissioned to work with primary care and identify and support people at high risk

Ø  Dementia coordinators commissioned to support case finding, early identification and support in primary care

Ø  Identifying and addressing bottlenecks in referral to diagnosis pathway

Ø  Piloting a multi-disciplinary team approach for diagnosis and treatment in primary care where appropriate, with consultant support

Ø  Engagement and promotion planned for Dementia Action Week 17 May


9.   Next Steps

Ø  Stakeholder and public engagement on the draft priorities from May 2021

Ø  Planned discussions with CYC communication and engagement team on drafting of strategy


10.                High level draft timetable




Engagement on priority areas

February 2020

January 2021

February 2021

Priorities determined as basis for action planning and wider consultation

Development of draft strategy template developed using best practice

Jan 2021

Strategy draft template developed

Meeting with  Dementia Collaborative to consult on template and shaping of the strategy

17 February 2021

Strategy template agreed

First meeting of multi-agency strategy group

25 February 2021

Strategy template agreed

Priorities agreed

Terms of Reference, including Chair

Stakeholder and public engagement

From 1 May 2021


Analysis from engagement sessions

August 2021


Equality Impact Assessment

August 2021


Final strategy drafted and approvals

September 2021


Strategy Implementation Group and work streams established

September 2021


Evaluation of Strategy implementation, and further review dates

April  2022