York Health and Wellbeing Board

Health and Wellbeing Board

17 November 2021

Report of the Adult Mental Health Commissioner, NHS Vale of York Commissioning Group

Development of a Dementia Strategy: Progress report

Summary

1. This report presents the Health and Wellbeing Board with an update on the development of a dementia strategy for York. It highlights a delay in completion of the strategy to allow time for further engagement with people living with dementia and their families. A revised high-level timeline for completion by March 2022 is available at Annex A.

2. The report describes the ongoing work and commitment by partners that action is needed before the ink is dry on the strategy to bring about positive changes and improvements in dementia care and support.  

3. The Board are asked to note the report and indicate their ongoing support for the direction of travel and revised timescale for completion of the York Dementia Strategy.

Background

4. A multi-agency group responsible for the delivery of the strategy was established in February 2021 with representation from City of York Council, Dementia Forward, York Minds and Voices, Vale of York CCG, TEWV, York CVS, The Alzheimer Society and York Hospital. Task and Finish groups have been established and actions are underway. These are outlined in Annex B.

5. The group is recently Chaired by Julie Hastings, Lay Member for Patient and Public Involvement, Chair of the Primary Care Commissioning Committee and of the Quality and Patient Experience Committee, Vale of York Clinical Commissioning Group.

6. The strategy is based on the findings of the former York Dementia Action Alliance and on the experiences and insights of York Minds and Voices and their strategy for dementia. The York Dementia Collaborative has a key role in ensuring the voices of people with dementia are heard and to exchange information, knowledge, and experience so that they actively influence service development and provision. Both the Mental Health Partnership and Ageing Well Partnership are sighted on the strategy development and progress reports have been presented on a regular basis throughout the year.

Main/Key Issues to be Considered:

More time needed to listen

7. The sense of frustration at the delay in developing the strategy is acknowledged, however it is suggested that more time is needed to listen to people with dementia and draw on their experiences, so they are reflected in the strategy and the ongoing work with partners across all sectors to ensure that people can live well with dementia in York. Nevertheless, despite this delay there has been and continues to be significant service development within this area including dementia care coordinators and a specialist dementia nurse in primary care.

8. The COVID-19 pandemic has had a significant impact on people with dementia and their families and carers. Social isolation, and loss of connections to families has resulted in worsening symptoms for some people. The pandemic has also had an impact on dementia diagnosis rates as some people chose to delay their memory assessment. This has accelerated the need for a coherent strategy which addresses the current and future needs of people with dementia and their families.

Engagement carried out so far

9. Healthwatch York secured funding from the Joseph Rowntree Foundation to undertake engagement aimed at understanding people's experiences of dementia and to use these findings to inform the dementia strategy. As part of this work, Healthwatch developed two surveys; one for people with dementia and one for carers. The timescales for the launch of the survey slipped by two weeks and it was ultimately launched on 24 June with a closing date of 7 September. The online survey is now closed however a link to the Healthwatch website which explains the reasons for the engagement is available in the background papers.  

10. To reach as many people as possible and support people to have their say, Healthwatch worked with a wide range of local organisations including York Minds and Voices, Dementia Forward, Older Citizens Advocacy York, the Alzheimer’s Society, and local Social Prescribing Link Workers to help complete the survey with the people they support. The survey was available online and paper copies were also distributed. Opportunities for face-to-face engagement however continued to be limited due to social distancing. In September, given there were few responses, the survey remained open online, and reminders were issued with an offer of postal packs for off-line contacts. In total over 700 surveys were distributed electronically, by post and through provider services. The following is a summary of survey responses received:

· 83 responses in total

· 67 from carers

· 4 from people with dementia

· 6 from carers with the person they support.

· 1 carer emailed their experience.

· 5 responses from Beetle Bank Farm

11. The limited number of returns indicates the challenges of a predominantly online approach for people with dementia. With face-to-face activities and dementia cafes now resumed, there are opportunities for genuine engagement, and it is proposed that this takes place over the next two months.  

Planned Consultation

12. At the time of writing, arrangements are being made to meet with people at local dementia cafes throughout the city. This is outlined in the high-level timeline at Annex A. Opportunities to hear from people with dementia are also being made with the Dementia Care Coordinators located within primary care. A case study illustrating an example of their work is available at Annex C and demonstrates the power of listening and hearing an individual's story and experiences.

Strategy drafting event

13. A strategy drafting event took place on 7 July, attended by eight members of the multi-agency group. A series of 'We Will' statements were developed and are available at Annex D. Work is ongoing to collate information from key partners and evidence to support the aims and objectives of the strategy.

        Recommendations

14. The Health and Wellbeing Board are asked to:

I. Note the report

II. Indicate their ongoing support for the direction of travel and revised timescale for completion of the York Dementia Strategy

Reason: To give the Health and Wellbeing Board oversight of the work of relation to the development of the dementia strategy.

Contact Details

Author: Sheila Fletcher	Chief Officer Responsible for the report:
Commissioner, Adult Mental Health NHS Vale of York Clinical Commissioning Group Sheila.fletcher1@nhs.net	Denise Nightingale Director of Transformation (Mental Health and Complex Care) NHS Vale of York Clinical Commissioning Group d.nightingale@nhs.net
	Report Approved	√	Date	4/11/2021
Specialist Implications Officer(s) None
Wards Affected:					All	√
For further information please contact the author of the report

Background Papers:

Web link to Healthwatch survey

https://www.healthwatchyork.co.uk/our-work/how-is-support-after-a-dementia-diagnosis-experienced-by-people-who-have-dementia-and-carers-in-york/

Annexes:

Annex A: High-level activity timeline

Annex B: Summary of ongoing work in Task and Finish Groups

Annex C: Dementia Coordinator case study

Annex D: " We Will" statements