National Dementia Pathway themes

"PREVENTING WELL

(Risk of people developing dementia is minimised)"

DIAGNOSING WELL (Timely accurate diagnosis, care plan and review within first year)

"SUPPORTING WELL

(Access to safe high-quality health and social care for people with dementia and carers)"

"LIVING WELL

(People with dementia can live normally in safe and accepting communities)"

 

DYING WELL (People with dementia die with dignity in the place of their choosing)

TRAINING WELL

Minds & Voices

strategy

Before diagnosis promoting awareness, challenging myths, a call for transparency

At the time of diagnosis - positive language and hope through research

Post diagnosis - services to fit us rather than us having to fit services

The future - ongoing support that is not time-limited'

 

 

 

DAA priorities and identified gaps

Prevention: Public Health promotion

 

Improve early identification and accurate diagnosis

 

Establish a post diagnostic pathway of support

 

Carer’s support

Have a positive campaign about living with dementia

 

 

 

Series of statements here for services to populate– see BMS as an example below

 

WE WILL

We will

 

Work to improve awareness and understanding of the factors that increase the risk of dementia and how people can reduce their risk by living a healthier life

 

Work with professionals to increase the uptake of annual NHS Health Check for people over the age of 65 and for earlier age groups there is education around risk factors and self-help

 

"what’s good for your heart is good for your head" campaign.

 

Work with professionals to increase

increase the uptake of health checks for people with learning disabilities.

 

 

Understand local Public Health data to target interventions aimed at risk factors e.g., obesity, alcohol, deafness

 

Increase opportunities to address social isolation and loneliness through social prescribing etc

 

 

 

We will:

 

Work towards a target of

everyone receiving a formal diagnosis in a timely manner (BMS)

 

Provide a personalised approach to assessment and diagnosis with shared decision making

 

Ensure that diagnoses are delivered in a way that recognises the impact on the person and their carer, their needs and that full follow up support is offered tailored to individual diagnosis/needs

 

Work to ensure that the

diagnosis process is clear and transparent (information beforehand) to people and involves no more professionals or appointments than necessary (BMS)

 

Work together to explore alternative diagnostic pathways, for example using other professionals and tools such as DIADEM

 

'Work together to address bottlenecks in the current pathway

 

Develop clear, accessible information to ensure people receive timely, appropriate support

 

Ensure a 'safe travel' from the point of diagnosis and throughout

 

Ensure that people affected by dementia design and participate in post-diagnostic support

 

'Provide proactive, personalised support with a named coordinator

 

We will

 

Ensure people with dementia are in the driving seat of shaping and developing services, learning and research in York

 

Promote participation in research with and alongside people with dementia rather than ON people with dementia

 

Improve access to support and develop peer support options delivered by people living with dementia

 

Offer more choice and control by expanding personal health budgets for people assessed as being eligible for care

 

Build on 'discharge to assess' and Home First approaches to prevent unnecessary long stays in hospital which could lead to worse outcomes and increase someone's long-term needs

 

Monitor and share the progress of new technology and the ways it could support people living with dementia and their carers

 

Provide seamless holistic support that is easily accessible with no thresholds or time-limit 

Refine data on people with dementia to inform planning and commissioning of high-quality services

Ensure that people with dementia have a single digital health and care record that is accessible to all professionals involved in their care. This must include advance care planning

 

 

 

We will

 

Develop family support (wider than just carers) and develop more support for working age adults to support them in employment'

 

Work with employers to emphasise the importance of supporting and valuing carers of people living with dementia in employment

 

Ensure people with dementia are not discriminated against because of their diagnosis

 

Establish a network of peer groups of people with dementia across the area

 

Start the dementia conversation and maintain an open dialogue with people living with dementia and their supporters throughout the life of this strategy and beyond'

 

Challenge the disabling language, attitudes and environment that impede the lives of people living with dementia

 

Develop dementia

awareness and intergenerational projects in schools

We will

 

Develop training and awareness around the importance of advance care planning and end of life care  

 

Improve and promote information advice and guidance to enable people to make early and informed decisions around mental capacity,  planning for the future and end of life care

 

Work to challenge the social and professional stigma and nervousness around death and dying

 

 

 

 

We will

 

Provide a learning and development framework that meets the learning needs of health and care professionals regardless of role, position, or experience

 

Review the training and development offer to independent sector care staff

and work with providers to assess training and development needs

 

Ensure that people with dementia are involved in leading and developing all dementia learning and development across the York area.

 

We will provide opportunities for everyone with dementia to answer questions about the impact of their diagnosis amongst peers.

 

Principles

Hearing patient voice, co-design, and person-centred approaches to improvement

 

 

Our we will statement include both people with dementia and carers….