Successes of the Dementia HIT in 2017-18

Sue Wensley, Elizabeth Coulthard and Emma Moody, outgoing Directors of the Dementia Health Integration Team (HIT), reflect on the team’s work and successes in 2017-18.

Dementia care is a local and national priority and the Dementia HIT aims to achieve the best quality of life for people and families living with dementia.

The Bristol Dementia Wellbeing Service (BDWS) and the South Gloucestershire Dementia Advisors continue to play an important role in supporting people affected by dementia. The BDWS has partnered with the Forest of Avon Trust on woodland wellbeing activity sessions, Growing Support on horticultural therapies, Reminiscence Learning on music and memories sessions and Age UK on information and advice.

Some talking therapies are delivered by The Harbour, a charity that supports people with life-limiting conditions. They provide couples counselling, which can help make sense of changes in a relationship, find ways to adapt to the changes dementia can bring, and explore other ways of being with each other. Read the BDWS annual report (PDF).

Dementia-friendly swimming sessions funded by the Department of Health and Social Care are now available at eight pools across the city, with staff trained by St Monica’s Trust. Watch a video about the sessions.

The inpatient dementia care service at Laurel Ward, Callington Road Hospital, temporarily closed in June 2017.Since the closure, there has been less demand for people with dementia to be admitted to inpatient care. Some people with dementia, and their carers, can find being admitted to hospital distressing, so community-based care may be better for those people. But when hospital care is needed during the Laurel Ward closure, those patients are being cared for at other local hospitals.

NHS organisations have been working together since the Laurel Ward closure to make sure that we have the right services and support in place.

Together the group, which includes Avon and Wiltshire Mental Health Trust (AWP), Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group (BNSSG CCG) and Devon Partnership NHS Trust, have been working to understand the longer-term needs of our population with dementia and the best way to meet them.

The group have made good progress in this review of the dementia care pathway and the work will continue until later in 2018, with Laurel Ward remaining closed until it’s finished. During February, clinical experts, social care partners and healthcare commissioners joined discussions. There will be opportunities for service user and carer groups, charities and residential care providers, to contribute to the work.

The South Gloucestershire Steering Group on Dementia secured £24,000 to work in partnership with the South Gloucestershire Dementia Action Alliance, to promote dementia awareness and dementia-friendly communities. They developed a local guide for GP surgeries on how to become dementia friendly, which was well received by Practice Managers, and opened new memory cafes in September in Kingswood and Thornbury. Winsome Barrett-Muir, a community development worker funded by BNSSG CCG and South Gloucestershire Council, is following up with GP practices.

Dementia services in Bristol and South Gloucestershire have worked hard to ensure people receive a formal diagnosis. In March 2018, 7,213 people were diagnosed with dementia, against an estimated prevalence of 10,664.This is above the national target diagnosis rate of 66.7 per cent.

Research continues to be a major focus for the Dementia HIT. Professor Rik Cheston created the draft of a new online survey of public attitudes to dementia, to be launched later in 2018. This is a follow-up to our previous survey in 2013. It will provide a snapshot of attitudes in 2018 and how they’ve changed over the past five years. Rik and colleagues published a follow up paper to the attitudes to dementia survey in January, showing that increased contact with people with dementia leads to more person-centred attitudes, and reduces stigma. Another survey is assessing the range of dementia research happening in the area.

We have also produced a film on how to get involved in dementia research, aimed at local post-diagnosis groups. The HIT has also developed links with the Clinical Research Network and Join Dementia Research to get more people to take part in dementia research.

The UWE report funded by Bristol City Council, on experiences of people affected by dementia in Black, Asian and minority ethnic (BAME) communities (PDF), led to a Research Capability Funding award of £23,488.

A BME working group is following through on the report’s recommendations. The group was awarded an Alzheimer’s Society grant of £2,500 to run lunchtime training sessions for staff and interpreters at GP surgeries with high numbers of people from BME communities. This was led by Subitha Baghirathan from UWE.

We’ve set up a new clinic for mild cognitive impairment at the Bristol Brain Centre, enabling new research on this condition, which often progresses to dementia.

An interdisciplinary team at the University of Bristol led by Dr James Selwood has got the ContinUous behavioural Biomarkers Of cognitive Impairment (CUBOId) project underway, part of a major programme to test the feasibility of monitoring patients at home using sensing technology. In June, Dr Emma Anderson at the University of Bristol won a three-year MRC Skills Development Fellowship to study life course aetiology of dementia and cognitive decline.

Jude Hancock, Julie Clayton and Sharon Parsons ran public events including ‘Who provides what dementia services in Bristol and South Gloucestershire’ in May, and public lectures at the University of Bristol, including by Dr Elizabeth Coulthard in November and

Dr Catherine Pennington in December. Both also appeared on BBC Radio Bristol. Several audience members, including carers of people with dementia, volunteered to join a new dementia patient-public involvement panel.

The education workstream organised a public event on how to support someone living with dementia in September. They are now developing online information about dementia education and training for health and care professionals.

The Real Life with Dementia training course for carers in South Gloucestershire won the National Dementia Care Award 2017 for Best Dementia Training Initiative in November. We are now working to make the training widely available.

Alzheimer’s Society continues to manage patient reference groups to feed into BNSSG CCG’s work. Two carers, Ray Raine and Karen Sargent, have joined the Dementia HIT Executive Group, thanks to Lorna Robertson from Alzheimer’s Society.

The leadership of the Dementia HIT changed in March 2018, with Dr Hilary Archer, neurologist at North Bristol NHS Trust, and Dr Maria-Paloma Sequeiros, Old Age Psychiatrist at AWP, joining as new co-Directors.