Agenda item

11:45

Contact Officers: Varsha Raja, Assistant Head of Service – Strategic Commissioning, tel (01865) 323618; Suzanne Jones, Service Development Manager – Older People, Oxfordshire PCT, tel (01865) 334613.

The Committee will have the opportunity to conduct a question and answer session in relation to the current position and issues regarding Dementia, with a view to identifying any issues for a ‘select committee’ investigation at its February meeting.

A briefing paper is attached at AS6.

Colour copies of the map have been given limited circulation and placed on public deposit.

Ms Varsha Raja (Assistant Head of Adult Services) will attend to present the paper and to answer the Committee’s questions, together with the Director for Social & Community Services and the Cabinet Member for Adult Services.

Ms Suzanne Jones (Service Development Manager - Older People - Oxfordshire PCT) and Mr Duncan Saunders (Service Manager - Oxfordshire and Berkshire - The Alzheimer’s Society) will also attend for this item.

The Committee is invited to receive the update and to conduct a question and answer session on the current position and issues, with a view to conducting a select committee investigation at its February meeting.

The Committee was provided with the opportunity to conduct a question and answer session in relation to the current position and issues regarding Dementia, with a view to identifying any issues for a ‘select committee’ investigation at a future meeting.

A briefing paper was attached to the agenda (AS6).

Ms Varsha Raja (Assistant Head of Adult Services), together with the Director for Social & Community Services, Mr Paul Purnell (Head of Adult Services), the Cabinet Member for Adult Services, Ms Suzanne Jones (Service Development Manager - Older People - Oxfordshire PCT) and Mr Duncan Saunders (Service Manager - Oxfordshire and Berkshire - The Alzheimer’s Society) attended for this item to answer any questions which the Committee may have wished to ask.

Ms Raja summarised some of the key information set out in the briefing paper to Committee as follows:

·        approximately 40% of the expected population of people with dementia in Oxfordshire had actually been diagnosed. This was in line with the national picture in terms of diagnosis of people with dementia, as nationally between 20 and 40% of people had received a diagnosis of dementia;

·        although there was some service provision in Oxfordshire, there was a lack of universal access across the county to these services and there were some gaps in service provision;

·        more detailed analysis was required to assess the quality of provision;

·        Adult Social Care had not been allocated any ring fenced funding to deliver the National Dementia Strategy, although an initial sum of £150,000 had been delivered from the pooled budget to deliver key priorities;

·        Oxfordshire was also one of the 22 demonstrator sites for dementia advisors and a total of £207,000 had been allocated by the Department of Health to deliver this project, which is a pilot information prescription for people with dementia and their carers. Other activities were also underway, as set out in the paper.

Mr Saunders then made the following points in response to a number of questions:

·        Dementia was an umbrella term for a variety of similar conditions with broadly similar symptoms - with Alzheimer’s disease being the most common condition - although all forms of dementia were degenerative and incurable;

·        ongoing research was underway regarding how best to prevent and slow down the onset of dementia and research evidence was showing increasing links between lifestyle and dementia. Some types of dementia were thought to be entirely due to alcohol abuse. The usual advice in terms of staying active and eating a healthy diet was relevant in terms of prevention. Staying mentally and socially active, for example by learning a musical instrument, was also thought to be beneficial;

·        people with Down’s Syndrome were at increased risk of developing dementia.

Ms Jones then stated that all of Oxfordshire PCT’s work in relation to dementia was undertaken jointly with Social & Community Services and that a county wide steering group was in place, with high level clinical leadership.

A further selection of the Committee’s questions is listed below, together with the officers’ responses:

·        Was Oxfordshire PCT also under financial pressure?

            Yes.

·        Was dementia still being under prioritised by the PCT?

No. Dementia now had the same priority as Strokes. Both were equally detrimental for people.

·                    Mental health services were being cut. Surely this was another reason to ensure that they were properly funded? What did Oxfordshire PCT do in terms of NHS Continuing Care for people with dementia? 

The PCT was supporting approximately one hundred people with mental health problems under NHS Continuing Care. This was not low in comparison with other PCTs. The government was benchmarking PCTs on a quarterly basis and Oxfordshire had come out as on par with other PCTs.

·        In terms of issues and gaps in provision what was ‘Just Checking and Wandering technology?’

This is technology that supports an extended period of assessment. If someone is diagnosed with dementia then technology is put into their home to enable an assessment to be made of which pathway they need. This is an extension of telecare and can be used to monitor lifestyle. It can be used to determine whether someone can manage in their own home if additional support is provided to them or if they need to move into a care home. For example it can monitor when a person goes to bed, if they are eating and if they are socialising. Consent is required before any monitoring can take place. This type of telecare is useful if there isn’t a carer in place.

·        Could more information about memory clinics please be provided and what action would be taken to evenly distribute provision against need?

The PCT’s role was to ensure that an accurate diagnosis of dementia is given. Not everyone has to go to a memory clinic to receive a diagnosis. However, their distribution does need to be aligned with projected demographic growth. They also need to be restructured and modernised. Dementia is progressive and therefore people’s needs change over time and a variety of provision needs to be available.

·        The briefing paper stated that there was no specialist dementia service in terms of home support and that service provision was task focused and not outcome focused. Please elaborate.

This was not a good situation. The focus needs to be on how quality of life and outcomes for people can be improved, and carers need to be attuned to the needs of people with dementia. This would require specialist services for people with dementia. A way forward needs to be devised within the next few months.

The Head of Social Care for Adults stated that both he and the Assistant Head of Adult Services welcomed Scrutiny’s assistance to help keep the profile of dementia high on their list of competing priorities, such as Transforming Adult Social Care, delayed transfers of care and financial management.

The Director for Social & Community Services stated that the Department of Health was undertaking benchmarking work in relation to Dementia. This would give Oxfordshire a good indication of how well it was doing against the benchmarks and how well it was improving outcomes for people.

Following the question and answer session, the Committee AGREED to monitor progress in relation to the delivery of the National Dementia Strategy in six month’s time, especially in relation to the current issues and gaps in provision.

Councillor Dr Peter Skolar undertook to bring the briefing paper to the attention of the Oxfordshire Joint Health Overview and Scrutiny Committee.