iSpace News – Autumn 2016

I iSPACE News

Autumn 2016

For further information on how to become a Dementia Friendly surgery, or

if as a carer you would like your practice to be involved, please contact:

Katherine Barbour: katherine.barbour@wessexahsn.net 07990 002106

Joanna Bazalgette: joanna.bazalgette@btinternet.com 07729 256941

iSPACE is a programme of change, initially developed by Dr Nicola Decker at Oakley

and Overton Partnership in North Hampshire. It is a number of actions designed to

enhance the patient experience through improvements in care planning,

communications and awareness of dementia for staff in primary care settings.

Wessex AHSN has funded a project to spread the iSPACE initiative and make GP

surgeries Dementia Friendly. This was piloted in Hampshire, implemented on the Isle

of Wight and evaluated by the Wessex AHSN Centre for Implementation Science at

the University of Southampton.

This project has shown good outcomes for patients and is now being implemented in

GP practices across Hampshire, Dorset and South Wiltshire.

iSpace News – Autumn 2016

iSPACE: Steps to Dementia Friendly

iSPACE comprises a number of changes to surgery practices, such as staff dementia

training, review of the care plan to make it relevant to dementia, collation of local

resources and creation of a localised leaflet, changes to the surgery environment such as

clear signage to toilets and exits, and information on display about dementia. All these

steps help to break down the stigma that still surrounds dementia and encourage patients

to come forward to seek an early diagnosis.

Carer comment

“It is a godsend that I can come down with Roger, as he won’t remember everything that

was said.”

Comments from staff

“There are a lot of quick wins that make a real difference to staff and patients.”

“We found we were already doing a lot of it – it was about bringing it all together to help

raise awareness.”

• Implement iSPACE plan

• Sign up for Dementia Action Alliance

• Start Dementia patients spreadsheet

Identify Dementia Champion

• Clinical meetings and training sessions

• Review Dementia QOF template

• Encourage staff

• Continuity of care

Staff

• Identify carers

• Support carers with information

• Include carers in appointments, treatment, referrals

• Encourage carers

Partnership

• Formal assessment

• Early support after diagnosis

• Audit all codes to ensure appropriate Dementia coding

Assessment

• 'This is me'

• Encourage patient

• Awareness of natural stages of Dementia

• Identification of patients who are progressing

Care Plans

• Lighting

• Colouring

• Signage

• Wayfinding

Environment

iSpace News – Autumn 2016

Summary The comparison of general practices in Wessex one year before starting the iSPACE implementation and then during the iSPACE process generated very impressive and positive results. Data was provided by 35 surgeries which agreed to collect information before, during and after project implementation.

The Wilson Practice in Alton became

Dementia Friendly in March 2016 and this has

been followed up by other local practices.

Chawton Park Surgery and Watercress

Medical’s Mansfield Park Surgery in Medstead

are both on track to join The Wilson Practice

soon. Their enthusiasm is infectious! If your

surgery has the iSPACE bug, please contact us to

support you through the process.

Dementia Friendly surgeries: Wessex roundup

iSpace News – Autumn 2016

Poundbury Doctors Surgery, Dorchester, became Dementia Friendly in December 2015 Jane Goodson, practice manager at Poundbury Doctors Surgery, said, “Eight months later, I’d just like to say how useful the staff felt that their dementia training was. They have certainly put it to use with regard to helping patients on a day to day basis and looking out for ‘signs’ without drawing attention to the situation. Staff are also about to receive training in telephone scamming awareness where the elderly/vulnerable are being targeted.”

Penny’s Hill Practice in Ferndown, Dorset, celebrated their accreditation as

a dementia friendly surgery in August 2016 with morning tea and cakes with patients and carers, together with representatives from Ferndown's dementia friendly community. The surgery has been very committed to achieving the recognised status, working with Dorset’s iSPACE team, Joanna Bazalgette and Sue Sparkes.

They are supported by a very involved Patient Participation Group who also came along to enjoy the tea and cakes and admire the symbolic forget-me-knots, handmade by Dr Emma Richards, one of the GPs very much involved with the accreditation.

Hill Lane Surgery, Southampton Practice manager, Paula Smith, says of iSPACE, “It has revolutionised the annual review. We used to just do blood pressure, weight and it felt like a tick box exercise. Now we have This Is Me’, we take details of the carer and give information about local services. Doing iSPACE has tightened up our system and improved our care.” The doctors at Hill Lane are ready to use This is Me if a patient with dementia has a consultation – this photo was not staged!

iSpace News – Autumn 2016

Dementia Friendly stories: Canford Heath Practice

by James Leyland, Practice Manager

We had been hoping for some time to make

ourselves a Dementia Friendly surgery and so

when we heard about the ‘iSPACE’ tool we

were intrigued as to how we could

implement this in practice.

Becoming Dementia Friendly felt like a

daunting task before Joanna visited us, but

after she started talking us through what we

needed to do it all seemed so straightforward

and completely obvious! We wondered why

we hadn’t done it years ago.

Joanna kindly came along to our Protected Learning session and gave her dementia talk to

the whole staff, including the GPs. It was informative, funny, endearing, engaging and

simply marvellous! By the end of the talk everyone said how wonderful it was and it further

enhanced our determination to become Dementia Friendly.

We are currently in the process of looking at our signage, putting differently coloured loo

seats in place and having pictures of our GPs up on the wall to direct patients to where

their consulting rooms are.

We’re putting up a dementia notice board and from the information Joanna provided we

will soon have a new central point for everyone to look towards for dementia information.

After Joanna’s talk one of the receptionists was inspired to become our dementia

champion and we are in the process of supporting him through the process. It will be his

responsibility to ensure that everything we do is Dementia Friendly.

We are taking small steps, but thanks to Joanna and the iSPACE tool we feel far more

empowered to help our dementia patients get the very best from our practice.”

iSpace News – Autumn 2016

Before and after

Signage on the toilet doors at The Quarter Jack Surgery, Wimborne

Smart refurbished toilets at West Moors Group Practice

iSpace News – Autumn 2016

A Carer’s Perspective: Veronica in North Dorset Q. How long have you been

registered with your GP?

A. I have been registered for 38yrs

and Christopher 23yrs. I was widowed

before I married Christopher.

Q. How long is it since diagnosis?

A. 8 years.

Q. Can you tell us about your

experience of Christopher’s diagnosis?

A. Christopher was having funny turns

and we spent two years previous to

diagnosis going to specialists, we had

private insurance then. Finally he was

sent to Southampton Hospital for three

days and was finally diagnosed after many

scans and checks by Mr McMonagle. He is

now under Dr Kipps. They have always

been wonderful and we look forward to

our annual visit. Christopher narrowly

missed being included in a research

programme that he would have been on

for a year but the criteria were too tight.

Q. What was your GP’s response to the

diagnosis?

A. We went to our then GP a few months

after diagnosis about another matter. He

said nothing at all relating to the diagnosis

of a terminal, degenerating, incurable

disease that Christopher has. Christopher

was very upset at the time. I checked a

few years later that his diagnosis was on

the screen and the GP was prescribing

Aricept. No advice or information was

given.

Q. Do you feel you were dealt with

sympathetically?

A. Yes, at the hospital we were, but not

at the GP practice.

Q. What would have improved the way

you were given your diagnosis?

A. We should have had a meeting with

our GP or a memory advisor to be given

info and help. This was 8 years ago; I’m

sure things have changed.

Q. Were you given any information

about local services?

A. We were given no info about anything

until I rang the Alzheimer’s Society who

told me about the memory café in

Shaftesbury. There I met the Mental

Health Team that helped to run it with

the Alzheimer’s Society. So we then came

under them and they came every few

months to monitor the pills. When this

was all changed we fell between stools

and only discovered a memory advisor

recently having asked the Alzheimer’s

Society why there weren’t any!

When in dire straits I ring Liz who works

for the CMHT. And of course Elizabeth

Bartlett’s group (The Laverstock Memory

Support Group) is a fount of information

and support, but we waited two years for

there to be room for us, having seen

Elizabeth speak at a conference.

iSpace News – Autumn 2016

Q. How easy is it to see the same

GP/nurse for each appointment?

A. You ask to see a doctor that you

choose or who you can get an

appointment with. We found recently

that our registration had been moved to a

doctor we had never met and when we

went to see her, which she had

requested, she looked at her watch and

had not read her screen at all and forgot

to take Christopher’s blood pressure. She

had no idea of our circumstances.

Q. Do you feel that there is adequate

communication between health care

providers?

A. That’s difficult to answer as we see

so few. Southampton always sends a

report to our surgery. I have now checked

that I have Carer on my screen which I

didn’t have previously. When I said to a

doctor I was in a bit of a hurry as I was a

carer she asked if I was looking after my

grandchildren!

Q. Has there ever been a specific

situation which you feel could have been

handled better?

A. After we came under the mental

health team we were sent to a

psychologist. As we walked in, he said to

Christopher, “And what is wrong with

you?” We wrote a letter of complaint and

never saw him again.

Q. Do you feel that the community you

live in could be considered Dementia

Friendly?

A. No, I don’t think so, although anybody

we know - like the bank staff,

optometrist, garage, chemist, postman -

those that know are extremely helpful.

Q. Has your own GP practice been

accredited by iSPACE as a Dementia

Friendly Surgery?

A. No. I’m sure some of their difficulties

are that they have just become a lot

bigger joining with another surgery. Also

a lot of the doctors are part time. There is

also no Dementia doctor, which

considering the extent of the disease is

surprising.

A friend who attends Elizabeth’s group,

who is with the same practice, has the

same problems as us.”

Veronica adds, “When my first husband

had cancer we had our own doctor and

clinicians, who were friends, and they

popped in here to see us.

I know it was a long time ago. But that is

why we are on the Appeal Board for the

Alzheimer’s Society as we need to raise a

lot of money for care and research, and

importantly for post diagnostic support.”

Our sincere thanks to Veronica and

Christopher for sharing their experiences

with us.

iSpace News – Autumn 2016

Wessex clinical update

iSPACE – 27 surgeries have completed the

process to become Dementia Friendly

and 101 are in progress. The project will

continue for a further two years and aims

to reach 75% of all surgeries in Wessex –

there are 312 in total. Data about

diagnosis rates, care plans and

identification of carers is being collected

and people with dementia and their

carers are doing walkabouts in surgeries.

http://wessexahsn.org.uk/programmes/3

/dementia

Acute care development programme –

this has resulted in seven hospitals

adopting John’s Campaign. Three

dementia champion conferences were

held in Winchester, Bournemouth and

Salisbury and frontline staff benefited

from these events. Action cards were

completed and these are being reviewed

to assess impact.

Bournemouth University has conducted

an evaluation of the programme. You can

read the report on the Wessex AHSN

website at

http://wessexahsn.org.uk/programmes/3

/dementia.

Watch our film about John’s Campaign

http://wessexahsn.org.uk/videos/show?t

ag=Dementia

National news

In March 2016 the Implementation Plan for the Prime Minister’s Challenge on Dementia 2020 was published. Complementing the NHS Five Year Forward View, this plan sets out the crucial enablers which need to be implemented in the next two years in order to meet the 2020 Dementia Challenge. Areas of focus include risk reduction, health and care, post diagnosis support, awareness and social action and research. The full implementation document can be found on the Department of Health website at this address: www.gov.uk/government/publications/challenge-on-dementia-2020-implementation-plan

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