Agenda item

7.1

The Committee received a report on the Sheffield Dementia Strategy and Commissioning Plan, which outlined the approach to dementia care across the City, including Continuing Healthcare funding criteria and the role of bed-based facilities in the Strategy.  The report also attached, at Appendix ‘A’, a copy of the Plan, together with the 2013/14 Work Plan and the NICE Guidance ‘Support for Commissioning Dementia Care’.

7.2

In attendance for this item were Sarah Burt, Senior Commissioning Manager, NHS Sheffield Clinical Commissioning Group (CCG), Eamon Harrigan, Head of Clinical Services, Sheffield Clinical Commissioning Group (CCG), and Steve Jakeman, Commissioning Officer, Communities.

7.3

Sarah Burt reported that good progress had been made in terms of the key objectives of the Sheffield Dementia Strategy and Commissioning Plan, building on the long history of the collaborative approach to the commissioning of dementia services in the City.  Health and Social Care Commissioners in the City were continuing to work hard in order to ensure that people with dementia and their carers were able to live well with the condition, and since the National Dementia Strategy was published in 2009, Sheffield had made significant progress in all key objectives.  In terms of benchmarking against key outcome indicators, Sheffield was presently ranked second in England and Wales for its diagnosis rate.  Ms Burt stated that she had recently met with Alistair Burns, National Clinical Director for Dementia, to discuss dementia commissioning in the City, and he had indicated that Sheffield was progressing well in terms of its dementia strategy and plans.

7.4

Members of the Committee raised questions and the following responses were provided:-

·                     Particular efforts were being made, as detailed under the heading ‘Early Diagnosis and Intervention’ in the 2013/14 Work Plan, appended to the report, with regard to making people aware of the signs of dementia at an early stage so they can access health services and receive the care and support they need.  The CCG was working with Public Health in terms of raising public awareness of early signs of dementia and the Alzheimer’s Society had also undertaken considerable work on this issue.  In addition to the work already undertaken, a national campaign in terms of raising awareness of dementia was planned for early 2014. 

·                     In terms of public involvement, there had been a number of involvement exercises and consultations with people with dementia, their carers and the public on dementia and dementia services. Since the Local Dementia Alliance had been created, the structure of the City’s Dementia Board was being reviewed to ensure service user views were integral to the planning process.

·                     The CCG was considering whether to change its arrangements for procuring nursing home care for people with challenging behaviour. The CCG purchased most nursing home care using the NHS national contract and a defined specification. Nursing home care for people with dementia and challenging behaviour was usually provided by two local homes, who were also contracted to the CCG. However, a small number of patients with challenging behaviour had nursing home care spot-purchased and the CCG was considering how to introduce specifications for their services so that quality could be better assured.

·                     The eligibility criteria for continuing healthcare is set out in the National Framework for Continuing Healthcare, published by the Department of Health. Eligibility was determined by assessing the individual’s needs and whether they had a ‘primary health need’.  This assessment was carried out by looking at all of their care needs and relating them to four key indicators – nature, complexity, intensity and unpredictability.

·                     Trends in terms of people suffering from dementia were taken into consideration as part of the long-term planning process.  There was a need to ensure that the system was sustainable in the light of the predicted longer life-expectancy and projected increase in population.

·                     Care planning was currently being tested in primary care, and for people with dementia, and should focus on living well, promoting independence, understanding the disease and managing other co-morbidities.

·                     Advanced care planning was on the agenda, and whilst there was significant work to do, there had been some good progress made.

·                     The issues regarding personalised care and how this would be included in the Commissioning Plan, would be discussed at a future meeting.

·                     The question of whether there were any plans to increase the number of carer breaks should be directed to the relevant Council officer.

·                     In response to what people with dementia have told the CCG, and through a planned joint commissioning project in 2014/15, all dementia sufferers would receive the offer of an annual review.

7.5

RESOLVED: That the Committee:-

(a)       notes the contents of the report now submitted, together with the comments now made and the responses to the questions raised; and

(b)       (i) thanks Sarah Burt, Eamon Harrigan and Steve Jakeman for attending the meeting and responding to the questions raised and (ii) requests (A) the Director of Business, Planning and Partnerships, Sheffield Clinical Commissioning Group, to submit a report to a future meeting of the Committee, containing details of the progress made in terms of the Sheffield Dementia Strategy and Commissioning Plan, with an emphasis on the Action Plan, financial details and work undertaken in terms of public engagement, together with details of an explanation as to how the service was integrated, and (B) the Executive Director, Communities, to attend the same meeting to explain how the Council and Health were responding to the requirement for integrated service provision.