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High Impact Change Area H: Facilitating ongoing, longer-term care needs – case studies
These case studies relate to High Impact Change Area H of the High Impact Change Model: Improving the timely and effective discharge of people with dementia and delirium into the community.
H1. Derbyshire Community Health Services – Dementia Palliative Care Service Toolkit
The Derbyshire dementia palliative care team have worked with NHSE to develop a to develop a Dementia Palliative Care Service Toolkit that provides a ‘gold standard model’ illustrating improved palliative and end-of-life care, including principles, values and practices, for people living and dying with dementia.
Implementation
The toolkit is based on practical experience, collating the knowledge and resources of the statutory and voluntary sectors, as well as incorporating national guidance. The aim was to create a dementia palliative care model, which is based on the Derbyshire Dementia Palliative Care Team, which would subsequently be adaptable and be shared across systems nationally. This would in turn address inequities in provision of services. Additionally, the toolkit can facilitate an Integrated Care System to create their own bespoke dementia palliative care provision.
The Dementia Palliative Care Service was launched in April 2020 and has expanded to support an average referral rate of 100 per month, and a service caseload of 350+ based on staffing levels in Feb 2023. The analysis conducted demonstrates a positive impact across the system, including reduction in health care usage and costs.
The analysis included investigating the effect on 111 calls, A&E attendances, non-elective inpatient spells and outpatient appointments for patients who had their first contact with the Dementia Palliative Care Team.
Outcomes
- In conclusion, overall, there was a reduction in healthcare usage levels after the first contact with the Dementia Palliative Care Team, compared to pre-first contact or intervention.
- Overall, there was a reduction in healthcare usage levels of 32 per cent.
- 111, A&E and non-elective inpatient spells experienced a significant reduction between 36 per cent and 43 per cent.
- There was a substantial cost reduction (43.4 per cent) following input and intervention from the dementia palliative care team, however the cost reduction is predicted to be significantly higher.
Contact
Gemma del Toro, Clinical Service Manager, Dementia Palliative Care Team, Derbyshire Community Health Services,
Email: [email protected]