Agenda item

(To receive a report from Carolyn Nice (Assistant Director Adult Frailty and Long Tern Conditions) and Gina Thompson (Commissioning Manager), on the Lincolnshire Joint Strategy for Dementia 2018-21. This is a refresh of the existing Joint Strategy for Dementia 2014-17 and has been developed and co-produced with strategic partners, people who live with dementia, their families and carers to provide a strategic framework around Dementia for the next three years)

It was reported that the Joint Strategy for Dementia 2018-2021 was a refresh of the existing Joint Strategy for Dementia Care 2014 – 2017 and had been developed and co-produced with the Council's strategic partners including CCG's, people who lived with Dementia, their families and carers to provide a strategic framework around Dementia for the next three years.

The Board was informed that the Strategy refresh set out the Council's vision and details the achievements since the implementation of the Lincolnshire Joint Strategy for Dementia 2014-2017.  It was noted that an event was being planned for early in the new year to launch the refreshed Strategy.  It was intended that this would be an interactive event for professionals, people living with Dementia, their families and carers.

It was also reported that this Strategy aligned with the Health and Wellbeing Board's priorities in relation to Dementia, and would be part of the action plan and would be governed by the Dementia Officer Group which it was hoped to reform into a sub-group of the Health and Wellbeing Board.

Officers advised that if the Strategy was signed off by the Board, it would then go to the Adults and Community Wellbeing Scrutiny Committee.  It would then be developed into a final draft and a summary version in plain English would also be produced.

The Board was provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         The importance of health checks for people with learning disabilities was highlighted as a factor in the prevention of vascular dementia.

·         It was commented that if performance was to be progress towards government targets there would be a need for a more radical approach to how signs of dementia would be picked up.

·         It was suggested whether when anyone approached social care services for support, a dementia check could be built in.  It was noted that the adult frailty strategy was due for renewal in April 2019.

·         It was commented that early diagnosis of dementia would not resolve it, however, it could be an opportunity to encourage people to move home before the condition worsened and when it did, it was often not possible to adapt quick enough in that situation.

·         The biggest issue to deal with in terms of dementia was the rurality of Lincolnshire, as those people who lived more rurally would have fewer opportunities to attend specialist groups without significant amounts of travel.

·         Having back up for carers could be a key part of this.

·         It was highlighted that not everyone would go to social services for help, some people were more likely to go their doctors for help.

·         It was queried what the mechanism for district councils to feed into this would be, and it was confirmed that it was through this Health and Wellbeing Board, through neighbourhood teams and directly to the Assistant Director Adult Frailty and Long Term Conditions.  It was highlighted that a district council representative on the dementia sub-group would be welcomed.

·         It was noted that there was a need for respite care for carers, particularly as many carers were elderly and dealing with situations that were not within their experience.  It was noted that there was a Carers Strategy in place, and the Council worked with Carers First.  The Board was advised that there were a lot of programmes in place, but there was a need to join them up.

·         It was commented that this was a really good strategy, and incorporated a lot of what had been spoken about during this meeting.  the priorities within the Strategy were around raising awareness and prevention.  Dementia was not inevitable, and research suggested that around 35% of dementia cases could be preventable.  Stimulation of cognitive function, reducing blood pressure and increasing physical activity were all thought to have a positive impact.  It was commented that being under the Health and Wellbeing Board was the right place for all the different aspects to be brought together.

·         It was queried whether there was anything specific to alcohol consumption, and it was noted that this would be included under blood pressure management. 

·         In terms of cognitive function stimulation it was commented that attending adult education course may help, but the opportunity for evening classes seemed to have diminished.

·         It was queried whether there was a need for more clinical pathways as there was variation across the country.  It was suggested that a countywide pathway was needed as sometimes the diagnosis was not quick enough.

·         In terms of blood pressure, it was highlighted that the number of people in Lincolnshire diagnosed with high blood pressure was higher than the national average.  However, it was noted that Lincolnshire tended to 'import' an unhealthy population from elsewhere in the East Midlands, due to the desirability of the county as the retirement destination. 

·         It was noted that a high diagnosis rate was not necessarily a bad thing.  The Director of Public Health advised that the real risk was the proportion of the population with undiagnosed with high blood pressure, as it was a risk factor across a whole range of conditions.

·         It was queried whether there was any connection between dementia and the amount of water that someone drank.  The Board was advised that there was a need to ensure that people with dementia stayed hydrated in order to prevent hospital admissions.  It was noted that this was something that could have a quick impact on avoidable admissions.

RESOLVED

1.    That the Health and Wellbeing Board approve the draft Joint Strategy for Dementia as shown in Appendix A of the report.

2.    That a summary document for the Strategy be developed.

3.    That the Health and Wellbeing Board note that the Strategy will also be presented to the Adult Care and Community Wellbeing Scrutiny Committee.