Care in
Working Together for
Better Mental Health
29 February 2012
Gordon King
Scale of the challenge
• Nearly one in every hundred Londoners has dementia
• 64,600 people in London with dementia including over
1,500 with young onset
• Increase expected by nearly 16% across London to
75,000 by 2021. Wide borough variation
• Up to 65,000 people with substantial or critical care
needs in 10 years
• SUS data shows 93% of acute admissions for dementia
are unplanned
• Nearly 4000 people with a diagnosis admitted to acute
beds 3 times or more
• 41% of people with dementia are on GP dementia
How do Health and Social care systems respond
to increasing demand in the current climate?
• What new thinking or progress is being made across
• National Dementia Strategy (DH, 2009); Dementia Services
Guide (CSL/LHP, 2009); Dementia Commissioning Pack
(DH, 2011); London Dementia Needs Assessment (NHSL,
• NHS London clinically led project to improve dementia
care and prescribing (established March 2011).
Highlights include
• High impact taskforce to reduce antipsychotic training
• GP skills and awareness programme
• Early diagnosis
• Acute trust training
How do Health and Social care systems respond
to increasing demand in the current climate?
• Mental health liaison model for dementia project (NCL
cluster with LHP support)
• QIPP project to reduce dementia related acute trust
admissions & readmissions, shorten stays & reduce
variation through a MH liaison model
• Readiness to grasp problems of fragmented systems with
fractures & variation within commissioning, service
provision & improvement/redesign
• Model developed now part of cluster contract negotiations
for 2012/13
• LHP will produce report with lessons for London - significant
potential savings modelled for the health & social care
economy in the capital through “whole system”
How do Health and Social care systems respond
to increasing demand in the current climate?
• Joint Improvement Partnership / London Councils
• Social care and dementia
• How do we begin to robustly commission a new model for
residential care?
• Integrated pathways require integrated commissioning
• How do we get whole system approach to dementia in
London which has both health and social care drivers &
levers working together?
• London-wide opportunities
What can we do
next year for
maximum impact?
Small group work sessions
• Identify up to 3 pieces of work likely
to make the most significant impact
on the commissioning or provision
of dementia services in London
over the next year & rank them in
priority order (10-12 mins)
• Taking the top priority, what would
be the major challenges in
delivering this piece of work? (8-10
• What are the key levers in the
system, who needs to be involved
or engaged to ensure success &
how will that success be
measured? (8-10 mins)
• Feedback briefly to whole group (2
mins maximum each group)
Thank you

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