LINk Workplan Discussion Session for 2012-13, 15 May 2012

Results of the roundtable discussions

Table 1

Dementia

• Memory Clinic, what is the package? What are the outcomes? What about carers?
• Non-recurring commitment to finances
• Training from last year’s underspend
• One-offs are no good to anyone
• Training the trainer
• Dementia awareness pack – Alzheimer café and memory service
• Living well with dementia – it’s a very scary time – you need ‘hand holding’
• De-mystifying dementia – what is the journey people go through? – following the care pathway through?
• 2200 current diagnoses
• Comparison with East Yorks – rural with coastline, pockets of deprivation
• Tied up with quality of life issues – E&V
• Torbay, similar demographic
• 27% increase predicted by 2020
• Earlier diagnosis / care pathways
• Post diagnosis quality for person with dementia and their family
• Dementia awareness pack
• No commitment to recurring funding for training
• Living well with dementia, links to quality of life
• 22 year illness

Hospital Discharge

• Night time
• Residential care
• Safeguarding and vulnerable people

Prison Healthcare – SG?

• CAB has prison advice service – difficult to get into prisons
• Who else works HMP IOW?
• Cranstone (CARAT)
• ICAS? Do they have anything? How are they treating MH prisoners?
• Maybe not worth spending a lot of time on?
• Seldom heard
• Find out from other providers
• Links to MH prisoners and their quality of service

CAMHS

• Anorexia
• What is there?
• No autism/aspergers service on the IW
• Children with MH problems rapidly become adults with MH problems
• Referral waiting times
• Fact finding – recent report
• Look at recent review of CAMHS – sarah cooke
• In quality account
• Reduction of statements being made - more invisibility
• Access/referral/short treatment blocks
• Youth trust? Intelligence

CAB

• Cancer and MH contracts
• People are frightened that making a complaint will affect their treatment or don’t’ have the energy for the process
• Complaints take a long time to be resolved both with GPs and hospital

GP Appointments

• Waiting a long time
• Self help, what does this mean?

Mental Health

• The lengths people will go to get seen
• Sharing good practice and shaping services are we prepared to spend money where it’s needed?

Public Health

• GPs tying up with public health campaigns

Table 2

Hospital Discharge

• Who is responsible? Pathways
• Whose responsibility is ‘discharge’?
• Care management/medical/procedure review
• How is this monitored?
• Discharge checklist

Prison Healthcare

• Waiting times for prisoners to access healthcare – how long for prescription?

Dementia Care

• Quality
• CQC very outcomes-focussed
• Training (quality) (accreditation)
• Alzheimer café
• Memory service

Oral Hygiene

• Public health – quality of service
• Education!
• Engagement

Comparison with a deprived area and affluent area

• Broad questionnaire

Table 3

Residential care

• Quality of life
• Care as a whole
• How have cutbacks affected this?
• Lots of negative, but lots trying to do good
• Funding not always correct, especially with elderly care
• Fears of some homes trying to categorise people as ‘difficult behaviour’ to get more money
• Funds currently allocated under headings, shouldn’t care homes decide instead?
• People can find it hard to get into a higher band as their care needs change
• Personal budgets
• No council funding so quality of care can be driven down unless family subsidises
• Bureaucratic structures being changed, but long way off ideal solution?
• Learning disabilities from supported living can’t always cope, safeguarding against financial abuse has risen. People can be seen as money machines by family and ‘friends’ people don’t know where to go for help
• People involved in an enter and view visit spoke about not being able to afford care and having to top up even for basic needs/supported housing
• Some have lost personal budgets but need people to go out with them as can’t go out alone
• Speak to section of people involved and see what they want then try to deliver this
• A view was expressed that some homes ‘like to see people medicated’

Mental Health – adults and children

• Priorities identified from questionnaires in current workplan
• Growing problem

GP Services

• Postcode lottery – shouldn’t be a different service
• Common standards
• Accessing GPs can be difficult
• 0844 numbers problematic for patients and surgeries at times
• Sometimes GPs complain about visiting ‘old people’s places’
• Introduce texts as a ways of cancelling appointments?
• 1 hour timeslot at St Mary’s for cancelling physio appointments
• Transport for hospital discharge is important topic/ Ambulances being used for this
• Communication problems

Secondary care for outpatients

• Consultants
• Secondary care service interface – get moved around lots so care not received quickly enough
• Prevention is key. Need somewhere to go if tricky to get hold of GP
• What facilities available for people who find it hard to question their GP?

Vulnerable people who don’t have a voice

• How they can access specialist healthcare/advocacy