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Wiltshire Dementia Strategy 2023 to 2028

How we will deliver the priorities

This strategy sets out the vision and outcomes that people with dementia, and their carers, have told us are important to them. We know we have a way to go to make this vision a reality in Wiltshire. Whilst awareness, identification and support for people with dementia has improved in recent years, we must be ambitious and work together to achieve excellence.

We will co-produce a detailed action plan of how we will achieve the aims in this document, by when, and who will be responsible and involved. 

The following are our high-level plans to improve outcomes.

Raise awareness of dementia across the county  

  • we will raise awareness about what dementia is, how to identify the signs and symptoms, and where to go for help
  • we will launch an education campaign about the steps people can take to reduce the risk of getting dementia
  • we will ensure that all campaigns are in different formats & languages to ensure accessibility
  • we will make sure that information about pathways and services is clear, accessible and understood by public and professionals

Develop a corporate approach to making Wiltshire a dementia-friendly county

  • we will ensure that the information we produce is accessible
  • we will develop an adult social care commissioning strategy with clear service and training expectations
  • we will look to include dementia as part of PHSE within schools and other education settings
  • we will deliver our Climate Strategy to reduce air pollution as a risk factor for dementia

Effectively screen for and identify dementia at an early stage

  • we will take a proactive approach in promoting screening for all people with an increased risk of dementia
  • we will promote NHS annual health checks
  • the memory service will work proactively with GP practices with lower diagnosis rates and ensure quality of pre and post-diagnostic support is consistent
  • we will use the latest digital and technological approaches to support the detection of dementia within the Wiltshire population
  • screening will be tailored to meet the needs of specific groups or communities - for example, people whose first language is not English, Gypsy, Roma, Traveller and Boater (GRTB) communities (working with Julian House), rural and farming communities, people with learning disability and/or adults at higher risk of early onset dementia

Ensure that the journey for anybody being assessed and diagnosed is consistent

  • we will make it easier for people to informally think and talk about dementia. We will ensure all people concerned about their memory, or concerned for others, are able to access the highest quality information and guidance from assured sources and in a range of formats
  • we will support people whilst they are waiting for a diagnosis, with Living Well teams within primary care taking the lead. Diagnosis should not be a "gateway" to receiving support
  • we will work with GPs to develop pathways in primary care
  • we will develop quality standards across primary care and the memory service
  • we will ensure everybody who is diagnosed with dementia can access the regular support of a dementia adviser
  • increase awareness and use of the "This is Me" document to ensure people's backgrounds, preferences and needs are met 

Reduce waiting times and increase diagnosis rates

  • we will invest in diagnostic pathways, reflecting the increased prevalence over the coming years
  • we will achieve the waiting times standards for dementia assessment and diagnosis 
  • by 2028, two thirds of people with dementia in Wiltshire will be formally diagnosed (as per the national target)
  • we will ensure that assessment appointments include discussion of hearing, alcohol consumption, eyesight and falls
  • we will ensure that diagnostic tools take account of people's literacy, so that people with reading and/or writing challenges are not misdiagnosed
  • we will ensure that adults with learning disabilities, who are at increased risk of developing dementia at an earlier age, can access appropriate diagnostic pathways

Ensure that everybody who is diagnosed with dementia can access NICE-recommended treatments

  • this includes the provision of support and breaks for carers, and non-pharmacological support for people with dementia, such as cognitive stimulation therapy (CST) and reminiscence groups
  • following diagnosis, regardless of whether they were diagnosed by their GP or through the memory service, every person diagnosed with dementia should be able to access a dementia adviser
  • we will ensure that all areas of Wiltshire will receive an equitable dementia adviser offer
  • we will develop pathways for people who are diagnosed with dementia earlier in life, recognising that the challenges facing people with a diagnosis in their 40s, 50s and 60s are very different to those in their 80s or 90s
  • we will publish our Technology Enabled Care Strategy, which will emphasise proactive and preventative use of technology to support independence, prolong the time a person can stay living at home, prevent the need for long-term care

Review our emergency and out-of-hours support for people with dementia

  • we will work with the Police, Ambulance service, health and social care teams and the community sector to ensure the right support is there for anybody in crisis
  • we will explore the offer of intensive support for people with dementia (as is currently in place for people with functional mental health conditions), in order to reduce admissions and placements
  • we will advise people who to call when there is an emergency
  • we will review the offer for people with rarer dementias or more specialist needs, such as Korsakoff syndrome, and crisis beds for people detained under the Mental Health Act  

"THINK Delirium"

  • delirium sometimes goes unrecognised and yet - unlike dementia - it can be treated and reversed
  • we will use the THINK Delirium approach to prevent, identify and treat delirium, especially in hospital and care homes
  • we will ensure training is in place to support professionals to identify and treat delirium

Ensure that information and support is easy to find and access

  • we will build on the online Wiltshire Dementia Roadmap and ensure that everyone - professionals and public - know what resources are available 
  • we will ensure that materials are translated, interpreted and/or adapted to be accessible throughout the diversity of our residents. For example, information must be accessible for adults with learning disabilities
  • we will engage with communities in Wiltshire (for example, LGBTQ+, refugee and migrant groups, boater and traveller communities) to understand the different perceptions of dementia and/or services, and respond to these sensitively
  • through the Wiltshire Dementia Strategy Group, we will ensure good communication between partners

Invest in our communities and markets

  • by investing in prevention and early intervention, we can improve long-term outcomes and make better use of our limited resources
  • we will publish market position statements, which will set out clearly the types of provision we will commission to meet different levels of need, as well as the levels of training, skills and experience we would expect staff to have
  • we will publish a clear commissioning framework which sets out its expectations of home care, extra care housing, residential and nursing care and other providers, and delivers clarity around the training and skills that care professionals need to have
  • we will review our accommodation provision for older people, including extra care and care homes
  • we will support individuals and groups to develop micro-enterprises - small, bespoke services which meet local needs in a personalised way
  • we will support communities to be dementia friendly.  We will also work with our local community groups, elected Members, Town and Parish Councils, local Area Boards, sheltered housing schemes etc to ensure positive messaging about dementia is embedded in our communities
  • we work with the voluntary and community sector to create a public presence offering advice and guidance, as well as the provision of information via stands in public places, supermarkets, community events
  • we will re-commission our community services to ensure consistent coverage across Wiltshire

Develop a training strategy for carers and professionals

  • as part of our Carers Strategy, we will develop a range of regularly delivered training opportunities for unpaid carers, including communication, understanding distressed behaviour, future planning and legal issues
  • we will audit training needs for home care, care home, hospital and other professionals and design comprehensive training opportunities
  • we will develop a training strategy which clearly sets out what levels of skills and training we require staff at different levels to access
  • specifically, we will ensure that dementia advisers receive high-quality, regularly updated training and supervision

Give people with dementia and their carers opportunities to plan for the future

  • the NHS and Council will promote advance care planning and Power of Attorney, recognising that people often need time to make these decisions
  • we will roll out the ReSPECT system of coding to identify people at the end of life in primary care  
  • we will ensure care home staff are trained in end of life care and increase the use of RESTORE2 to enable care home staff to identify and escalate earlier signs of deterioration to avoid unnecessary and often unwanted hospital admission
  • we will ensure all staff working with people with dementia receive high-quality end of life care training
  • primary care will be supported to embed the Gold Standards Framework (GSF) and the NHS Integrated Care Board (ICB) will audit and meet training needs around end of life care
  • care homes will be supported to access training and support - for example, via the care home liaison service, Admiral Nurse resource and Tulip Standard training focusing on person-centred palliative care
  • through the Wiltshire Carers Strategy, we will support family carers, including people who are going through a bereavement and adapting to the end of a caring role

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