Agenda item

A report will be presented by Claire Taylor, WCC Commissioner (Maintaining and Promoting Independence).

A report was presented by Claire Taylor, the commissioner responsible for maintaining and promoting independence. This included a PowerPoint presentation which covered the following areas:

• Coventry and Warwickshire’s Living Well with Dementia Strategy, a joint, system-wide strategy across Coventry and Warwickshire (with a place-based focus in action plans). An outline of the work undertaken in drafting the new strategy.
• The vision and six key priority areas of: preventing well (reducing risk), diagnosing well, supporting well, living well, dying well and training well. The strategy had a ‘plan on a page’ approach for each of the six priority areas.
• A focus on key objectives; reviewing progress and additional objectives where required.
• A focus on what still needed to be achieved and how it would be measured.
• Reflection on progress to date.
• The equality impact assessment, to be reviewed throughout the lifetime of the strategy.
• Ensuring effective alignment with other strategies. 
• Current engagement with stakeholders over six weeks. Details provided of the mechanisms being employed and next steps to review and collate feedback, leading to the revised strategy being submitted for approvals and publication early in 2022.

It was reported that Coventry and Warwickshire’s Living Well with Dementia Strategy had been refreshed. A period of engagement commenced in early September 2021 and the strategy for the period 2022-2027 would be reviewed thereafter and published in early 2022. The report set out the close working with colleagues through the Health and Care Partnership Dementia Board. The draft strategy had been presented at various boards and approved by the County Council’s Portfolio Holder for Adult Social Care and Health. There were benefits of having a joint strategy for Coventry and Warwickshire, both for commissioning and service providers.

The strategy would be a system document across health and social care in Coventry and Warwickshire with a system partnership approach, fully supported by NHS colleagues and delivered in partnership with the voluntary and community sector. The report detailed the approach to producing the draft strategy, the wide engagement including stakeholders and how this strategy aligned to other local strategies, which focussed on carer wellbeing. Following the engagement, feedback would be collated, published and provided to stakeholders with the findings incorporated in the draft strategy where appropriate. The strategy would be presented to various boards and bodies including the Health and Wellbeing Board and the county council’s Cabinet for approval and would then be published on the Council’s website. 

The following points and observations were made:

• A question on the age profile of those with dementia as it seemed that more young people now had dementia. Key information would be provided in the strategy. An offer was made to provide up to date information regarding early onset dementia for the committee.
• Points about end-of-life care and ‘dying well’. There was praise for the services provided by the Admiral nurses. An area where the strategy could be strengthened concerned the end-of-life period and the dialogue with relatives. Some family members only became involved at the end-of-life but might not concur with an individual’s wishes by seeking to extend that person’s life. There were plans to re-establish multi-agency groups for each of the priority areas to develop and deliver the associated actions. 
• A point about enhancing and strengthening the dementia friend and dementia communities work, for example with the retail sector. It was agreed that these were powerful, positive initiatives which had been impacted by the pandemic. There had been a previous training session for this committee which could be repeated.
• A reflection on the challenges for those with dementia. In the early stages, some people might be in denial or resistant to receiving support. Whilst dementia could not be prevented, there were ways people could reduce the likelihood of developing dementia or help themselves during the early stages of cognitive impairment. This mirrored the ways people could protect their physical health through reducing alcohol intake, not smoking, having a good diet and taking exercise. Further points about cognitive stimulation, making people more aware how they could reduce the risk of dementia and the availability of NHS health checks for people over 40 years of age. Dementia messaging had been embedded within other Public Health and Strategic Commissioning work strands.
• Some people chose not to access support but doing this at an early stage was key. There were a range of opportunities to help people and their families through early diagnosis and to avoid them presenting when in crisis. A need to remove the perceived stigma associated with dementia. An example was dementia cafés and some people travelled away from their immediate area to use one, because of not wanting people to know they had dementia.

·       A reflection on the greater awareness of dementia now. It was questioned if the number of dementia cases was increasing. Further points about the dementia friend initiatives in Kineton paused due to Covid and the dementia café in Tysoe. Councillor Mills felt inspired to relaunch these initiatives due to this item. Claire Taylor offered to assist with this and confirmed the likelihood of increasing dementia cases in Warwickshire as it had an aging population.

• Reference to the service to provide a link person.  It was suggested that this should include monthly contact with the person’s carer. An example was given of the support provided to a friend during times of crisis with her husband’s dementia, and the lasting impact for the person providing the care, even after their husband moved into a nursing home. An outline was provided of how the link person scheme now worked through ‘keep in touch’ calls. It was common that carers wouldn’t ask for help. Also raised were day services. The key aspect was ensuring a referral to these services at the time of diagnosis.
• Further praise for the Admiral nurses. There seemed some confusion about current service provision. Councillor Bell confirmed that they were attached to acute health trusts and provided services at the point of diagnosis. However, it was viewed they should be available in the communities and provide further services at later stages too. Claire Taylor understood there were some community-based services but was a need for consistency across Warwickshire. This would be investigated, and an update provided to members.
• A point on the additional challenges for dementia patients who were admitted to hospital. There were well established links with the George Eliot Hospital via the dementia strategy board.
• The Chair spoke of the need to keep people with dementia safe from both physical and financial harm. From personal experience she was aware of this occurring and would discuss this with officers after the meeting.

Resolved

1.     That the Committee responds to the draft Living Well with Dementia strategy as set out above.

2.     That the Committee notes the engagement plans for the strategy.