Agenda item

To provide an outline of the Council’s approach to Living Well with Dementia, including partnership work.

Paul Allen, Head of Integrated Commissioning (Integrated Care & Frailty) for the Council and ICB, introduced the report on this item which summarised issues around dementia, including the process of how a dementia diagnosis was made. This often started with the GP, but it was also important to engage with communities and residents on this as people didn’t necessarily always recognise when they have cognitive impairment. The report also highlighted the importance of listening to patients and residents and a number of areas for improvement that could be made around this. Post-diagnostic support was another area where improvement efforts would be made to develop a network of support so that people didn’t feel isolated after their diagnosis.

Paul Allen also highlighted some specialist areas including the multi-agency care co-ordination team to support people with frailty, including dementia, and enhanced support in care homes as around 70% of care home residents had some form of dementia.

Paul Allen then responded to questions from the Panel:

• Asked by Cllr Brennan why a greater proportion of BAME people suffered from dementia compared to white groups as stated in the report, Paul Allen explained that there was a genetic component which impacted on the likelihood of acquiring particular conditions. There was also less likelihood of people from some under-served communities coming forward for diagnosis and so a Dementia Co-ordinator had been funded to work with communities to raise awareness around cognitive impairment. A bid had also been put in for a Dementia Facilitator which was a different role working with GPs on diagnosis rates. Cllr Connor proposed that a further update should be received by the Panel at a later date on the progress with these roles. (ACTION) Cllr Brennan asked whether more details could be provided on the genetic component and it was agreed that a link to a relevant medical research study could be circulated. (ACTION)
• Cllr Peacock spoke about her experience of working with people with dementia suggested that swimming sessions could be made available for them as she had seen how beneficial this could be. Paul Allen acknowledged that, while dementia was progressive, it was possible for people to have a good quality of life for many years if they were diagnosed early and had access to the right treatment. This treatment was not just about medication but also about physical and mental activity and so there had been investment in community assets to support this. This included activities such as walking programmes, but he was open to other suggestions in this area. Helena Kania asked whether this offer on activities had been connected to social prescribing so that people were aware that these were available. Paul Allen said that the team were preparing an Aging Well training and awareness pack, an element of which was on dementia. An aim was to encourage the more than 170 social prescribers and community navigators in this space to come forward and learn more about dementia. This could involve some of them becoming dementia friends or experts/champions to develop a network of people who could mutually support each other.
• Cllr Abela referred to the drop in the diagnostic rate during the pandemic that was described in the report and asked about the consequences of this and the current status of the backlog. Paul Allen acknowledged that the consequences were still being felt, both in terms of workforce issues and of people feeling isolated. His general sense was that people were coming forward later than we would want them to, meaning that interventions were not always as effective. This position was still being recovered from, which was why there was a strong emphasis on supporting individuals over the next few months.
• Referring to the underdiagnosis issues, Cllr Iyngkaran asked how many residents in the borough would be expected to be diagnosed. Paul Allen responded that the estimated figure was 2,200, as mentioned in the report, and it was thought that around two-thirds of those had been diagnosed, not all of whom would necessarily have been diagnosed at an early stage. Camden borough had diagnosed around 80% of its residents with dementia and so this was a benchmark to aim for. The key investments to improve this included the Dementia Co-ordinator, the work with GPs on diagnosis levels and the work with communities to improve understanding of cognitive impairment.
• Cllr Iyngkaran highlighted that dementia did not just affect people over the age of 65 as there were a small proportion of people with dementia who were younger. Paul Allen concurred with this point and mentioned that one of the members of their Dementia Reference Group was a carer for somebody with early onset dementia. While this was a small group, there were conversations and strategies around supporting these people, not least because they would have potentially a long time yet to live.
• Cllr Peacock commented that the Haynes Centre in Hornsey provided an excellent service but felt that a similar service was needed in the east of the Borough as the former Grange centre in White Hart Lane had closed some years ago. Paul Allen referred to a slide with the list of current dementia services across the Borough which included new premises for the Grace Organisation but agreed that there should not be an overreliance on one side of the Borough. Beverley Tarka added that the Grange has been closed as part of the Council’s response to the austerity measures that had been put in place. She acknowledged that it was important to have resources in different sections of the Borough which is why the Cypriot Centre in the Central area and the Grace Centre in the East area were highlighted on the slide. Cllr Peacock said that there was a religious element to the Grace Centre which may not be suitable for all residents. Asked by Cllr Connor whether a dementia centre for excellence would be established in the east and whether this would be linked with the Grace Centre site, Beverley Tarka clarified that this would all be part of a single service within the former Irish Centre site and that the refurbishment of the building was being designed to dementia standards. Conversations were ongoing with the Grace Organisation in terms of the service delivery. She was not aware of the religious element described by Cllr Peacock but would be happy to report back on this point. Cllr Peacock also commented that the former Irish Centre previously provided a luncheon club which was attended by a wide cohort of people, including some with dementia and their carers, and would welcome something similar being reinstated. Cllr Connor requested that an update be provided on the expected offer from the Grace Organisation at the Irish Centre. (ACTION)
• Vicky Murphy noted that there had been a request to provide information on the number of people accessing dementia services. However, there was some complexity around this as there were a full range of services that people could access, including through direct payments, and not just day services.
• Cllr Connor referred to paragraph 2.13 of the report which set out key priorities highlighted by patients and carers, noting that these priorities would be implemented and co-produced through the Aging Well Board, and asked when a progress update on this was likely to be available. Paul Allen explained that the dementia pathway illustrated at the end of the report had been co-produced. The team would engage with as many people as possible but the key group in that space was typically the dementia reference group which had been quite vibrant recently in term of attracting people. The focus was currently on delivery and so an update may be possible in approximately six months. (ACTION)

RESOLVED – That further information be obtained on the evidence of dementia risk and ethnicity and on the expected offer from the Grace Organisation.

RESOLVED – That a future update on dementia issues be added to the work programme.