Dementia expert calls for innovation to improve NHS dementia services

Speaking alongside Rt Hon Norman Lamb MP and Chief Executive of the Alzheimer’s Society Jeremy Hughes today, Dr Chris Fox will discuss how current innovations in dementia care have the potential to revolutionise service redesigns across the healthcare system.

Dr Fox said: “The NHS is under increasing severe funding constraints and the forecast reduction in resources is an enormous challenge. Better standards of care can and must be implemented across the NHS.

“NHS Service redesign can save money and improve quality but much depends on how care is co-ordinated and the way services are implemented in a local setting.”

Dr Fox will present initial data from the NIHR-funded five-year ‘PERFECTED’ programme (Peri-operative Enhanced Recovery hip FracturE Care of paTiEnts with Dementia), the first dementia-specific study to combine the most feasible and effective elements of best care with a formal system for putting them into practice.

“Despite one quarter of acute NHS hospital beds being occupied by people with dementia, there is little research on how best to look after these people in hospital. They are exceptionally vulnerable and at high risk of serious complications.”

“Our research is looking at people with dementia admitted with hip fractures, but it will have impact across the board. Inconsistent standards, poor physical and mental health management and overuse of sedatives have been highlighted in national reports. While these reports provide recommendations for improving care, for example preventing delirium in people who have broken hips – which is known to delay recovery – not enough is yet known about how modification in hospital care can prevent delirium in people with dementia.”

Speaking ahead of the event, Norman Lamb MP said: “In the coming decades our health and care system will face increasing pressure as a result of our ageing population and the increasing numbers of people who are living with complex long-term health conditions.

“It is essential that we transform our health and care system to join up care around the needs of individual patients, helping them maintain their quality of life and independence for as long as possible.

“In particular, dementia is going to be perhaps the greatest health challenge in the years ahead, with the numbers suffering from the disease expected to reach 1 million by 2025. Nationally, we are investing not just in research into treatments for the condition, with the aim of developing a cure or disease-altering therapy by 2025, but also into ways to improve care.

“It is incredibly important that organisations like the UEA continue to carry out pioneering research into improving dementia care, protecting patients’ quality of life and helping the NHS meet the challenges of the future.”

The PERFECTED programme will develop and pilot evidence based interventions to improve the hospital care of physical and mental health problems in people with dementia, leading to the creation of an Enhanced Recovery Pathway (ERP). The development of implementation principles will be central and include the consideration of patients, families and staff.

Dr Fox said: “We will create a set of guidelines for care and rehabilitation of people with dementia alongside training materials for staff. These may have massive benefits to people with dementia, their families and healthcare professionals – not only in the UK but around the world. We are creating a better system of care that can feature in any hospital in any country with our international collaborators.”

“This approach challenges the way care is currently delivered, creating a proactive rather than reactive approach and can be available to every patient, delivered by every nurse and by every clinical team. This could revolutionise care across the board.”

Invited guests at the “Innovative and integrated care for people with dementia in acute settings?” event include clinicians, service user representatives, managers and commissioners with expertise in dementia.

Head of Policy and Public Affairs at the Alzheimer’s Society, George McNamara, said: “Too often we hear of people with dementia who are struggling without support because of our fragmented care system. We know that people who aren’t supported are more likely to end up needing crisis care. Hip fractures are one of the most common reasons a person with dementia is admitted to hospital, and they often stay there much longer than those without dementia.

“Research into how we improve the lives of people with dementia today is a vital part of the fight against dementia and is more than just a stopgap until we find a cure. We’re really pleased to be a partner in this important piece of work in order to make a difference to the lives of the 850,000 people who’ll be living with dementia by next year.”

PERFECTED is funded by the National Institute for Health Research Programme Grants for Applied Research (NIHR PGfAR) Programme and aims to improve hospital care for patients with dementia who break their hip.

The study is hosted by the Norfolk and Norwich University Hospitals NHS Foundation Trust, where initial research is taking place. A further 10 hospitals will also be involved after three years. After the programme has ended, it is hoped that the guidelines will be rolled out under a four-year trial across the NHS.

University of East Anglia – Communications Office