Meeting documents

To consider a report by the NHS Dorset Clinical Commissioning Group (attached).

The Committee considered an update on the Dementia Services Review containing co-produced model options and sought support for public consultation in June/July 2019.

An accompanying presentation to the report was provided by the Dementia Services Review Project Manager (CCG) who outlined the objectives, outcomes and services in scope that had been included in the report.  She explained the future stages in the process as follows:-

• review stages and view seeking - completed in March 2017
• model options development - completed in September 2018
• NHS Assurance - March 2019
• sense check meeting with NHS England
• Clinical Senate - March 2019
• Strategic Outline Case (synopsis contained in report)
• Consultation - June/July 2019
• Implementation as soon as possible following the public consultation

The preferred model, Option B had been outlined in the report and resulted in a cost variance of £669,000 and it was felt that this additional cost could be identified within mental health budgets.

A co-production approach had been taken in terms of the consultation with advice and guidance from key stakeholders on the materials and wording.  The consultation would be for a minimum period of 8 weeks.

The Chairman asked whether the 40 specialist beds at Alderney Hospital in Poole had increased to reflect the loss of beds in the other hospitals that had been closed.

The Project Manager advised that this was not the case as steps had been taken in East Dorset to introduce an intensive support service that had resulted in a decline in the need for hospital admissions.  The money from the closure of the Chalbury Unit had been used to develop a similar service in West Dorset that would see reduced hospital admissions in future so that 40 beds was likely to be too many in 2-3 years' time.

Members heard that beds were becoming more relevant to the needs of the individual (rather than bed category) and that current demand was being met. The day hospitals would support individuals and prevent the need for inpatient stays unless absolutely necessary.

Members asked about the analysis behind the 4 options and the rationale for discounting the most expensive option.  They were informed that this was not a CCG decision and that the other options had been discounted through a co-production process whereby stakeholders had considered the different options, recognising the budget limitations, staff resources and measuring against critical success factors. The strategic outline case would provide the analysis and the final decision would take into account the consultation outcome.

In response to further questions in relation to Dementia Friendly groups and Admiral Nurses, the Project Manager explained that such groups had been funded through the Alzheimer's Society, but due to budget cuts, could no longer be funded. Local communities were becoming increasingly involved, resulting in dementia friendly towns. It was hoped that the Dementia Co-ordinators would be able to help people to take advantage of this resource. 

Admiral nurses had been discounted in the long list of options as it was felt that nurses were costly to provide and would not add value to what was to be provided in Dorset.  In addition, the intensive support service supported individuals without families which was not covered by the Admiral nurses.

Resolved

1.       That the progress of the review be noted;

2.       That the proposed consultation plan be supported; and

3.       That a link to the consultation documents is sent to members of the Committee when available.

Reason for Decisions

The report provided the Committee with an opportunity to be updated and to contribute to the consultation plan for the Dementia Services Review.