What needs to be done and why?
Strategic Issue 1
What needs to be done
Acknowledge the higher prevalence of Dementia in Hartlepool. Invest in community awareness and screening programmes and collaborate with primary care to improve early diagnosis and risk factor management. Use data-driven strategy to determine geographical locations in the Borough requiring intervention and population groups.
Why
As there is a higher prevalence in the Borough in comparison to the region and England, the council should be aware and prepare for current and future need, through increasing diagnostic capacity and providing tailored community support. By collaborating with primary care to improve early diagnosis and risk factor management this will diminish the burden.
Strategic Issue 2
What needs to be done
Increase annual review rates to ensure appropriate management of symptoms and care plans and provide support to carers. Use data-driven strategy to highlight GP surgeries with low annual review rates to provide support.
Why
Increasing the number of annual reviews for those with Dementia ensures they are receiving appropriately managed care, this will reduce the number of missed opportunities to manage systems, prevent crisis and provide support to carers. This will overall reduce the number of hospital admissions that could have been prevented, lessening pressure on hospital services.
Strategic Issue 3
What needs to be done
Provide community intervention on modifiable risk factors such as physical inactivity, smoking cessation, alcohol-use and social isolation through community hubs and data-driven location strategy. Support GP surgeries with the management of modifiable risk in co-morbid conditions such as diabetes and hypertension through health literacy and education and annual reviews.
Why
Reducing modifiable risk factors early in residents’ life will reduce the prevalence of dementia in future years and will help to reduce the burden of dementia on current patients.
Strategic Issue 4
What needs to be done
Provide support to care homes on Dementia by upskilling staff, providing guidance and training and ensuring quality end of life care and advance care planning for residents.
Why
The majority of people dying with Dementia in Hartlepool die within care homes, therefore there is a need to support care homes.