Report of the Director of Public Health and Executive Director of Adult Social Services

This report details the progress made in the last six months around key developments of the Dementia Action Plan, with specific focus on the early commission of the Manchester Dementia Alliance, led by Alzheimer’s Society, with Manchester Carers Forum and Together Dementia Support.

The Committee considered the report of the Director of Public Health and Executive Director of Adult Social Services that described the progress made in the last six months around key developments of the Dementia Action Plan, with specific focus on the early commission of the Manchester Dementia Alliance, led by Alzheimer’s Society, with Manchester Carers Forum and Together Dementia Support. Noting that at the Health Scrutiny Committee meeting of 8 March 2023, the first progress report on the developments across the Dementia pathway had been presented. (See minute ref. HSC/23/19 Dementia Developments in Manchester).

Key points and themes in the report included:

·         The development of the Manchester Dementia Alliance and early work and achievements to date;

·         An update on Delirium work in Manchester, noting that as part of the Greater Manchester Dementia United work, delirium had been a particular focus and Manchester University NHS Foundation Trust (MFT) had been at the forefront of this work, led by Dr Scott Mather, Consultant Geriatrician;

·         An update on the forward plan on the next 6 months priorities, aligned to the Dementia Action Plan; and

·         Reference to a new Extra Care Scheme in the development pipeline specifically focused on Dementia Care with our partners, Irwell Valley Homes.

Some of the key points that arose from the Committee’s discussions were:

·         Were the number of patient admissions in Manchester with delirium comparable with other regions;

·         Was delirium only experienced by older citizens;

·         Were some groups of residents more susceptible to experiencing delirium; and

·         Supporting the next step to have this comprehensive approach to delirium in all settings and supporting the discussions with Manchester Local Care Organisation and clinical leads at the GM Integrated Care Board about rolling it out to care homes.

Dr Scott Mather, Consultant Geriatrician, Manchester University NHS Foundation Trust stated that the improved coding of patients had helped correctly diagnose incidents of delirium, adding that rates in Manchester were comparable with other regions. He advised that delirium could affect all ages, however, it was more prevalent in older citizens as they became more vulnerable to this condition. He stated that this was also exacerbated by infections, constipation and/or dehydration. He also commented that a change in settings could also contribute to incidents of delirium. He also stated that some patient cohorts, including those for whom English was not their first language or had an existing condition such as Korsakoff syndrome were also more susceptible to experiencing delirium, adding that this demonstrated the importance of correct early diagnosis and care. 

Hazel Savage, The Alzheimer's Society, informed the Committee that the Dementia Changemakers had held another meeting since the report had been published. She advised that they planned to meet again in January 2024 and the focus of that meeting would be Home Care. She stated that the Professionals Workshop had met in October. The aim of that workshop was to collate feedback of current Dementia services within Manchester, from the professionals’ point of view; to map out current service offers; and to see if the service offers aligned with the views/needs of service users. She commented that this had been a very positive and empowering experience. She stated that the feedback from this event would be collected and evaluated. Jeff Seneviratne, Dementia United, commented that this had been important as it represented the first steps to developing a holistic model of dementia care that reflected upon the recommendations of the All-Party Parliamentary Group on Dementia.

The Director of Public Health stated that Manchester benefited from an established clinical network who were committed to the issue of dementia, and this foundation would strengthen and inform the local strategy. He further paid tribute to the Manchester Dementia Steering Group, adding that it was an example of genuine partnership working. He further commented that diagnosis rates of dementia were higher than the national average. The Assistant Director Commissioning MLCO added that a person-centred, strength-based approach was taken to assess an individual’s needs and this would be reviewed by social workers to ensure that they were receiving the correct care in the correct setting.

The Executive Member for Healthy Manchester and Adult Social Care stated that he had welcomed the frank and open discussions he regularly had with Dementia Together Support. He commented that he had reservations about national policy in relation to dementia and he would continue to lobby on this issue. He reassured the Committee that discussions were ongoing locally with the Greater Manchester Integrated Care Partnership with the view to replicating the good practice witnessed in Manchester across Greater Manchester.

The Chair commented that the Committee would be considering a report on End of Life Care at the February 2024 meeting and themes that had been discussed in the report and at the meeting today would be included in that report.

The Chair further requested that when the Manchester Dementia Alliance Newsletter was available this should be circulated to all Councillors.

The Committee expressed their gratitude to all guests for attending the meeting and contributing to the meeting.

Decision

To note the report.