(Time to read: 4 minutes)

According to figures from NHS England, around 850,000 people live with dementia in the UK – a figure that’s expected to rise to over a million by 2025.

This is clearly piling pressure on already hard-pressed GP services, yet it’s an area that simply can’t be ignored, especially given the fact that CQC inspections focus on how key population groups are cared for. One such group is people experiencing poor mental health, including people with dementia.

The good news for practices is that small changes can make big differences. In its report, Dementia services: Findings from the Healthwatch network, it was made clear that practices can dramatically improve service delivery in relatively straightforward ways. Healthwatch followed up its report by working with Exeter Dementia Action Alliance to show GP practices the changes that can make a big difference to patients’ experiences of visiting the doctor. They include:

1. Improve the environment

People living with dementia can find it difficult to read everyday signs and may require additional help to find their way around. Having dementia friendly signs, which include symbols and pictures, can be easier for people to understand.

2. Longer appointments

People with dementia can struggle to remember to attend appointments. Having an easy-to-use appointments system and sending reminders to patients or their carers can help to reduce missed appointments. Communication and understanding is often an issue for people living with dementia. It can sometimes be difficult for patients to recall past discussions regarding their care, so offering double appointments can give people extra time to express themselves.

3. Increase dementia awareness for all staff

Some staff at GP practices are unable to spot when patients have dementia. Regular awareness training for staff could help them understand what information and support people need to manage their condition. Dementia Friends, an initiative run by the Alzheimer’s Society, offers training and resources to support organisations.

4. Better community engagement

By listening to people from every part of the community, services can understand what patients with dementia and their carers need.

The benefits to practices

While the above might sound like just another list of additional jobs in an already overloaded work schedule, it’s worth considering the fact that improving care to dementia patients could actually boost your practice.

For example, the Alzheimer’s Society points out that people with dementia can struggle with remembering to attend appointments. This can result in missed appointments and, therefore, repeat appointments – something every practice could do without.

Dementia friendly general practice has benefits including:

• Improving quality of care and support for people with dementia
• Improving quality of care and support for other patient cohorts
• Supporting national frameworks and standards for dementia including the NHS England Well Pathway and the CCG Improvement and Assessment Framework
• Supporting key lines of enquiry of the Care Quality Commission
• Reducing missed appointments and repeat appointments
• Increasing dementia awareness and understanding for all practice staff, as well as contributing to personal development and job satisfaction

Quick wins

Practices can make a number of quick wins. These could involve setting up extra appointment reminders for dementia sufferers, utilising patient ‘champions’ to enhance care, providing written summaries of appointments and required care and increasing appointment time. After all, ten minutes isn’t long when discussing often complex care plans (and ensuring patients and their carers are clear about what’s required.

Another important point to bear in mind is the practice environment. A few simple steps can be taken to ensure the environment is dementia friendly, including:

• Good lighting, a welcoming face at reception and a sense of calm
• Use of bright colours for the staff uniforms – pink and red have been successful
• Consider making the surgery a safe haven for people who are found wandering in the area
• Uncluttered floor space and plain carpets
• Clear signage – Alzheimer’s Society has a handy library of free dementia friendly signage, which is available here.

It could be worth your patient participation group doing a walk around of the practice in order to obtain multiple views and ideas.

Recognising great care – a case study

One practice that has been recognised for its excellent dementia care is John Hampden Surgery, Great Missenden, Buckinghamshire, which received an outstanding CQC rating as a result.

The practice has become dementia friendly through a number of initiatives, starting with the early identification of patients, the ongoing support needed to help them access good quality care, improve their quality of life and prolong independent living.

The practice has a named dementia support nurse ensuring a personalised care plan for all dementia patients, all staff had additional training in recognising and supporting people with dementia, double appointments for dementia patients were routine and the practice environment was dementia friendly with appropriate signage and a ‘quiet space’.

The vulnerable patient and dementia support nurse visits dementia patients at home and supports their carers by producing advanced care plans and ‘This is Me’ documents (a practical tool that people with dementia can use to tell staff about their needs, preferences, likes, dislikes and interests).

Dementia is something all practices need to be aware of given it’s a problem that is only going to grow. However, simple measures can be taken to improve delivery of care, which is a win-win for practices and patients alike.

How do you deal with dementia patients? What changes have you made to your practice? What ese do you think you could do? Let us know by commenting below or take it to the Practice Index forum here. 

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