26th March 2014 1

Overview on National Clinical Programmes focusing on:

Programme for Older People and HSE National Dementia

Education Programme

Progress to date

Carmel Hoey Project Officer NMPD & Mary Manning Interim Director NMPD

26th March 2014 2

Presentation Overview

• Clinical Strategy and Programmes Directorate

• National Clinical Programme for Older People- Model of Care- Acute Service Provision

• Work Streams

• National HSE Dementia Education Programme

26th March 2014 4

Director General HSE

Mr Tony O’Brien

Clinical Strategy &

Programmes

Directorate

(Dr Aine Carroll)

ONMSD

(Dr. Michael Shannon)

Quality

& Patient Safety

(Dr. Philip Crowley)

26th March 2014 5

HSE Directorate and Leadership Team

26th March 2014 6

Office of the Nursing & Midwifery Services Director (ONMSD) Structures

• The ONMSD was established in 2006 operates within the HSE Clinical Strategy and Programmes Directorate

• The Nursing & Midwifery Planning & Development Units (NMPDUs) established in 2001 provide professional and visible strategic professional leadership at regional level to nurses and midwives

• The Centre’s of Nursing & Midwifery Education

26th March 2014 8

Structured Programme Approach

Agreed key principles – Clinically led, multidisciplinary team – Structured approach from design to implementation – 8

steps – Patient representation – Nationalise existing best practice – Make data driven decisions – Local ownership and leadership – Alignment of stakeholders e.g. Management, Nursing,

AHPs, Doctors, DoHC, Colleges, to a shared vision and a way of collaborative problem solving that builds trust

26th March 2014 9

Programme structure

• National Programme Working Group

– Programme Lead (Consultant); Programme Manager; Public Health Dr; Regional Leads (Clinical) x4; Therapy representative; nursing representatives; management admin; GP leads on chronic disease programmes & PDC for Practice Nursing.

• Clinical Advisory Groups (College appointed)

• Director of Nursing/Midwifery Reference Group

• Therapy Reference Group

• Patient Consultative Forum

26th March 2014 10

National Clinical Programme for Older People

(NCPOP) Overarching Aim

Every older person has access to the right care and support

26th March 2014 11

Our Vision

• Better hospital services

• Better community services

• Better integration and communication between hospital and community services

• Easier access

26th March 2014 12

Model of Care Part 1 Acute Service Provision

• Aims to improve quality and efficiency of care for older people

with complex health care needs and for the frail older person • To develop and implement specialist geriatric teams • To provide specialist multidisciplinary core geriatric services • To act as a specialist resource and provide clinical leadership for

the care of all older patients in the hospital

26th March 2014 13

Model of Care – Acute Service Pathway

Specialist Geriatric Team

Dedicated Specialist Geriatric Wards

Rehabilitation of Older People

Ambulatory Day Care Outreach to Long Term Care

Timely access to home supports and long

term care

26th March 2014 14

Work Streams 2014

• Model of care part 1; Implementation phase

• Model of care Part 2; Specialist Geriatric Services for Older People in the Community

• Model of Care Part 3; Specialist Mental Health Services for Older People

• Specialist Geriatric Team Guidance for Comprehensive Geriatric Assessment

26th March 2014 15

References

• Ellis, G et al (2011). Comprehensive geriatric assessment for older adults admitted to hospital. The Cochrane Database of Systematic Reviews doi10.1002/14651858.CD006211.pub2

• National Clinical Programme for Older People (2012) Specialist Geriatric Services Model of Care Part 1: Acute Service Provision. HSE

26th March 2014 16

Further information on NCP’s

• www.hse.ie/go clinical programmes

• www.rcpi.ie

• www.onmsd.ie

26th March 2014 17

Research tells us that:

• Caring for people with dementia is highly skilled work that is emotionally & physically demanding & requires on going specialist training

• Staff who have the most contact often have the least knowledge

• What happens in general hospitals can have a profound and permanent effect on individuals with dementia and their families

• Provision of dementia specific education associated with job

satisfaction reduced stress, more positive attitudes to care, resident well-being, greater knowledge& skills

26th March 2014 18

National Dementia Education Programme Overview

• Project plan developed • Audit of programmes available/provided nationally • Literature review completed • National Educational needs analysis conducted • Suite of dementia education programmes developed • National steering group established • National Governance Structure established

26th March 2014 19

National Programme - Progress to date

• Generic Educational Dementia Programme

• Early Identification of Memory Problems

• Dementia Champion Module (Level 8)

• Home Help Education Awareness Resources

• Delirium Awareness Information

• Responsive Behaviours Programme

• National Governance Group established

• Evaluation & Review

26th March 2014 20

Gaps & Challenges

• Acute Care Poor uptake for Education

• Moratorium/Release of staff

• Whole systems approach

• Involving the Person with Dementia & Carers

• Need for creativity & new ways of working across services

26th March 2014 21

Future Plans

• HSE/DCU Dementia Elevator Project

• Changing Minds Project IHF/HSE/ASI

• Genio Projects

• National Clinical Care Programmes

• National Dementia Acute Audit

• National Dementia Strategy

• Undergraduate/FETAC Courses

26th March 2014 22

Meeting the challenge to build capacity

• Commitment to a person-centred philosophy • Good practice is not static and involves the ongoing

evaluation of current practices and the development of new initiatives

• Organisational support crucial - Education alone will

not change practice

• Strong Leadership & Management Support critical at all levels

26th March 2014 23

26th March 2014 24

References • Ayalon.L. (2009). Long term care beliefs about evidence based practices for the management of dementia and

agitation. International Journal of Geriatric Psychiatry. 24 pp118-124.

• Brooker, D.(2004). What is Person-Centred Care in Dementia? Reviews in Clinical Gerontology. (13), pp.215-222

.

• Cahill, S,O Shea E; Pierce M; (2012) Creating Excellence in Dementia Care. A Research Review for Irelands National Dementia Strategy

• DEMENTIA:NICE-SCIE Guideline on supporting people with dementia and their carers in health and social care. (2007) National Clinical Practice Guideline Number 42: The British Psychological Society and Gaskell.

• De Siún, A. and Manning, M. (2010a) National Dementia Project: Dementia Education Needs Analysis Report, HSE, Dublin

• RCN (2010) Improving Quality of Care for People with Dementia in General Hospitals. Royal College Nursing Publishing Company. Middlesex.

• Visser,S., Mc Cabe,M. Hudgson,C., Buchanan,G., Davison,T., George,K. (2008) Managing behavioural symptoms of dementia: Effectiveness of staff education and peer support. Aging & Mental Health.12(1) pp 47-55.