genio dementia programme_2013_acutestream

November 2013

Context

• National Dementia Strategy being drafted

• Current Genio Dementia Programme

• Addressing the spectrum of “the dementia

journey”

• Two funding streams proposed

November 2013Dementia Programme 2

Stream 1: Integrated Care Pathways

• Focused on the acute sector

• 2 ‘groups’

(i) Dublin Academic Teaching Hospitals (DATHS)

and regional hospitals (CUH, UCG, Limerick)

(ii) Other hospitals

• Funding for two projects available -

approximately €500,000 each

• Three year time frame Jan 2014 to Dec 2016


Aim of stream 1

• For people with dementia (including early onset

dementia) who need to access acute hospital care:

� That access is planned and appropriate (whenever

possible)

� Clearly defined pathways into and out of acute care

� Variety of options available in terms of support

(outlined on next slide): outreach; access through

routes other than ED; ‘dementia friendly’

environment; appropriately trained staff; supports ‘in-

reach’ of community supports where appropriate;

works proactively with community to facilitate timely

discharge


Aim of stream 1 (continued)

• Outreach (i.e. hospital out to community)

• Access into hospital through routes other than

ED

• ‘Dementia-friendly’ environment with

appropriately trained staff

• Supports ‘in-reach’ of community supports

where appropriate

• Works proactively with community to facilitate

timely discharge

5November 2013Dementia Programme

What the funding will provide

• An opportunity to really work this out on the

ground

• Develop and demonstrate how this might

operate – emphasis on learning

• Acknowledgement that not everything will work

• Whole systems approach across acute hospital

and community services

• Approach that other similar hospitals can adopt

– models developed have to be transferable


What the funding will provide (Cont’d)

• Opportunities to explore:

� Required skill mix

� Skills required for newly focused approach

� Physical infrastructure

� Linkages and triggers


Requirements

• Consortium to make application – membership

equally balanced between acute and community

side and including people with dementia and

their carers – led by acute side

• Contribution in resources from consortium (can

be staff time as well as finance)

• Commitment to release appropriate staff to

actively carry out the work and attend events

• Members of consortium commit to implementing

and maintaining the changes after the life of the

grant


Essential consortium membership

• Relevant personnel from acute hospital

• GP and primary care team members

• Relevant personnel from other HSE health and

social care services (including community

hospitals)

• People with dementia and carers

• Relevant personnel from nursing homes

• Representatives of community groups and

mainstream services (e.g. community development

organisations, family resource centres etc.)


Outcomes to be achieved Short term 2014

• Local partnerships of key stakeholders implementing

plans to provide ICPs for people with dementia;

• More efficient service delivery, clear and easier access

to appropriate services, resulting in better experiences

for people with dementia and their carers;

• Early learning informing the development of emerging

national policy and practice on the benefits of ICPs and

individualised supports;

• Increased understanding of dementia and the dementia

journey amongst staff working in acute hospital settings,

primary care settings, other care settings, and in the

general community.


Outcomes to be achieved Medium term 2016

• Improved care supports provided to people with dementia in

the demonstration sites leading to increased well-being;

• Framework for ICP developed and ready to be scaled up;

• Improved care experience for people with dementia through

development of in-reach and outreach options which create

joined up pathways of care;

• Clarity on delivery arrangements across acute hospitals, non-

acute services and other services to ensure appropriate

integrated care is provided in appropriate settings for people

with dementia and their carers;

• Guidance produced on the most appropriate skill mix for

caring for people with dementia in acute hospitals and linking

to community setting


Stream 2: Individualised supports in the community

• Focused on the community sector

• Funding for approximately 10 projects

available in the region of €100,000 each

• Minimum of 30-40 people to be supported

• Two year time frame Jan 2014 to Dec 2015


Aims of stream 2

• Focus on people with high level of needs still in

community

• How to provide supports that are additional to

‘service as usual’ (i.e. not just more of the

usual service)


Individualised supports

• Planned and delivered on the basis of a consideration of the wider

needs and potential contributions of the person, moving away from

a focus on deficits

• A response to one person rather than group-based

• Chosen by the person (or their family or advocate as appropriate)

• Delivered in the community fostering inclusion and participation

rather than in segregated, stigmatising settings

• Inclusive of family and community supports and mainstream

services

• Reliant on paid professionals only when necessary

• Cost-effective and represent good value for money.


Hierarchy of supports

Level of support Response of community supports model

1. What is family able to do, want to

do, do well (that the person being

supported will find acceptable)

Develop a range of initiatives that will support

families in this role (e.g. alternative respite

models)

2. Who else in the person’s social

network might be interested in

assisting the person in specific ways

Identify, mobilise and support these informal

supporters (e.g. match person with informal

supporter)

3. What generic options for support

are available in the community

Identify and mobilise existing organisations,

agencies and generic services in the community

to be more dementia friendly and to develop a

specific supporting role

4. What gaps need to be filled with

formal health and social care

services

Integrate with existing services. Formal services

to look outside their usual offering to consider

these other forms of support and how they can

be harnessed and supported


Outcomes across the two streams

• Improved care supports provided to people

with dementia in the demonstration sites

leading to increased wellbeing;

• Clarity on delivery arrangements across acute

hospitals, non-acute services and other

services to ensure appropriate integrated care

is provided in appropriate settings for people

with dementia and their carers;

• Comparative costs of new approaches and

initiatives to services as usual' established;


Expected outputs

• Documented care pathways

• New models of support developed in acute and

community settings

• Transferable learning

• Clarity around implementation e.g. training,

infrastructure, skill mix etc.


Long term outcomes (2016 and beyond)

• Rates of admission to and durations of stay in

hospitals for people with dementia reduced

• Inappropriate admissions reduced

• Replaced by quality home and community

based supports


How funding through Genio works

• Not for capital

• Not substitution funding

• On-line application system

• Guidelines and criteria

• Applications evaluated against criteria


Draft content of application form

• Applications are on-line

• Summary and detailed project description –

focus on aims, activities and how these will

achieve the desired outcomes

• Budget - linked to activities and used to evaluate

value for money of overall proposal

• Sustainability – how the new developments will

be sustained after the grant

• Consortium description, capacity to deliver and

governance arrangements


The experience of projects supported through Genio

• Hard work!

• Challenging working through a consortium

• Commitment to be involved in learning and

learning transfer

• Commitment to be involved in research and

evaluation

• Commitment to implement and sustain the

changes made beyond the life of the grant


Learning network and evaluation

• A Learning Network has been established which

provides learning and training opportunities for

projects supported through Genio , other

dementia consortia and other stakeholders

• Other capacity building and training support

available

• Comprehensive evaluation programme underway

in the current Genio Dementia Programme

• An evaluation will be commissioned to cover the

grantees in this round


DRAFT timelines – Subject to change

• Presentations and consortia development

• Funding advertised around 1st Nov 2013

• Applications close around 22nd Nov

• Applications evaluated last week in Nov

• Genio funding approval process

• Announce successful applications around 2nd

week Dec

• Contracts signed by 1st week Jan 2014


www.genio.ie

genio dementia programme_2013_acutestream

Health & Medicine