This guest post was contributed by Ewan King, director of business development and delivery, at the Social Care Institute for Excellence (SCIE).
“I am doing something worthwhile. I am earning my bread again”. This is what Brian, who has dementia, said about how his life has changed for the better as a result of directly shaping the care that he and others receive. He is not alone in benefiting from being involved in decisions about care.
In England, it is estimated that around 676,000 people have dementia. This number is expected to grow over the coming years. And this comes at a time when there are severe cuts in budgets, particularly in social care. So what can public services do when more traditional solutions – such as recruiting more staff or expanding services – are not open to them? Whilst at the same time we know that people with dementia – and their carers – need person-centred holistic care and support, including high quality social care.
Faced with these challenges, many are looking outwards to communities for solutions. Inspired by the notion that citizens are the ‘renewable energy’ on which better care services are created, some local authorities and NHS Trusts are looking at ways to better engage local people in developing improved dementia care.
At SCIE, we call this co-production; that is, involving people who use services and carers in the design, commissioning and delivery of care and support. Done well, co-production can greatly enhance the quality of life of people who use services whilst saving hard pressed providers money. Reports for Think Local Act Personal (TLAP), along with those from Nesta and our own research at SCIE, are packed with examples of where co-production and co-design have improved outcomes for service users.
This was all up for discussion at a recent event on post-diagnostic dementia support I presented at, hosted by Walsall football club and organised by the West Midland Strategic Clinical Networks ADASS West Midlands Network. Over 100 people in the room, all debating how health, social care and communities can work better together to support post diagnostic care for those with dementia.
So how do we deliver co-production in dementia care? In my talk at the Walsall event, I talked about how we can do things like encouraging small providers into the market place. Or by adopting an asset based approach, like they have in York, where they commission user-led and micro-providers to work in the community and build on people’s capabilities and skills. Certainly, there was a strong theme discussed throughout the day of the need to transfer more services, including specialist care, into communities. As one tweeted: “How can more hospital care be brought out into the community, where specialist care is really necessary? #wmdementia15”.
Over in Doncaster, a new system of carers’ assessments is being brought in, based on the strengths that already exist in communities. I’m interested in how we can build on these types of community strengths and assets. I asked delegates in Walsall to think about how strategic partners can facilitate a vibrant local community.
I’ll finish with another tweet and what an interesting suggestion. The Improvement and Efficiency West Midlands suggested that services and pathways are too complex and that we need a London Underground map of services for people with dementia and their carers. What an interesting idea. Let’s look at anything that can bring the community into the equation and improve the quality of life and quality of care and support that people like Brian receive.