Dementia Support UK: Connect, Consult

**痴呆症支持英国：连接，咨询**是一项无障碍痴呆症咨询服务，旨在为新冠肺炎期间疗养院部门的痴呆症患者护理构建支持基础设施。利用视频会议，这种非药理和以人为中心的模式将为护理院工作人员提供专门的一对一痴呆症顾问：*更好地了解痴呆症患者的行为*解决问题*在部门内建设能力这一高度创新的方法是由澳大利亚痴呆症支持组织(DSA)开发的。自2016年启动以来，这个由HammondCare牵头的澳大利亚政府资助的项目已经在疗养院、家庭之家和医院为1.4万多名痴呆症患者提供了支持。DSA通过咨询来建设行业能力。毕马威的一项分析集中在护理者的痛苦、药物使用、卫生资源利用和临床结果上，报告称，该模型实现了临床症状的显著减少(无需求助于抗精神病药物)，并显著减少了护理者的压力。毕马威的经济分析显示，该模式比同类计划更有效，成本更低，重要的是，下游医疗服务利用也节省了成本，例如住院。英国没有类似的服务。因此，它增加了当前系统的价值，不需要已经捉襟见肘的卫生和社会保健服务提供投入。这项创新的独特之处在于：*提供全国一致的基础设施；*任何疗养院都可以访问；*提供直接接触痴呆症专家顾问的机会--不依赖第三方授权；*除了确认某人患有痴呆症之外，对转诊没有临床限制。我们知道护理部门受到了新冠肺炎的严重影响；服务感觉孤立，例行公事和理所当然的支持网络已经中断。然而，如果痴呆症患者和护理伙伴在受到干扰时得到**支持，帮助培养韧性，**有计划**调动资产和资源**，并在他们自己的疗养院和社区内**在压力和困境时得到**支持，我们可以减少对更昂贵的卫生资源的需求，例如医院护理。通过避免痴呆症患者生活中的危机应对，并将痴呆症患者的老龄化视为一项理解复杂性的任务，我们相信我们可以显著影响我们服务的人的福祉和生活质量，并减少痴呆症患者目前在医疗和社会护理系统中面临的不平等。**扩展影响**痴呆症支持英国，Connect Consulting使用当前的创新英国企业领导的响应新冠肺炎赠款来测试与痴呆症相关的护理劳动力支持的新模式。目前的赠款促进了对痴呆症患者在这一大流行期间需要的支持类型以及护理人员满足这些需求所需的支持的新理解。我们的早期影响数据发现，我们已经看到痴呆症患者和疗养院工作人员的积极结果。从到目前为止收到的回复来看，82%的受访者报告他们寻求帮助的行为有所减少，73%的受访者报告说他们的行为造成的压力有所减少。有强有力的证据表明护理团队内的能力建设，73%的工作人员报告说，如果与另一位处于相同情况的居民一起使用我们的建议和资源，他们会感到自信。也有早期证据表明，英国痴呆症支持可能会减少对法定服务的使用，73%的转介者表示，如果没有英国痴呆症支持组织的投入，居民将被转介到更昂贵的服务，例如心理健康团队。我们认识到，这种影响必须随着时间的推移进行测试，我们将计划使用延期拨款来更详细地探索影响。此外，我们已经能够在当前的卫生和护理系统中确定我们的USP，为面临压力的护理人员提供实时、解决问题的解决方案，他们的支持基础设施支离破碎。正是这些因素的结合，导致我们专注于基于应用的订阅模式，为任何与痴呆症患者合作的部门提供支持。我们相信，这有可能节省下游的医疗和社会护理成本，并将利用赠款延期来构建一款应用程序，开发演示能力，收集影响数据，并确保Beta客户的安全。我们已经利用目前的赠款为这项服务开拓了新的和新兴市场，并将利用延长的时间来巩固这一早期范围。没有类似的服务可供选择。护理部门利用现有的NHS资源来满足需求。由于新冠肺炎的限制，这些服务可能会受到长时间的延误，或者目前无法使用。目前的劳动力也经历了不同于以往的一年，鉴于迄今大流行的持续时间，疲惫和精神健康问题现在令人担忧，而且看不到明显的结束的迹象。此外，还出现了新的市场。例如，监狱服务部门和家庭护理部门在满足工作人员在没有现有专业知识应对的情况下可能遇到的实时行为问题方面得不到支持。专门为家庭提供痴呆症支持的慈善机构已经存在，但需求很大。总而言之，这种范围的变化侧重于实时、移动、可访问的响应，以满足任何支持痴呆症患者的劳动力的需求。其目的是在工作人员遇到问题时向他们提供支持，促进对痴呆症患者的更好护理，并降低潜在下游卫生资源使用的成本。在防止员工疲惫和个人、组织和社会的相关成本方面，二次节省有望实现。

**Dementia Support UK: Connect, Consult** is an accessible dementia consultancy service that builds a support infrastructure for the care of people with dementia across the care home sector during COVID-19\. Using videoconferencing, this non-pharmacological and person-centred model will provide care home staff with dedicated one-to-one time with a dementia consultant to:* Better understand the behaviour of the person living with dementia* Problem solve* Build capacity within the sectorThis highly innovative approach was developed in Australia by Dementia Support Australia (DSA). Since its commencement in 2016, this Australian Government-funded programme led by HammondCare has supported over 14,000 people with dementia in care homes, domestic homes and hospitals. DSA builds sector capacity through consultancy. A KPMG analysis focused on carer distress, medication use, health resource utilisation and clinical outcomes reported that the model achieves significant reduction in clinical symptoms (without recourse to antipsychotic medication) and significant reduction in carer stress. KPMG's economic analysis revealed that the model is more effective and less costly than comparable programs and, importantly, there are also savings to downstream health service utilisation, e.g. hospitalisations.There is no comparable service in the UK. As such, it adds value to the current system and does not require input from already stretched health and social care services. The innovation is unique in that it:* Offers a nationally consistent infrastructure;* Can be accessed by any care home;* Provides direct access to a dementia specialist consultant - there is no reliance on third party authorisation;* There are no clinical restrictions on referral, other than confirmation that a person is living with dementia.We know that the care sector has been severely impacted by COVID-19; services feel isolated and routines and taken-for-granted support networks have been interrupted. However, if people with dementia and care partners are **supported in times of disruption, helped to develop resilience,** have plans in place to **mobilise assets and resources**, and are **supported in times of stress and distress within their own care homes and communities**, we can reduce the need for more costly health resources, such as hospital care. By avoiding crisis responses in the lives of people with dementia, and seeing ageing with dementia as a task of understanding complexity, we believe we can significantly impact on the wellbeing and quality of life of the people we serve and reduce the inequalities that people with dementia presently face within the health and social care system.**Extension for Impact**Dementia Support UK, Connect Consult has used the current Innovate UK Business Led Response to COVID-19 Grant to test a new model of care workforce support in relation to dementia. The current grant has facilitated new understandings about the types of support people with dementia need during this pandemic and the support the care workforce requires to meet these needs. Our early impact data finds that we are already seeing positive outcomes for both people living with dementia and care home staff. From the responses received to date, 82% of respondents report a reduction in the behaviours that they were seeking assistance with and 73% reported a reduction in stress caused by the behaviours. There is strong evidence of capacity building within care teams, with 73% of staff reporting that they would feel confident using our advice and resources with another resident in the same situation. There is also early evidence that Dementia Support UK may reduce the use of statutory services, with 73% of referrers indicating that the resident would have been referred to a more expensive service, such as a mental health team without the input of Dementia Support UK. We recognise that this impact has to be tested over time and we would plan to use the extension grant to explore impact in more detail. In addition, we have been able to identify our USP in the current health and care system, in offering real-time, problem solving solutions for care staff, who are under pressure, with a fragmented infrastructure of support. It is the combination of these factors which have led to our focus on an app-based subscription model of support for any sector working with people living with dementia. We believe this has the potential to save downstream health and social care costs and will use the grant extension to build an app, develop demonstration capabilities, gather impact data and secure beta customers. We have used the current grant to explore new and emerging markets for this service and will use the extended time to consolidate this early scoping. There are no comparable service offerings. The care sector uses existing NHS resources to address need. These are subject to lengthy delays or are currently unavailable, due to COVID-19 restrictions. The current workforce has also had a year like no other, with burn-out and mental health issues now of concern given the duration of the pandemic to date, and no clear end in sight. In addition, new markets have emerged. For example, the prison service and the domiciliary care sector, where support is not available in meeting real-time behavioural issues that staff can experience without the available expertise to respond. Charities that specialise in dementia support for families are available but under significant demand. In summary, this change of scope is a focus on real-time, mobile, accessible responses to the needs of any workforce that supports a person living with dementia. The aim being to support staff as they are experiencing a problem, to promote better care for people living with dementia, and to reduce the costs of potential downstream health resource use. Secondary savings are expected in preventing workforce burnout and associated costs to individuals, organisations and society.