For our Dementia Friendly Hospitals Charter relaunch we’re speaking to senior dementia specialists from hospitals that are signed up to the charter. Julie Willoughby is Consultant Nurse – Dementia Services at Royal Wolverhampton NHS Trust and provides an update on the progress made within the hospital and how that relates to the charter.
1. Which hospital do you work in? Could you tell us a bit about it?
I am based in New Cross Hospital, part of the Royal Wolverhampton NHS Trust, which is one of the largest acute and community providers in the West Midlands having more than 800 beds on the New Cross site. It also has 56 rehabilitation beds at West Park Hospital and 54 beds at Cannock Chase Hospital. As the second largest employer in Wolverhampton the Trust employs more than 8,000 staff. Our pioneering dementia services have been developed and embedded over the past decade and include our centre of excellence, a 20 bedded specialist acute medical ward providing care for patients with a diagnosis of dementia in an appropriate environment with skilled staff; a Consultant Nurse led Dementia Outreach Service providing help and support to patients with an existing or suspected dementia diagnosis and their family and carers in all areas across the Trust; and a bespoke staff training and education programme, which employs a tiered approach to staff competency informed by nationally recognised frameworks. Specialist staff lead by example and equip the workforce with the confidence to challenge dementia related stigma, myths and poor practice. Our services are underpinned by our ‘reach out’ care bundle, which, informed by a person-centred assessment, ensures effective communication, adequate nutrition and hydration and a safe and orientating environment. Building on our innovative services, we are currently working through our 5 year Dementia Strategy 2015-2020, which outlines our ambitions and commitment to become a truly dementia friendly health community that strives to consistently deliver high quality person-centred care that meets the needs and expectations of our patients and their family and carers.
2. What does your role involve?
As Consultant Nurse for Dementia Services, I lead on the implementation, evaluation and review of our Dementia Strategy. Clinically, I lead the Dementia Outreach Service providing screening, specialist assessment, therapeutic intervention, family / carer liaison and support, staff education and training and comprehensive care management planning. I run a weekly Cognition Clinic providing assessment and review of patients with suspected underlying cognitive impairment, in addition to providing on-going input and support to patients with a diagnosis of dementia post discharge with the aim of avoiding repeated hospital admissions. My role also involves supporting a number of volunteers who provide a range of input from mealtime help to therapeutic intervention and carer support. I lead and support our Dementia Action Network (DAN), which consists of over 200 champions of all disciplines across the Trust who commit to providing and advocating ‘dementia friendly’ services. In return I provide a regular dementia related email circulation, quarterly newsletter and bi-monthly workshop and ‘drop in’ sessions. My role also involves the development & facilitation of our comprehensive Trust-wide dementia training and education programme. I am currently research active exploring the efficacy and outcomes of cognitive screening and impact on dementia diagnosis. I am a member of the Trust Research Leads Network, Research Peer Review Committee and I am a member of the British Geriatric Society and am a peer reviewer for their Age & Ageing Journal. I lead on local and national audits including the National Audit of Dementia. I ensure that we engage with the local community by chairing a quarterly Dementia Public Reference Group.
3. Has the dementia friendly hospital charter helped you and your staff when providing care to people living with dementia?
Following the research and planning phase, our suite of dementia services were launched in December 2010, pre-dating the DAA’s original ‘Call to Action’ for the improvement of care for people with dementia in Acute Hospitals. The Dementia Friendly Hospital Charter has helped us to reaffirm our approach, stay focused and avoid complacency. It provides clear standards and expectations that our patients and their family and carers can expect and has helped to inform our ongoing strategic review. We have also been able to network and benchmark with other organisations, including our ‘matched’ hospital in Bath, to help further improve standards.
4. Are there any particular elements of the charter that have been important in your hospital?
All parts of the charter are as important to us as they are to those living with dementia and their family and carers. A small snapshot of our more notable developments that mirror expectations of the charter include:
- Staffing – In addition to our formal training and education programme, we have also recruited in excess of 2500 ‘Dementia Friends’ in the pursuit of raised dementia awareness.
- Partnership – We have developed a Visitor’s Charter, which includes flexible visiting. We are strong advocates of John’s Campaign to enable carers to visit and assist as necessary at any time of day or night, including mealtimes. We have an overnight stay room for family and carers.
- Assessment – We have our dedicated Dementia Outreach Service and Cognition Clinic in addition to access to Mental Health Liaison Services.
- Care – Our ‘About Me’ person-centred assessment document and ‘reach out’ care bundle are well established throughout the Trust. We have designed, developed and opened a reminiscence room within the hospital in addition to the bespoke day rooms on our specialist ward. We have a programme of therapeutic activities, including digital reminiscence, pet therapy and multi-faith chaplaincy. Our ‘OUCH!’ campaign aims to improve recognition, assessment and treatment of pain in dementia.
- Environment – We have representation at our Trust Environment Group with the aim of ensuring a standardised approach to dementia friendly design.
- Governance – We are fortunate to have support from the highest level of the organisation and a highly skilled and passionate team. We are active members of our local Wolverhampton DAA and are currently a designated ‘Dementia Friendly’ Community.
5. Why do you think other hospitals would benefit from signing up to the charter?
Every person living with dementia and their family and carers deserve the very best of care when encountering a hospital visit or stay no matter where they live in the UK. All hospitals should sign up to the charter in order to provide national consistency of standards and assurance to patients and their family and carers. The Dementia Friendly Hospital Charter provides a very clear set of minimum standards with notes for self-assessment, which helps with the development and update of action plans and strategies. Being a member of the Dementia Action Alliance and signed up to the Dementia Friendly Hospital Charter provides networking opportunities, enables benchmarking with other organisations, and highlights good practice examples and learning opportunities.
6. What is your favourite thing about working in your hospital?
After nursing older people with dementia for over 30 years, becoming part of the team that pioneered the development of dementia services within the Trust and sharing the successful model with other organisations across the UK has been particularly satisfying. I feel privileged to work with staff at all levels within the organisation who demonstrate such passion, enthusiasm and commitment to providing excellence in dementia care. I also enjoy representing the Trust as a member of the local Wolverhampton DAA in the pursuit of maintaining Wolverhampton’s ‘dementia friendly’ community status.
Undoubtedly, the best thing about my role is making a positive difference to the care experience of patients with dementia and their family and carers both directly and indirectly.