ccg dementia early diagnosis campaign

Issue 3

Dementia Early Diagnosis

Welcome from the CCG Chair

Health and SocialCare Directory

ELC Update

Patient Participation Groups

‘Health Matters Event'

District nursing team

Role of a practice nurse

Healthy Lives Healthy Futures

Safeguarding Adults Team

Dementia Focus

Falls - reduce your risk

Medicines Review

Expert Patient Programme -real-life story

'On the Horizon'

Get Involved

Inside this issue

your community, your health

News from NHS North Lincolnshire Clinical Commissioning Group

Contact Us

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NHS North LincolnshireClinical CommissioningGroupHealth PlaceWrawby RoadBrigg, North LincolnshireDN20 8GSTel: 01652 251000E-mail:[email protected]: www.northlincolnshireccg.nhs.ukFollow us on twitter@northlincsccg

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NHS North Lincolnshire Clinical Commissioning Group (CCG) is encouraging thepublic to be aware of the potential signs of dementia and to encourage earlydiscussion of any concerns with their GP through a local, targeted campaign.

CCG Dementia EarlyDiagnosis Campaign

DEMENTIAFOCUS

A series of posters have beendeveloped that highlight some of thecommon signs and signals of possibleonset dementia and direct people toa short, self-assessment tool on theCCG's web site to find out if theyshould consider talking to their GP.

The test consists of 4 simple questionsbased on potential symptoms of thecondition. If respondents answer 'yes'to any of these, they are advised tocontact their GP to discuss the resultsfurther. The aim of the campaign isto increase early diagnosis of dementiato enable patients to access treatmentsand support and to allow them timeto plan for the future.

However, the campaign also reassuresthat answering yes to the testquestions does not necessarily meanthe respondent has dementia. This iswhy a visit to see their GP is stronglyencouraged in order to provide a morein-depth, clinical diagnosis.

Visitors to the CCG's web site canalso access a dedicated dementiasupport page which includes regularlyupdated information and advice froma range of local and national partners,such as The Alzheimer's Society,Mental Health Foundation and NorthLincolnshire Dementia Action Alliance.Visitors to the page can also take amore detailed, online symptoms testto measure mild cognitive impairmentand the risk of developing dementiaor Alzheimer's as a follow-on fromthe dementia symptoms test.

Take the test atwww.northlincolnshireccg.nhs.uk/your-health and click on 'Dementia'in the menu.

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your community, your health2

North Lincolnshire Clinical Commissioning Group

Hello and welcome to the third issue of NHS NorthLincolnshire Clinical Commissioning Group's quarterlynewsletter, Health Linc.You will have undoubtedly been following the news coverage about the pressureson accident and emergency departments over the winter, including at ScunthorpeGeneral. We urge you to play your part in helping us to manage these pressuresby 'choosing well' when you have a minor ailment or illness, be this treatingyourself better at home or seeking advice or treatment from the most appropriatesource. We have developed a handy 'aide memoire' to help you decide on page12.

Practice nurses are often the unsung heroes and heroines in our GP surgeriesand not everyone realises that they can see them for a wide range of treatmentsand advice rather than seeing a GP. We catch up with local practice nurse, LindaNorris, on page 5 to tell you more about the valuable work they do.

We continue our efforts to tackle dementia. On our front page you can readhow we have recently launched an awareness campaign to encourage peopleto seek an early diagnosis if they suspect that they may be showing signs of thecondition so that they can benefit from prompt treatment and support.

Finally I'd like to encourage you to come along to our ‘Health Matters’ eventon 27th February. This is a golden opportunity to hear about and share yourviews on our plans and priorities for local healthcare services in 2015-16. It willalso be a chance to meet and ask questions of the CCG and network withothers involved or interested in the health and social care agenda. Find out moreon page 4.

To keep up to date with our latest news, visit our web sitewww.northlincolnshireccg.nhs.net or follow us on twitter @northlincsccg

Best wishes

Dr Margaret Sanderson, Chair, NHS North Lincolnshire CCG

Healthwatch North Lincolnshire has launched its new Health & SocialCare Signposting Directory, a comprehensive guide to local health andsocial care services.

The directory is available at health and social care service providersacross North Lincolnshire. A free download of the directory is alsoavailable online at www.healthwatchnorthlincolnshire.co.uk

For more information contact Annabel Tindale, Marketing Assistantfor Healthwatch North Lincolnshire Tel: 01724 844986 ore-mail: [email protected]

Welcome from the CCG Chair

Dr Margaret Sanderson,Chair, North Lincolnshire CCG

Health and SocialCare Directorynow available

your community, your health


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Experience Led Commissioning -Adult Mental Health UpdateIn the last edition of Health Linc, we told you about this year's planned topics for our Experience Led Commissioning programme - 'Adult MentalHealth' and 'Children with Long Term Conditions'.

We have now completed our engagement work around 'Adult Mental Health' which involved us going out and about in the community talkingto people living with mental health conditions, carers and professionals to find out how we can deliver services that support recovery from mentalhealth crisis and sustain health and wellbeing. We also collected information about their experiences of current mental health services.

In December, we invited everyone we had spoken with to join us at a co-design event held at The House in Scunthorpe. Fifty people came tothe event to develop a visual plan - called a PATH - of how they would like to see mental health services develop in the future. It was a veryinteractive and productive session and we collated a wide range of ideas. Here's what the PATH visual plan looked like:

The purpose of the PATH is to inform the CCG's commissioning plans and there has already been evidence of this happening. For example,there was a strong feeling that the pathway for people with dual diagnosis needs to be addressed and professionals at the co-design event madean immediate commitment to discuss this at the Mental Health Collaborative meeting which took place in January.

We are now using all the information we have gathered to help us to write our action plan for delivering a shared vision for mental healthservices. We will update you on the progress of this plan in the next issue of Health Linc.

We would like to thank everyone who took part in this stage of our ELC programme. Work on the next stage around 'Children with Long TermConditions' will begin in the coming months. Visit our web site - www.northlincolnshireccg.nhs.uk/getinvolved - and click on 'ExperienceLed Commissioning' in the menu to find out about upcoming engagement events and activities.



Patient Participation Groups are groups ofactive volunteer patients who, through regularmeetings with surgery staff and GPs or virtuallyby email, provide feedback on the servicesoffered and how improvements can be madefor the benefit of all.

The CCG has been working closely withHealthwatch, who are the local consumerchampion for health and social care, to helpPPGs create better relationships betweenthemselves, surgery staff and other patientswith the aim of increasing public involvementand reducing the number of issues andcomplaints.

On 9 December, the CCG and Healthwatchhosted the second quarterly PPG Chairs meetingwhich brought together patient representativesin order to share their experiences and to tellus how they could be better supported to workeffectively on behalf of their fellow patients.In response to their feedback, we are now

organising a series of training sessions anddeveloping a PPG induction pack to supportPPGs in the recruitment and training ofvolunteers.

Ian Reekie, CCGGoverning Body LayMember for Public andPatient Involvement, isthe CCG representativeworking withHealthwatch onimproving patientparticipation and is astaunch champion ofPPGs. He explains whyPPGs are so important:

“Patients must be at the heart of decisionmaking about their care, and their views areessential for shaping services that are fit forpurpose for themselves and others. Groupsalso provide practical support in the surgery,

help improve communication and facilitateways for fellow patients to take moreresponsibility for their own health.

“Currently 13 of the 19 GP practices in NorthLincolnshire have PPGs that meet regularly anda further 3 practices have virtual groups. If youare interested in having a say in the way yourlocal health services are delivered, PPGs are agreat place to start. Not only can joining agroup influence the delivery of services, manymembers also find that volunteering is a greatway to meet new people and develop skills,and it is good for personal health and well-being. To find out more and to enquire whetheryour local PPG has any vacancies for newmembers, do get in touch with the practicemanager at your GP surgery.”

On 27 February 2015, we are holding our annual business planning event - 'Health Matters' - where members of the public are invited tocome along to hear about our plans and priorities for local healthcare services in 2015-16. Attendees will also have the opportunity to sharetheir views on these plans, particularly around how the public and stakeholders can continue to be involved in shaping services as theydevelop, as well as a chance to meet and ask questions of local health chiefs and network with others involved or interested in the healthand social care agenda.

The event will open with an address from the Chair of the CCG, Dr Margaret Sanderson, who will set the scene by outlining our achievementsso far and the challenges and opportunities that lie ahead.

The CCG's Chief Officer, Allison Cooke, and Director for Commissioning, Caroline Briggs, will explain the national context of our work andshare our commissioning plans, including details of our key priorities and how these have been shaped by the views of the public andstakeholders we have engaged with. This will be followed by a review of our Healthy Lives Healthy Futures programme and how this willcontinue to be the catalyst for driving forward essential change to future healthcare services.

Attendees will then have the chance to discuss our work so far around long term conditions, frail and elderly and mental health and givefeedback on where they think the public and stakeholders can play an active role in the future development of services in these areas.The event will close with a questions and answers session to a mixed panel of CCG staff, GPs and Healthwatch representatives.

Don't miss this valuable opportunity to have your say about our plans for healthcare in North Lincolnshire!

The 'Health Matters' event will be held on Friday 27 February 2015 from 1.30pm to 3.30pm atThe House, New Life Church, Brumby Wood Lane, Scunthorpe, DN17 1AB

To book your place, contact the CCG's Engagement Team on [email protected] or by telephone on 0300 3000 567.

'Health Matters' - have your say onour healthcare plans for 2015-16 inNorth Lincolnshire

Want your sayon how your GPsurgery is run?Join a PatientParticipation Group!

Ian Reekie, CCG GoverningBody Lay Member for Publicand Patient Involvement


The CCG has commissioned a pilot schemeto help keep care home residents out ofhospital by early recognition and treatmentof commonly occurring health issues.

Staff in the district nursing team at NorthernLincolnshire and Goole NHS FoundationTrust have been working with five* carehomes in the Scunthorpe area to provideeducation and support to care home staffalongside carrying out health assessmentsof care home residents to identify anypotential problems before they becomemore serious and need hospital treatment.

Urinary tract infections, pressure ulcers,dehydration and falls are amongst the mainconditions that affect residents in carehomes. Whilst these conditions may not beof a very urgent nature, they can beparticularly unpleasant and affect the qualityof the people's lives. By giving care homestaff the knowledge and skills to proactivelymonitor for these conditions, combinedwith the professional health assessmentsby the district nursing team, it is hoped thatthe pilot scheme will make a big differenceto residents' health and well-being.

Tina Sykes, head of nursing for communityand therapy services at Northern Lincolnshireand Goole NHS Foundation Trust, said: “Byworking with carers in homes we areempowering them to spot the signs of theseconditions early and we're also educatingthem about the different types of help andsupport available to their residents. Byproviding this early intervention we canhelp keep people well in the community,avoiding the need for hospital admission.”

If a member of care home staff has aconcern about a patient whose conditionhas changed or if a resident is worriedabout a health issue, the care home cancall on the district nursing team fortreatment or reassurance. The team canalso liaise with the patient's GP if necessaryand offer the support and care needed tohelp them remain in their own homeenvironment.

At the end of the pilot the scheme will beevaluated and, if it proves successful, theevidence will be used to put forward a caseto continue funding it through the BetterCare Fund Plan for 2015/16.

*The five care homes the Trust have beenworking with are Carrisbrooke Manor,Balmoral House, Richden Park, Sycamorelodge and The Valleys.

Linda Norris never planned to go into nursing.When she started her working life, she was anadministration officer and then a full-time mumto her 3 children for almost 20 years. It wasn'tuntil her sister became terminally ill and Lindatook on the role of carer that she consideredthe idea of becoming a nurse. Motivated byher experience - and a large dose ofencouragement from her sister - Linda embarkedon her training at the University of Hull, finallyqualifying in 2004.

Linda's nursing career began in hospitals whereshe worked as a ward nurse for 7 months, butit soon became apparent that hospitals werenot where she wanted to be and that practicenursing was her calling:'Hospital wards are fast moving places. Patientscome and go quite quickly so I never felt I hadmuch opportunity to spend the quality timewith them that I wanted to to really make adifference. There also wasn't much time to bepioneering and develop initiatives to stoppatients needing hospital care in the first place.Being a hospital nurse is about rescuing peoplefrom existing situations, but as a practice nurseyou can help prevent problems before they ariseand make the difference to people's lives I wentinto nursing to make.'

Many people are unaware of the wide rangeof treatments and support services practicenurses perform and how they can help themcheck and maintain their health. Practice nursesrun special clinics for chronic conditions, suchas asthma, diabetes or high blood pressurewhere they carry out a review of patients' health,initiate and monitor any medication they mayneed and discuss ways they can self-managetheir condition better. They can also providesmoking cessation and dietary advice, give jabs

and change dressings. Practice nurses usuallytake care of routine tests such as blood pressurechecks, blood tests and smear tests.

Nowadays practice nurses are also becomingmore involved in the treatment of a range ofminor illnesses that traditionally a GP wouldhave dealt with, such as chest infections, ear,nose and throat complaints and urine infections.Linda has a particular interest in family planning,another service practice nurses are increasinglyoffering rather than GPs, and again her interestis motivated by personal experience:'My eldest son was born as a result of anunplanned pregnancy when I was 17 and,although I don't regret it one bit, I do think if I'dbeen better informed about contraceptionoptions, I would have waited until I was olderto start a family. I think it's really important thatpeople know about sexual health and the choicesavailable to prevent unplanned pregnancies sothey can make the best decisions for them. I'mglad I am in a position to help with this - it is apersonal goal of mine.'

Making an appointment with a practice nursecan often be quicker and easier than trying tosee your GP. At Linda's practice, Central Surgeryin Barton, they operate a 'telephone triage'service where she and other healthcare colleaguestake calls from patients looking to make a doctor'sappointment. In many cases, the patient canactually be dealt with more conveniently andjust as effectively by a nurse or other healthcareprofessional at the practice. An appointmentwith a practice nurse can also often feel morepersonal and relaxed as usually they have moretime to spend with patients. This means theycan get to know the whole person and lookdeeper into their issues to find a way to help.

'I love the interaction and feedback I get frompatients,' says Linda. 'They smile at you and wantto see you to tell you how they are doing. I geta lot of satisfaction from seeing someone getwell because of the time and care I've giventhem. I especially remember a lady coming tosee me with breathing difficulties and she thoughtshe had asthma. During the consultation wediscussed her excess weight and how it mightimprove her breathing if she could lose some ofthis. We worked out a weight-loss plan, whichshe followed, and her breathing problems ceased.She was delighted and couldn't thank meenough. You can't put a price on something likethat.'

Districtnursing teamwork withcare homes totackle healthissues

'Making a difference -the role of a practice nurse'

Linda Norris,Practice Nurse atCentral Surgery,Barton-upon-Humber

An interview with Linda Norris, Practice Nurse atCentral Surgery, Barton-upon-Humber

Practice nursesprovide a wide

range oftreatments and

services



Healthy Lives Healthy Futures -Hyper Acute Stroke and ENTconsultation outcome

In November we published our feedback reportwhich presented the outcomes of our HealthyLives Healthy Futures (HLHF) consultation on theproposals for Hyper-Acute Stroke Services andEar, Nose and Throat Inpatient Surgery. 69% ofrespondents were in support of our preferredoptions which were:

To have 24/7 Hyper-Acute Stroke care atScunthorpe General Hospital (SGH) only, asit is at the moment. There would be nochange to how services are provided currentlyand the temporary arrangements put in place in November 2013 would become permanent.

To move ENT Inpatient Surgeryto Diana Princess of WalesHospital, Grimsby only.

Outpatient clinics and day surgerywould still be available at bothScunthorpe and Grimsby.Emergency ENT care would betreated only at Diana Princess ofWales Hospital.

On Thursday 13th November 2014,extraordinary meetings of North

Lincolnshire CCG's Governing Body and NorthEast Lincolnshire CCG's Partnership Board tookplace. Both CCGs approved therecommendations for the preferred options andso we are now moving forward withimplementation. Services remain the same forHyper-Acute Stroke care which will continue tobe delivered from Scunthorpe General Hospital. The changes to ENT Inpatient surgery will beimplemented as soon as possible.

How can I find out more about the decision?

The feedback report and outcome of the decisionhas been e-mailed to GP practices, local librariesand community and voluntary groups and otherkey stakeholders. A copy of the report, includingan 'Easy Read' version, is also available todownload from the HLHF websitewww.healthyliveshealthyfutures.nhs.uk/publications along with a short video explainingthe decision. If you are involved in a localcommunity group, CCG representatives areavailable on request to attend group meetingsto share the feedback report and explain thereasons for the decision.

The next challenge for Healthy Lives Healthy FuturesIn January 2015, lead clinicians from GPpractices, hospitals, community care and socialcare in Northern Lincolnshire attended aworkshop to work together on the challengingtask of planning health and social care provisionfor the local population that delivers high qualityservices in an affordable way. Four priority workstreams, each of which will be led by a dedicatedworking group, as well as a number of keyprinciples that will underpin the approach toservice redesign, were identified

The four main work streams are: Unplanned care (also called urgent oremergency care)

Planned care Long-term conditions Women and children's services

The underpinning key principles are: Strong focus on primary/community andhome-based care

Focus on prevention of illness and injury Decisions must be based on evidence Make better use of technology/diagnostics

The four working groups will now meet todebate a five-year vision for each area that willthen be used to form the basis of the overall

HLHF plan. As with all HLHF activity so far, anyproposed major service change would gothrough a rigorous process involving fullengagement and consultation with the publicand other stakeholders.

Dr Margaret Sanderson, CCG Chair, explainsthe challenge ahead: “There are some toughdecisions to make over the coming months. Weneed to change services for the better and makesure that from both a quality and financial pointof view we are in the best possible position tocontinue providing high quality care for yearsto come.

“We are determined to make our money stretchas far as it can but we are all agreed that thingscannot stay as they are. We may have to moveservices and also provide some services closerto people's homes. We will continue to focuson modelling a variety of different options foreach of the four priority areas and look forwardto pulling together a plan ready for publicengagement later this year.”

For any further information on the HLHFprogramme, please contact a member of theHLHF Team at [email protected] ortelephone 01482 672020. You can also post aquestion or comment on our Facebook pagewww.facebook.com/HLHF.nhs or tweet uson Twitter @hlhf_nhs And don't forget ourdedicated web site atwww.healthyliveshealthyfutures.nhs.uk



DEMENTIAFOCUS

Meet theSafeguarding Adults TeamThe CCG's Safeguarding AdultsTeam works with North LincolnshireCouncil, Northern Lincolnshire andGoole NHS Foundation Trust,Rotherham, Doncaster and SouthHumber NHS Foundation Trust andHumberside Police to prevent theabuse and neglect of vulnerableadults and to promote their well-being, also known as'safeguarding'. 'Vulnerable adults'are people aged 18 or over whoare, or may be, in need ofcommunity services due to age,illness or a mental or physicaldisability. They may be unable totake care of themselves or may beunable to protect themselvesagainst significant harm orexploitation.

Representatives from all of theseorganisations form the 'NorthLincolnshire Safeguarding AdultsBoard'. The Board is responsible formaking sure that our localsafeguarding arrangements arerobust, fit for purpose and aremaking a difference to the lives ofvulnerable adults.

North Lincolnshire Council is thelead agency for Safeguarding Adultsand is responsible for setting upthis Board. Up to now, there hasbeen no legal requirement to setup a Safeguarding Adults Board -it was simply considered goodpractice. However, from 1st April2015, the Care Act 2014 will beimplemented and SafeguardingAdults Boards will be a statutorybody for the first time.

The CCG must be a partner on theBoard and contribute to thestatutory duties of publishing aStrategic Plan, an Annual Reportand carrying out any SafeguardingAdult Reviews. In preparation forthese statutory arrangements, NorthLincolnshire CCG have employed aDesignated Nurse for SafeguardingAdults to work across the healthand care services in NorthLincolnshire and to make sure thatthe CCG is fulfilling its role insafeguarding vulnerable adults inthe area.

If you are worried that avulnerable adult may have been

neglected or abused, or be atrisk of neglect or abuse, contactthe Adult Protection Team on01724 297979

Deborah Pollard is the CCG'sDesignated Nurse for SafeguardingAdults. A Registered Mental Nursefor almost 25 years, she is the“clinical expert” who advises theCCG, North Lincolnshire Counciland the Safeguarding Adults Boardon issues around safeguarding.She also provides support to health

professionals within NHS Trusts, GPPractices, Dental and PharmacyServices.

Speaking about the forthcomingimplementation of the Care Act2014, Deborah comments, 'I'mlooking forward to thedevelopments and improvementsthat the Care Act will bring to thelives of our most vulnerable people.

“For the first time it will be astatutory requirement that allagencies work together to ensurethat vulnerable adults are safe andmaking their own life choices withinour community. In particular, theCare Act stipulates that we “MakeSafeguarding Personal”, so whereabuse is discovered to have takenplace, the adult concerned isinvolved in making sure that theoutcome is what will make themfeel safe in the future. They willhave choice and control over theirown well-being and safety, withprofessionals working alongsidethem to improve their quality of liferather than driving them througha process.'

The Dementia CommunityRoadshow is coming to atown near YOU!

Dementia is one of the biggest health and social care challenges of ourgeneration. Yet it continues to be a condition blighted with stigma andlack of understanding. This can mean that people who are worriedabout dementia in some way, or simply want to find out more may notknow where to turn.

The Dementia Community Roadshow, the first of its kind in the UK,has been touring since June 2011, providing members of the publicwith accessible information, advice and support about dementia. Visitorsare able to receive free, tailored, and confidential advice if they areworried about their memory or that of a loved one, living with dementiaor caring for someone with dementia from local trained Alzheimer'sSociety staff. They can also find out about local dementia supportservices.

The Roadshow is coming to North Lincolnshireon the following dates:Tuesday March 17th 10am-4pm Epworth Market Place

Wednesday March 18th 10am-4pm Barton Market Place

Thursday March 19th 10am-4pm Brigg Market Place

Friday March 20th 10am-4pm Scunthorpe Town Centre

Deborah PollardCCG's Designated Nurse forSafeguarding Adults



The CCG and North Lincolnshire Council have been working with the Alzheimer's Society to set up 'The North Lincolnshire Dementia Action Alliance'.The Alliance is organised and run by local people, to help improve the lives of those with dementia by developing dementia friendly communities.

The aim of the Alliance is to raise awareness of dementia at a local level in order to reduce stigma and encourage people in the local community whohave dementia or who are worried about their memory to seek and be given patience, kindness, understanding and support.

The Alliance will focus on helping to ensure that anyone living with dementia is not excluded from anything that they would reasonably want to do,including encouraging people to use leisure, cultural and spiritual resources in the North Lincolnshire area.

Communities that are dementia friendly have more opportunity to support people in the early stages of dementia. This allows people with dementia tomaintain and boost their confidence and encourages them to retain their ability to manage everyday life.

The North Lincolnshire Dementia Action Alliance is working towards the following standards:

'Living with Dementia'magazineThe Alzheimer's Society publish a regularmagazine, called 'Living with Dementia', whichis packed with useful and interesting featuresaimed at those with dementia and also theirfamilies, friends and carers. Both the currentissue and back copies can be downloaded atwww.alzheimers.org.uk

North LincolnshireDementia Action Alliance

The Dementia Directory is the first virtual resource in the North Lincolnshire area specificallyfocused on providing high quality and responsive information for people affected bydementia. It has been produced by the Alzheimer's Society, in partnership with the CCGand North Lincolnshire Council, as a single point of access for finding local advice andsupport, including details of local dementia support groups, courses for dementia carersand where to get advice about financial help and care services. The Directory can befound on a dedicated web site, hosted and maintained by the North Lincolnshire DementiaAction Alliance www.ddnl.org.uk

Have a say on the web site - we need your views…The Dementia Directory web site needs to be developed by the people of North Lincolnshireand we are asking you to look at the website and give your views or suggestions usingthe online comments box. The feedback will be used to further develop the next upgradeto the website which takes place every 6 months.

To leave comments and suggestions about the website, go to: www.ddnl.org.uk/contact

Your help with this is greatly appreciated.

The North Lincolnshire Dementia Action Alliance is open to all types and size of organisation and groups, from coffee clubs to corporations.More members are welcomed so that the Alliance can reach out and support even more people affected by dementia in North Lincolnshire.Come along to one of the regular meetings to find out more - telephone 01724 848594 for the date of the next meeting.

For further information visit www.dementiaaction.org.uk or call Alzheimer's Society North & North East Lincolnshire on 01724 848594.

We will support other organisations inbecoming dementia friendly

We believe that people with dementia have theright to a good quality of life and to remainindependent in their local community

We believe that people with dementia have theright to live well, engage in and contribute totheir local communities as long as they wish to

We will address negative attitudes and raiseawareness and understanding of dementia

The Dementia Directory

Dementia FactsheetsTwo new 'easy read' factsheets, designedfor people with learning difficulties are alsonow available from the Alzheimer's Society:

What is Dementia? (ER1) Supporting a person with dementia (ER2)

The Society has also updated two ofits regular factsheets:

What is Alzheimer's disease? (401) Assessment and diagnosis (426)

Download the factsheets fromwww.alzheimers.org.uk/easyreadfactsheetsor call 0300 303 5933 to order copies.

Visit the website at www.ddnl.org.uk

DEMENTIAFOCUS

www.northlincolnshireccg.nhs.uk9




Who needs one and why?Anyone on repeat medication should seek amedicines review annually. This is to ensure thatyou are comfortable and confident about takingyour medication and that you are feeling the fullbenefits of taking it. It's also an opportunity toask any questions you may have about yourmedication and for your healthcare professionalto advise you of any changes or to ask youquestions.

Some people should have review meetings atleast every year. They are:• People aged over 75• People who are regularly taking prescription

medicines• People who are taking medicine for a long term

illness (like asthma, arthritis, diabetes or epilepsy)• People who are taking hospital-prescribed

medicines, or have recently come out of hospitaland have been put on medication

• People who have recently had major changesmade to their medication

Even if you're not in any of these groups, youcan ask for a meeting if you have any concerns.You should not wait for a review if you:

• have taken too much of any medicine• have an allergic reaction to a new medicine

(such as wheezing, rash, swelling or fainting),• notice a serious side effect or any unusual

symptoms• notice your health getting worse

In these cases, see your pharmacist or GPstraightaway for advice.

GPs will normally contact patients on regularmedication to come in for a review. Your regularpharmacist may also suggest a review if they thinkyou may benefit.

What happens at a medicines reviewand what are the benefits?The review will start with your GP or the pharmacistgoing through all the medicines you take, findingout how you take your medicines, and if you haveenough information about them.

They will then check how well you are getting onwith your medicines, for example, if you canswallow your medicines easily, or if you are usingyour inhaler properly.

Together, you will discuss how you think yourmedicines are working. You might find that notall your medicines may be necessary, the dosemight need to be adjusted, or you may be

experiencing certain side effects. Your GP orpharmacist may be able to suggest some changesto your medication that will improve how you feel.

How long does a review take?Most people find that their meeting takessomewhere between 20 and 45 minutes. Itdepends on how much there is to talk about.

Does it cost anything?No - medicines reviews are free of charge.

Is it confidential?The meeting is confidential. Whoever you talk to,the details will be kept private. You can talk openlyand your questions or worries will be listened to.

Where do I go for a review?Your local pharmacy* or GP practice can undertakea medicines review with you.*Not all pharmacies offer a medicines reviewservice - ask at your local pharmacy if they offerthis service. For a full list of North Lincolnshirepharmacies and their opening times, go towww.northlincolnshireccg/your-health andclick on 'Pharmacies' in the menu.To find out more and to watch a video aboutwhat happens at a medicines review, visit theRoyal Pharmaceutical Society web sitewww.rpharms.com/health-campaigns/medicines-use-review.asp

Falls -reduce your risk

Strength and balance training

Doing regular exercises to improve your strengthand balance can help reduce your risk of havinga fall. This can range from simple activities suchas walking and dancing to specialist trainingprogrammes.

The Community Well-being Hubs in NorthLincolnshire run exercise groups and classes, as dolocal leisure centres and gyms. Contact your localCommunity Well-being Hub to find out what's onoffer:• Barton 01652 634554• Brigg 01652 653384• Epworth / Isle of Axholme 01427 873709• Scunthorpe 01724 277906

Or visit www.northlincs.gov.uk/people-health-and-care/services-for-adults/solutions-for-you/community-well-being-hubs

Medicines reviewIf you are taking long-term medication, your GPwill invite you to a review of your medicines everyyear to make sure they are still right for you,especially if you are taking four or more medicinesa day.

Your GP may recommend alternative medicationsor lower doses if they feel the side effects mayincrease your chances of having a fall. In somecases, it may be possible for the medication to bestopped.

You should see your practice nurse or GP if youhave not had your medicines reviewed for morethan one year, or if you are concerned themedications you or a relative are taking mayincrease the risk of falling.

Read more about medicines reviews below.

During the winter, we are all at risk of havinga fall in slippery conditions. However, oldermembers of our community are particularlyat risk of falling - and for them theconsequences can be much more serious.Here are some tips for helping older peopleto reduce their risk of falling when out andabout:• Try to minimise the need to go out. Ask

friends or neighbours to shop for you ortake you to where you need to go

• If you do decide to go out, plan a saferoute from your home to where you aregoing so as to avoid slopes, steps and areasthat have not been cleared or gritted. Don'ttake short cuts through areas where theslipping hazards are greater

• Ask a friend or neighbour to clear a safepath from your front door

• Wear proper footwear with a good grip• Consider using a stick or a walking pole

(such as a Nordic walking pole)• Don't rush - take slow, small steps• Use rails or other stable objects that you

can hold on to• Wear extra layers to protect the more

vulnerable parts of your body like yourhead, neck and spine if you do fall

• Wipe your feet well when entering buildings

It's not just falling outdoors that's an issuefor older people. Falling in the home is alsoa major concern - and also much more likely.However again there are positive thingspeople can do to reduce their risk.

Reducing the risk of a fall at home• Wear well-fitting shoes or slippers that are in good

condition and support the ankle•Take care of your feet by trimming toenails regularly,

using moisturiser and seeing a GP or chiropodist aboutany foot problems

• Avoid wearing loose-fitting, trailing clothes that mighttrip you up

• Don't walk on slippery floors in socks or tights• Use non-slip mats and rugs• Mop up spillages straight away• Remove clutter, trailing wires and frayed carpet• Use high-wattage light bulbs in lamps and torches

so you can see clearly• Organise your home so that climbing, stretching and

bending are kept to a minimum, and to avoid bumpinginto things

• Get help to do things that you are unable to do safelyon your own

What should I do if I have a fall?If you have a fall, it is important to keep calm.If you are not hurt and you feel strong enough to getup, do not get up quickly. Roll onto your hands andknees and look for a stable piece of furniture, such asa chair or bed. Hold on to the furniture with both handsto support yourself and when you feel ready, slowly getup. Sit down and rest for a while before carrying onwith your daily activities.

If you are hurt or unable to get up, try to get someone'sattention by calling out for help, banging on the wallor floor or using your aid call button (if you have one).If possible, crawl to a telephone and dial 999 for anambulance.

Try to reach something warm to put over you, particularlyyour legs and feet, such as a blanket or a dressing gown.Stay as comfortable as possible and try to change yourposition at least once every half an hour or so.

Medicines Review - have you had yours?



Linda Shaw is real-life proof that living with longterm health conditions doesn't have to get youdown.

She recently attended The Expert PatientProgramme (EPP), a free, six week course jointlyprovided by the CCG and North LincolnshireCouncil, that gives people with long term healthconditions practical help and advice about howthey can manage their conditions and get themost out of life.

“I first found out about the course when I sawleaflets on display in Scunthorpe General Hospital,and as I have had Addison's disease for 38 years,Graves' disease for 20 years and diabetes for 14years, I thought any advice on how to managethese conditions would be beneficial,” says Linda.

“On my course were people with a wide rangeof long-term conditions including asthma, multiplesclerosis, severe depression and chronic fatigue

syndrome. Although we all had differentconditions, we all shared a common goal - tolearn how to cope with our conditions and livelife as positively and as fully as we can,” explainsLinda.

The Expert Patient Programme takes courseattendees through a range of strategies for:• Dealing with pain and tiredness• Coping with depression• Relaxation techniques• Healthy eating and exercise• Communicating with friends, family and health

professionals• Positive planning for the future

The emphasis is on attendees working at theirown pace and finding strategies that work fortheir particular conditions and circumstances.There's no pressure to reach a particular standardand everyone takes something different awaywith them.

“Each session we learned about different topicsand techniques that would help us to manageour conditions better and these were tailored tosuit the needs of the group. We covered topicssuch as eating the right foods to improve howwe feel, breathing exercises to help us to relaxand tips on how to talk with healthcareprofessionals so that we work together to getthe best care. For me, I particularly wanted tolearn about other people's experiences ofmanaging medication and hearing about differentkinds of treatments that had worked for them. I really benefitted from being able to talk withpeople who knew exactly what I was goingthrough and sharing ideas and tips about howto manage.”

As well as providing attendees with informationand advice, the Expert Patient Programme alsoaims to support people to develop a positivemental attitude and not to see their condition aslife-limiting.

“I really liked how the course focuses on whatyou can do, rather than what you can't. Someof us even found out about skills and talents wenever knew we had before. There was one manin my group who used to be a long-distance lorrydriver, but his condition meant he had to givethis up because he is now in a wheelchair. Hewas feeling like he lacked a purpose in life andwas missing his old job,” Linda recalls.

“As part of the programme we had to setourselves achievable goals and try new things todevelop our confidence and abilities, so the coursetutor suggested that this man try a local paintingclass. He went along and found out that he wasa natural and very talented artist, and now heexhibits his work all over the country! His fellowpainters joke that he's so good that he's shownthem all up and wish he'd never joined their class-and he may never have done so if it wasn't forthe Expert Patient Programme.”

Linda concludes, “Having been on the course, Ican vouch that it is time well spent. I have seenfor myself how going along every week andbeing amongst a group that started out asstrangers and ended up as friends can changethe way you view the future. We all went awayfeeling we had lots to look forward to.”

You can ask your GP or practice nurse to referyou onto EPP or you can book onto it yourself.Visit www.northlincolnshireccg.nhs.uk/yourhealthand click on 'Expert Patient Programme' in themenu for more information and to download areferral form.

Or you can contact the EPP team direct [email protected] or on 01724298404. The team can take your booking overthe phone or post out a copy of the referral form.

Smokefreelife is North Lincolnshire's FREE 'stopsmoking service' available to smokers who liveor work in North Lincolnshire. It provides advice,support and encouragement to help people quitsmoking for good.

Smokefreelife recognises that everyone isdifferent. What is suitable for one person maynot be suitable for another. This is why theyoffer a range of interventions for smokers, sothat whatever life's demands are, every smokercan access professional support from accreditedstop smoking advisor's to help them quit theiraddiction.

Smokefreelife can make giving up smoking aseasy as ..... 1, 2 or 3:

1. Face-to-face support: Weekly meetings witha Stop Smoking Advisor who can offerbehavioural support and, where necessary, afree supply of a range of Nicotine Replacement(NRT) products for up to 8 weeks or medication.

2. 'Quitline', Text and Email support: A trainedadvisor will be able to give you the samebehavioural support as the face to face serviceand also give information about NRT productsthat are available to purchase.

3. Online interactive service: The 'YooQuit'programme is a new online support servicewhere you can receive the same professionaladvice and help at your own pace with theoption to speak to a Stop Smoking Advisor ifyou wish to. 'YooQuit' uses online videos andaudio information to help you quit in the comfortof your own home.

How do I sign up?Visit www.smokefreelifenorthlincolnshire.co.ukto access online support or to complete a referralform to request one of the Stop SmokingAdvisors to contact you -www.smokefreelifenorthlincolnshire.co.uk/Book-an-Appointment.aspx

You can also phone the 'Quitline' on0800 772 3249 or 01724 642014or text 'QUIT' to 66777Or you can drop into any of the Smokefreelifeclinics - find your nearest atwww.smokefreelifenorthlincolnshire.co.uk/Locations.aspx

Your GP or practice nurse can also refer you.Need any more information?Visit the Smokefreelife web sitewww.smokefreelifenorthlincolnshire.co.uk oryou can follow them on twitter @North_Lincs

'Living life to the fullwith a long term condition' - Linda's story

Linda Shaw

'Commit to quit'with Smokefreelife North Lincolnshire



Health & Well Being BoardTuesday 24 March 2.00pm

Meetings are usually held at Scunthorpe Civic Centre. To confirm thedate and time of meetings and to view the agenda and papers, visitwww.northlincs.gov.uk/people-health-and-care and click on 'Healthand Well Being Partnership Board' in the box to the bottom right handcorner of the page.

Who is NHSNorth LincolnshireClinicalCommissioningGroup?NHS North Lincolnshire Clinical CommissioningGroup (CCG) is responsible for planning andbuying (commissioning) high quality healthcareservices for North Lincolnshire's 167,000people. We commission hospital care, mentalhealth services, community services, includingdistrict nursing, the rapid response service andEmergency Care Practitioners.

The CCG is led by your local GPs supportedby a small team of non-clinical staff who carryout the day-to-day business of the CCG. Wealso work in close partnership with the localcouncil, voluntary groups and privateorganisations, as well as local people - patients,carers and the public - to ensure that we listento their views and work with them tocommission healthcare that meets the needsof our population, is accessible and is the bestvalue for money.

The CCG is governed by a Governing Bodymade up of GPs, other health professionalsand lay members.

On the HorizonGoverning Body meetings 2015Thursday 9 April 1.30pmThursday 11 June 1.30pmThursday 14 August 1.30pmThursday 8 October 1.30pmThursday 10 December 1.30pm

All meetings are held in theBoard Room, Health Place, Wrawby Road, Brigg,North Lincolnshire, DN20 8GS.Agenda and papers can be viewed on our web site 5 working days beforeeach meeting. Any changes to the above dates will also be posted on theweb site.

'Health Matters' - CCG annual business planningevent for public and stakeholdersFriday 27 February 2015 1.30pm to 3.30pm

The House, New Life Church, Brumby Wood Lane,Scunthorpe, DN17 1AB

To book your place, contact the CCG's Engagement Team [email protected] or by telephone on 0300 3000 567

GET INVOLVED!Patients and the public in North Lincolnshirehave a key role to play in the design of localhealth and social care services. Many servicesare being planned and put in place by the CCGbased on what people have told us is importantto them. Here's all the ways you can tell us yourviews:

EmbraceEmbrace isour patientmember networkwhere you can get involved in the design of localhealthcare services through surveys, meetingsor events.Membership is open to anyone registered witha GP in North Lincolnshire and patients canchoose to participate as much or as little as theywish in areas of healthcare that they have aninterest in.Join Embrace online atwww.northlincolnshireccg.nhs.uk/embraceor call 01482 672156or e-mail [email protected] request a joining form.

Patient Participation GroupsPatient Participation Groups are groups of activevolunteer patients who, through regular meetingswith surgery staff and GPs or virtually by email,provide feedback on the services offered andhow improvements can be made for the benefitof all.

13 of the 19 GP practices in North Lincolnshirehave Patient Participation Groups (PPGs) thatmeet regularly and a further 3 practices havevirtual groups. Anyone registered with a practicecan join their PPG to put forward theirsuggestions for improving how the Practiceoperates so that patients get the best experienceand service. Members of PPGs can also getinvolved in CCG engagement programmes toinfluence wider improvements to local healthservices. To join your local group, contact yoursurgery's Practice Manager.

Patient Relations Service (PALS)PALS can provide confidential advice and supportto help you resolve complaints, queries andconcerns about your NHS care as well as generalinformation about NHS services. PALS are notable to help with social care complaints, thoughthey can advise you who to contact.Patient Relations ServiceHealth HouseGrange Park LaneWIllerbyHU10 6DTTel: 01482 335409Email: [email protected]

ccg dementia early diagnosis campaign

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