Enhanced Dementia Care Service (EDCS) data captured between April 2023 – February 2024 demonstrated significant results for a cohort of 185 patients, who saw a significant reduction in hospital activity post-referral, resulting in:
• 29% reduction in non-elective admissions,
• 36% reduction in non-elective bed days
• 17% reduction in ED attendances
The EDCS comprises of health, social and voluntary services who provide community-based support for patients living with dementia. The service supports patients with their diagnosis, helps to prevent crisis, unwarranted hospital admissions, and aims to enable patients to live independently.
It was established in 2019, and due to their incredible work, the service received further funding from the BBP to establish a broader multi-disciplinary team, which launched in April 2023 providing a 7-day service.
By evolving the team into a functioning multidisciplinary team operating 7 days a week, the team can deliver improved responsiveness by the correct professional at the right time as there is no break in the continuity of service. They can meet wider needs quickly and reduce risks in different ways and by working across different disciplines. EDCS have also improved joint working pathways, and now attend older persons MDT with CIDs.
The team also work closely with the Alzheimer’s society especially in WMUH to support more effective discharge pathways and maintain people at home for longer.
The following case studies highlight where the community-support offer has benefited Hounslow residents and improved their independence.
In April 2022, John was diagnosed with mixed dementia. His GP referred him to the EDCS team for dementia support in the community. He lives at home with his wife, and prior to EDCS’s involvement he had been admitted to hospital due to a stroke; he was discharged under the fast-track pathway. However, post discharge he was unwell, delirious and had no rehabilitation support. His wife was very stressed and unable to cope with his new care needs.
Once the EDCS were involved, the team ordered John a new chair to support his physical needs and prevented aspiration, they also liaised with his GP practice to register John as housebound. This was a great support to his wife who had been struggling to get John there due to his reduced mobility. The team then worked to alleviate his wife’s carers stress and reduce her social isolation. They liaised with Harlington Care to increase respite support by 33 percent.
The team continued to liaise with Adult Social Care (ASC) and the Continuing Healthcare (CHC) team to also increase John’s package of care. His wife now feels more supported, better educated, and equipped in dementia care and is overall less stressed.
The BBP is prioritising the quality of life for people living with dementia and their families by providing more patients with community support with their diagnosis, and offering services that can help prevent crisis, prevent unwarranted hospital admissions, and enable more people living with dementia to live independently in their own home.
One priority focused on The London Borough of Hounslow receiving Dementia Friendly Community status by The Alzheimer’s Society, which it was awarded in 2023. This status recognises the borough for its achievements in supporting people who are living with dementia as it creates an environment where people living with dementia will be confident that they can contribute to community life.
During Dementia Action Week 2024, Hounslow Council, West London NHS Trust and the Alzheimer’s Society hosted a range of events to support people living with dementia in Hounslow. More than 200 residents attended Syon House