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Quality Improvement in Dementia using the Dementia Golden Ticket
Dementia is a condition in which there is a continuous decline in cognitive function and is most prevalent with the ageing population. Within England, dementia is most common amongst people living in East Sussex with prevalence of 13000. Suggested by the local review there is a lack of support and care available to patients with dementia; this is having a negative impact on the patients as well as resulting expensively on the NHS. In response to the National Dementia Strategy and the Prime Ministers Challenge on Dementia 2020, Buxted Medical Centre, developed the Dementia Golden Ticket project to improve the quality of life of patients with dementia and their carers.
An initiation stage involved the set-up of actions and tasks for the multidisciplinary team to carry out; from patient diagnosis to advanced care plans. A 3 month pilot study led by Buxed Medical Centre was carried out from October 2015 to December 2015 in the area of High Weald Lewes Havens Clinical Commissioning Group in East Sussex.
The aim of this study was to develop a new management approach for patients with dementia in primary care using interventions. These include working with the secondary providers to enhance service use, providing dementia awareness in practices and in community, and allowing timely access to health and social care routes. In addition, to be able to evaluate the impact on peoples independence and quality of life through quality measurements and evaluations.
The Golden Ticket method involves a series of tasks that include supporting the basic needs of the patient with dementia and their carer. These include maintaining their identity and to prevent them from feeling lonely within their family and their community.
A list of 40 diagnosed and newly diagnosed patients were selected who were registered at Buxted Medical Centre and were piloted for the Test Phase which was run for a 3 months evaluation phase These patients were living in their own house who had a family carer.
There were 20% fall in GP consultations. 47% of patients who were receiving secondary care were referred to primary care forming the culture shift. 25% fall in A&E admissions. 13 patients were able to save costs in prescribed medication through use of interventions.
The dementia golden ticket model demonstrated that the holistic approach was successful and that the patients concerns were addressed in the consultation time was manged well in various parts of the system.
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