RORY’S VALUES
Dementia care: knowledge is power
© 2014 MA Healthcare Ltd
T
he increasing incidence of dementia provides a challenge to all health providers. Across the UK, the number of people diagnosed with dementia is expected to increase by at least 30% by 2031 (Alzheimer Europe, 2006) Dementia has been identified as a national priority by all of the four countries across the UK. A central aspect of dementia policies is the aspiration to develop a workforce with the knowledge and skills to provide a world-class dementia service. It is crucial that all health and social care organisations have a consistent approach to developing guidance around the knowledge and skills staff require while working with a person with dementia, their family and/or carers to achieve a service truly centred around them. In my experience, there is a clear expectation from society that all staff will have the required level of knowledge and skills relevant to their role to enable them to work in an effective and person-centred way. A key purpose of workforce development is to enable health, social care and the third sector to deliver services to people with dementia, their families and carers, that are in line with their rights. The provision of evidence-based treatments in dementia services must be tailored to the needs of individuals and delivered by competent staff. This will improve the ability of people to live well with dementia for as long as possible; to manage the effects of their condition; and to remain as independent as they can, for as long as they wish; as well as helping to avoid poor outcomes such as inappropriate admission, delayed discharge or premature admission to long-term care. Health boards and NHS foundation trusts are constantly reviewing existing knowledge and skills of all staff. This enables them to identify gaps within services that can be addressed by developing a workforce plan for dementia services. This plan should then provide guidance to the staff that will require different levels of training and development and should describe the range of educational opportunities that can enable staff to develop the requisite knowledge and skills. Educational opportunities that could be identified must include online resources, internal and external training workshops, and training programmes or ongoing continuing professional development (CPD). A range of dementia-care-related educational resources and training has been developed across the UK. It is crucial that development plans demonstrate a knowledge and skills framework for all health and social care staff working with people with dementia, their families and/or carers. It must describe the knowledge and skills staff require, depending on their role and level of contact with this client group. In June 2010, Scotland’s National Dementia Strategy was launched.This was followed by Promoting Excellence: A framework for health and social services staff
British Journal of Nursing, 2014, Vol 23, No 11
working with people with dementia, their families and carers (The Scottish Government, 2010). The framework outlines four levels of practice: ■■ Informed Practice Level: the knowledge and skills required by all staff that are in direct contact with patients/public across health and social care areas. This provides baseline dementia knowledge ■■ Skilled Practice Level: the knowledge and skills required by all staff that have direct and/or substantial contact with people with dementia and their families and carers. Core knowledge and skills should include symptoms and difficulties of dementia; stages of individual’s journey with dementia; impact on family and individual; risk factors; communications; environmental aspects; equality, diversity and inclusion ■■ Enhanced Practice Level: the knowledge and skills required by all staff that have more regular and intense contact with people with dementia, providing specific interventions, and/or direct/ manage care services. Specific knowledge and skills including techniques; risk enablement; life-story work; environmental adaptation; acting as a local trainer or facilitator in aspects of dementia care; acting as a local Dementia Champion ■■ Expertise in Dementia Practice Level: the knowledge and skills required by all staff who by virtue of their role and practice setting will play an expert specialist role in the care, treatment and support of people with dementia. Examples of expert/specialist knowledge and skills are delivery of highly specialist interventions to people with dementia; delivery of expert advice or training to staff working in dementia care services; research within dementia care; and practice development within dementia care services. In addition to policy drivers, organisations will be considering current dementia workforce and development plans and, no doubt, these plans will identify where services need to redesign to meet the needs of people with dementia. All managers must be effective leaders; it is about managing with vision and imagination, with a drive for positive change and with a real focus on engaging with staff and users of dementia services.This approach enables organisations to develop a workforce that feels positive, listened to and valued, and where all staff take responsibility for identifying and addressing issues around quality, efficiency and effectiveness, with a real BJN focus on improving the care they deliver.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Alzheimer Europe (2006) Who Cares?: The State of Dementia Care in Europe. Alzheimer Europe, Luxembourg The Scottish Government (2010) Promoting Excellence: A framework for all health and social services staff working with people with dementia, their families and carers. http://tinyurl.com/ndelzbe (accessed 4 June 2014)
The views expressed in this column are those of the author
627
British Journal of Nursing. Downloaded from magonlinelibrary.com by 144.082.108.120 on June 9, 2016. For personal use only. No other uses without permission. . All rights reserved.
Dementia care: knowledge is power
© 2014 MA Healthcare Ltd
T
he increasing incidence of dementia provides a challenge to all health providers. Across the UK, the number of people diagnosed with dementia is expected to increase by at least 30% by 2031 (Alzheimer Europe, 2006) Dementia has been identified as a national priority by all of the four countries across the UK. A central aspect of dementia policies is the aspiration to develop a workforce with the knowledge and skills to provide a world-class dementia service. It is crucial that all health and social care organisations have a consistent approach to developing guidance around the knowledge and skills staff require while working with a person with dementia, their family and/or carers to achieve a service truly centred around them. In my experience, there is a clear expectation from society that all staff will have the required level of knowledge and skills relevant to their role to enable them to work in an effective and person-centred way. A key purpose of workforce development is to enable health, social care and the third sector to deliver services to people with dementia, their families and carers, that are in line with their rights. The provision of evidence-based treatments in dementia services must be tailored to the needs of individuals and delivered by competent staff. This will improve the ability of people to live well with dementia for as long as possible; to manage the effects of their condition; and to remain as independent as they can, for as long as they wish; as well as helping to avoid poor outcomes such as inappropriate admission, delayed discharge or premature admission to long-term care. Health boards and NHS foundation trusts are constantly reviewing existing knowledge and skills of all staff. This enables them to identify gaps within services that can be addressed by developing a workforce plan for dementia services. This plan should then provide guidance to the staff that will require different levels of training and development and should describe the range of educational opportunities that can enable staff to develop the requisite knowledge and skills. Educational opportunities that could be identified must include online resources, internal and external training workshops, and training programmes or ongoing continuing professional development (CPD). A range of dementia-care-related educational resources and training has been developed across the UK. It is crucial that development plans demonstrate a knowledge and skills framework for all health and social care staff working with people with dementia, their families and/or carers. It must describe the knowledge and skills staff require, depending on their role and level of contact with this client group. In June 2010, Scotland’s National Dementia Strategy was launched.This was followed by Promoting Excellence: A framework for health and social services staff
British Journal of Nursing, 2014, Vol 23, No 11
working with people with dementia, their families and carers (The Scottish Government, 2010). The framework outlines four levels of practice: ■■ Informed Practice Level: the knowledge and skills required by all staff that are in direct contact with patients/public across health and social care areas. This provides baseline dementia knowledge ■■ Skilled Practice Level: the knowledge and skills required by all staff that have direct and/or substantial contact with people with dementia and their families and carers. Core knowledge and skills should include symptoms and difficulties of dementia; stages of individual’s journey with dementia; impact on family and individual; risk factors; communications; environmental aspects; equality, diversity and inclusion ■■ Enhanced Practice Level: the knowledge and skills required by all staff that have more regular and intense contact with people with dementia, providing specific interventions, and/or direct/ manage care services. Specific knowledge and skills including techniques; risk enablement; life-story work; environmental adaptation; acting as a local trainer or facilitator in aspects of dementia care; acting as a local Dementia Champion ■■ Expertise in Dementia Practice Level: the knowledge and skills required by all staff who by virtue of their role and practice setting will play an expert specialist role in the care, treatment and support of people with dementia. Examples of expert/specialist knowledge and skills are delivery of highly specialist interventions to people with dementia; delivery of expert advice or training to staff working in dementia care services; research within dementia care; and practice development within dementia care services. In addition to policy drivers, organisations will be considering current dementia workforce and development plans and, no doubt, these plans will identify where services need to redesign to meet the needs of people with dementia. All managers must be effective leaders; it is about managing with vision and imagination, with a drive for positive change and with a real focus on engaging with staff and users of dementia services.This approach enables organisations to develop a workforce that feels positive, listened to and valued, and where all staff take responsibility for identifying and addressing issues around quality, efficiency and effectiveness, with a real BJN focus on improving the care they deliver.
Rory Farrelly NHS Greater Glasgow and Clyde Director of Nursing Acute Services Division
Alzheimer Europe (2006) Who Cares?: The State of Dementia Care in Europe. Alzheimer Europe, Luxembourg The Scottish Government (2010) Promoting Excellence: A framework for all health and social services staff working with people with dementia, their families and carers. http://tinyurl.com/ndelzbe (accessed 4 June 2014)
The views expressed in this column are those of the author
627
British Journal of Nursing. Downloaded from magonlinelibrary.com by 144.082.108.120 on June 9, 2016. For personal use only. No other uses without permission. . All rights reserved.
