Date: 23^rd March 2011  

Venue: Lighthouse, West London

Theme: Older People’s Health

Eddie Chan (Chinese National Healthy Centre & BME Health Forum Chair), welcomed all to the meeting and introduced the first Item.

Item 1:

Joint Commissioning – Older People Services 

Paula Arnell – Joint Commissioner

As Paula has been responsible for Westminster up until now she concentrated mainly on Older People’s services in Westminster for this talk.

To read the power point presentation for this talk press this link (requires Microsoft Powerpoint). 

Q&A

Question: Is the Demographic similar in Kensington & Chelsea?

Answer: Yes it is similar but the population in K&C is smaller.

Question (Sue Vahid, resident) : When you spoke about figures for undiagnosed Dementia I am confused as to how you can tell. If indeed the condition is undiagnosed, how would you know?

Answer: There have been various studies about people who have entered services at a later stage and it has been noted that although they would have suffered from symptoms for a long time they were not recognised.

Question (Intlak, MCHC) : What sort of support is offered people who have been discharged  

Answer: Imperial trust, UCH, St Thomas’s – all have hospital discharge teams who will contact services in advance before patients are ready to leave. Doctors, when they discharge the patient should have assessed the needs of the patient who is about to be discharged.

Question (Judith Blakeman, RBKC councillor) Could you clarify what you mean exactly by re-enablement services?

Answer: This is offered to people who need further help when they move back home – usually it’s for a limited period of about 6 weeks.

Then there is Intermediary care, which is similar but usually involves more specific professional help such as physiotherapy or more intensive care – often for people who may need to learn extra skills to cope with a new limitation in mobility for example.

Question: Could tell us what are the implications for Older people’s care with all the changes due to the restructuring of the NHS, GP commissioning etc.

Answer: Our task is to get a good level of parity in the services across the 3 boroughs and over the next few years we will be working in parallel with GP commissioners.

Question (Lorraine Slee, Advocacy Plus): Could you tell us a bit more about Personal Health Budgets and whether they will cover use of Mental Health services?

Answer: Personal Health Budgets are being piloted at the moment. They won’t apply to those in acute care but rather for those in need of continuing care – people with long term conditions. We want people to be able to use their Personal Health Budget in a way that is effective. Of course there are lots of complexities but there will be an interim report on the pilot coming out in April. The pilot project will run for 2 years and end in September 2012.

Question (Vee Scott, NHS Westminster): Will the Personal Health Budget be means tested? How are they allocated?

Answer: Health is free at the point of delivery so no – they are not means tested in that way, they will rather be allocated based on what individuals need.

Question (Rod Goodyer, Parkinsons UK):  For all those new to Personal Health Budgets is it not important that there is an infrastructure in place to support people to manage these budgets?

Answer: People will not be forced to manage the budgets themselves – the Local Authority will be able to perform this function, however the question is that there would be more flexibility if they manages their own budgets through a broker.

Item 2:

The Future of the BME Health Forum

Nafsika Thalassis, BME Health Forum Manager

Nafsika announced that after the end of the April 2011 the BME Health Forum will no longer be hosted by NHS Westminster. For the next year the Forum will be hosted by Abbey Community Centre (in terms of housing the budget).

Brian Colman will act as Treasurer for the Forum and Eddie Chan of Chinese National Healthy Living Centre is the next Chair.

We are about to embark on three new projects:

1. Maternity Guides Project
2. Mental Health
3. GP Consortia: enforcing the relationship between Community organisations and GP Commissioners.

For more information about our current projects please visit the BME Health Forum website at this link.

Item 3:

Advocacy and Older People

Kate Wolf, Dementia and Mental Health Advocate, Advicacy Plus

To read the power point presentation please click on this link (requires Microsoft Powerpoint).

In addition a case study was also presented:

Case Study:

An 86 year old lady who was living alone was referred to Advocacy plus from her lunch club. She was worried a neighbour was entering her flat and taking things on a regular basis. An advocate went to see her at her lunch club and with her agreement she contacted Mental Health services. They ended up closing her case as she was not considered a danger.

She wanted to move home or see a spiritual medium.

Her advocate tried to help her find other home options but it was considered that this might not solve the problem and eventually the lady agreed to be reinstituted to Mental Health services. She ended up in a hospital which she didn’t take to at all. She returned home but with winter she wouldn’t use her heating. Her advocate was concerned and finally got the Mental Health team’s home team involved. This did finally seem to help her and they managed to persuade her to try medication. The lady told her advocate that she no longer needed her as she was happy with the Hospital team looking after her. The main success or learning from this case study is that it is vitally important for people to feel that they are being listened to and heard.

Q&A

Question (Sarah Cellar-Jones, Occupational therapist in Westminster): How do you deal with the fact that often people with Dementia won’t want to talk to someone they don’t know?

Answer: They can talk on the phone or a third party can be involved if it is helpful to reduce intimidation.

Question: What is the time frame? How long will someone have to wait for an Advocate once requested?

Answer: We have Advocate allocating meetings every 2 weeks – so it could be up to two weeks.

Question (Alison Devlin, CNWL): Is your service used by a range of BME communities and how do you bridge the language barriers and communication issues?

Answer: 40% of users of our service are BME and language issues are real. We have some volunteer bilingual Advocates and 1 bilingual staff member. Family members have been used to help out though we realise this is not ideal. We believe that if we are referred by statutory services we are eligible to have interpreters.

Question (Nafiska Thalassis (BME Health Forum Manager): Is there something we can do in this respect? Is this something we could take up with commissioners?

Answer: Yes.

Question (Sue Vahid): Referring now to the case study, you said that you ignored the request by a client for a spiritual medium. Was there not a way you could have partially helped her in this respect? Perhaps it was a call for spirituality?

Answer: In actual fact we did not ignore the request exactly but rather we did not encourage it. We were worried that the client could have been taken advantage of, i.e money being taken from her.

Item 4: 

Dementia in BME Communities in London and Local Resources 

David Truswell, Dementia Implementation Lead, Commissioning Support for London, Jasmine Scott, Dementia Advisor, Housing 21 & Dr. Claudia Wald, Consultant Psychiatrist, Westminster Memory Service 

To read the power point presentation press this link (requires Microsoft Powerpoint).

Q&A

Question (Vee Scott, NHS Westminster): Why is it so expensive to treat those with Dementia?

Answer: It’s related to more moderate to advanced cases of the illness taking into account complications that can arise, their long term placement needs (institutions etc.) Earlier intervention of course helps people to be able to stay at home for longer.

Question: Are there similar services to Westminster Memory Service in other boroughs?

Answer: There are similar services throughout the country and all London boroughs will have a memory service. What is unique though about this one is the amount of work done in people’s own homes. Even in our trust there is a huge variation in the services available.

Question (Sandy Homada, IAPT Westminster): What kind of things can we do to look after ourselves?

Answer: Remaining physically and emotionally healthy. Staying fit. Making sure that you treat anxiety or depression. Be sociable.

Question: What about vitamin D supplements? Does that help?

Answer: That is actuallystill being investigated – it is not definitive.

Item 5:

Somali elders support project

Mohamed Farah, Coordinator, Hodan Somali Community 

To read the notes for this presentation press this link (Requires Microsoft Word).

Q&A

Lev Pedro (Kensington & Chelsea Social Council) announced that a piece of work with all three Somali community groups in K&C has just been completed. It is a great resource for the community and has a lot of information. ‘Somali Diaspora in K&C’ will be available from next week.

Item 6:

London Neurological Alliance – supporting people with neurological conditions across London

Rod Goodyer, Influence & Service Development Officer, Parkinson’s UK 

To read the power point presentation press this link (requires Microsoft Powerpoint). 

Q&A

Question: Are the Fact sheets and info on all the conditions available in different languages?

Answer: Most of them are available in a number of different languages and if they aren’t they would be available upon request.

There is also a helpline that offers help in a number of different languages.

AOB – end of meeting.