Cost of Living Support

Essex County Council - Provider Hub
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Market Context

Dementia is an umbrella term used to describe a collection of symptoms that affect the brain including memory loss, perception, problems with reasoning and communication skills. Dementia is defined as a progressive disease that affects more than one aspect of daily life and can lead to a reduction in a person’s ability to conduct routine tasks such as washing, dressing and cooking.  There are over 200 types of dementia including Alzheimer’s, Vascular and dementia with Lewy bodies. Dementia is not a natural part of ageing and does not just affect older people (though is most prevalent in people over 65). It has a physical, psychological, social, and economic impact, not only on people with dementia, but also on their carers (particularly unpaid carers), families and communities.

Dementia is one of the major causes of disability and dependency among older people with no known cure. It is estimated that a person is formally diagnosed with dementia every three minutes in the UK and that one in three people born this year will develop dementia in their life.

The Council can provide social care support and services for adults, or the carers of adults, at all stages of Dementia. Although people living with dementia are likely to require longer term support, the Council can provide person centred support to enable the person living with dementia to live well at home, safely, for as long as possible. Carers and families can also benefit from support to help maintain their own wellbeing. People living with dementia may also require residential or nursing care at the later stages of their long-term condition.

It is possible for providers to enter the market at set periods throughout the lifetime of the contract. For more information refer to the following services/contracts:

A financial assessment may be undertaken for adults who are in receipt of certain services. The adult can then choose to have either a managed service via one of the Council's contracts, or manage their own support via a direct payment, personal health budget or individual service fund.

Work has been underway to develop the Southend, Essex & Thurrock (SET) strategic approach for supporting people affected by Dementia and the Southend, Essex & Thurrock Dementia strategy 2022-2026 is due to be adopted in Autumn 2022.

Our mission is to make sure that:

  • Those who experience dementia, and their families and carers feel they are understood and can access the support they need when they need it
  • That communities and local organisations are aware of the impact dementia has on those who experience it and their families and carers
  • That support for people with dementia and their families and carers is underpinned by levels of training and expertise among professionals and volunteers

And to further promote and enhance the conditions which will contribute to a reduction in prevalence and promoting health improvement in the long-term, recognising health inequalities and the wider determinants of health to promote better health outcomes for people across SET.

  • Dementia prevalence is known to increase with age, the most recent figures from NHS Digital highlight that there are 24,578 people (over 65) in Southend, Essex & Thurrock (SET) living with dementia, with a 33% increase predicted, resulting in 34,560 people by 2030.
  • 64% of those diagnosed with Dementia are female and 70% are aged 80+ (48% are both female and aged 80+)
  • Old age dependency ratio: currently equivalent to 335.6 people aged 65+ being economically inactive to every 1,000 working age people. In Southend, this is 310. These are both higher than the national average and whilst this is lower in Thurrock, these are all predicted to increase
  • If the prevalence remains constant, for SET as a whole, there will be an additional 10,554 people aged 65+ with dementia in 2030
  • Around 1 in 5 adults with a learning disability who are over the age of 65 will develop dementia.
  • People living with dementia who are over 65 have on average four comorbidities, while people without dementia have on average two and 91.8% of people living with dementia have another health condition.

The Community Dementia Support Service (CDSS)  and South East Essex Community Dementia Support Team (CDST) ) (iBCF funded)  aim to ensure that all people affected by Dementia, their carers and wider family network are empowered, supported and enabled; offering information and practical guidance to cope with day to day challenges and plan for the future, supporting and signposting to appropriate care & support and prepare for the future.

Both the CDSS and Southeast Essex Community Dementia Support Team (CDST) have seen the significant increase in the number of people reaching out for information and support throughout 2021 continue to date.

Essex Community Support Service Market
 
Spend £1.3 million
No of Providers 2
Quality Not assessed

The information shown in the table(s) above is correct as of 31st August 2021

Good progress has been made across Essex, however recent consultation with people in Essex and local engagement have told us there is more to do, some of the challenges highlighted include:

  • The impact of an ageing SET population, with an increase in long-term conditions
  • The need to improve timelier dementia diagnosis – through access to diagnostic/memory assessment services and encouraging people to pursue diagnosis, for example where delays or stigma may be present 
  • The complexities of system change i.e., when new operating models are introduced, or system goals change to address causes rather than symptoms
  • The need to enhance alignment of priorities amongst multiple stakeholders
  • The need for greater understanding and fulfilment of expectations across the system
  • Tackling the stigma associated with dementia
  • Cost implications for the wider economy
  • Greater understanding of the cost of health and social care to support those living with dementia
  • A population needs analysis based upon current and projected dementia diagnosis
  • Increased need to share data and insights among multiple stakeholders to enhance diagnosis, support and understand the impact of dementia for organisations and partners
  • The impact of Covid-19 such as a lack of face-to-face services, social isolation, loneliness, and increase in digitisation of services

To build on the learning and best practice from the previous strategy, there is a need for a greater insight and understanding of dementia across Southend, Essex and Thurrock to enable us to build on community assets and drive the development of high-quality dementia care and support for residents of Essex.

Covid-19 has had significant impact on the most vulnerable members of our communities, placed additional pressure on carers and created an environment which has impacted on people living with dementia and their carers. A quarter of all those who died of COVID-19 had dementia.  

During this time, approaches used included an increased focus on the use of social media channels and digital technologies to facilitate one to one conversations with people, virtual dementia awareness sessions and increased opportunities for communities to come together virtually via the Dementia Action Alliances.

Lived experience research and insight undertaken highlighted:

  • Delays in Dementia diagnosis, a lack of face-to-face services
  • The volume of health checks completed since the Covid 19 pandemic has reduced as has the inclusion of dementia advice
  • social isolation, loneliness, Fear of being abandoned, Physical & Emotional deterioration
  • Risky behaviours, self-neglect and risk of premature admission to residential care.
  • increase in digitisation of services

Current market risks:

  • Escalating levels of crises: Systems remain fragmented and bureaucratic. The challenge of finding support wears carers down and professionals also find it challenging to navigate the many system pathways
  • Capacity in the market: Support is often not personalised enough and does not enable people to maintain their capabilities, interests or relationships. Carers are often unable to access current services as they are prescriptive in their availability and timings. There are few options available in the evenings, overnight and at weekends
  • Increased costs: Existing systems push people towards residential care because communities do not understand and are not supportive.
  • Data does not support the NHS & Social Care systems to explicitly identify the cost of care services provided to support adults living with dementia or identify those affected by dementia accessing care and support.

Our mission:

  • To improve use of population health management data and insight to enable development of an earlier offer, reducing health inequalities across greater Essex and at a neighbourhood level for people affected by dementia and their carers
  • Prevention: People in greater Essex will have good health and wellbeing, enabling them to live full and independent lives for longer.
  • Supporting carers: Carers are supported to enable people with dementia to remain as independent as possible
  • Reducing the risk of crisis: All people with dementia receive support to reduce the risk and manage crisis
  • A knowledgeable & skilled workforce: All people with dementia receive support from knowledgeable and skilled professionals where needed

The areas of focus for 2022-2026 will be delivery of our nine strategic priorities which, following stakeholder engagement, are:

  • Prevention: People in Southend, Essex and Thurrock will have good health and wellbeing, enabling them to live full and independent lives for longer
  • Supporting unpaid carers: Unpaid carers are supported to enable people with dementia to remain as independent as possible
  • Reducing the risk of crisis: All people with dementia receive support to reduce the risk and manage crisis
  • A knowledgeable and skilled workforce: All people with dementia receive support from knowledgeable and skilled professionals where needed
  • Finding information and advice: Everyone with dementia will have access to the right information at the right time
  • Diagnosis and support: All people with dementia will receive appropriate and timely diagnosis and integrated support
  • Living well with dementia in the community: All people with dementia are supported by their Southend, Essex and Thurrock communities to remain independent for as long as possible
  • Living well in long-term care: All people with dementia live well when in long-term care
  • End of life: People with dementia and their families plan ahead, receive good end of life care and are able to die in accordance with their wishes.
Last updated: 11/10/2022