Dementia | Provider Hub

Market Context

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

Dementia currently represents one of the greatest challenges to our health and social care landscape. With no known cure and with limited treatments available, dementia is redefining our individual and collective experience of ageing, irrevocably changing the lives of citizens and their families across Essex. Dementia is not restricted to age, gender or ethnicity.

About Dementia

Dementia is an umbrella term used to describe a collection of symptoms which affect the brain. Dementia is progressive, meaning symptoms will get worse over time. People may find it difficult coping with everyday tasks. Symptoms include decline of functions such as memory, processing skills, orientation, understanding, judgement, calculation, learning, language and thinking. Dementia 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. Alzheimer’s disease is the most common form, accounting for around 60% of all cases, followed by vascular dementia, and dementia with Lewy bodies which together account for 15-20% of cases. Dementia is not a natural part of aging and in young-onset dementia (under 65yrs), frontal-temporal dementia is the most common disease, followed by Alzheimer’s. The rarer forms of dementia are more likely in the under 65 age group and account for some of the more challenging behaviours. Diseases that may also cause dementia include Parkinson’s and Huntington’s, HIV and AIDS, Korsakoff’s syndrome, Creutzfeldt-Jakob disease, multiple sclerosis, and motor neurone disease, amongst others. There are also mixed cases of dementia such as Alzheimer’s and Dementia with Lewy bodies.

Dementia 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 provides both community and accommodation-based services for this cohort, via specific and framework contracts. Some contracts allow for providers to enter the market at set periods. 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, Further information on relevant Market Cohorts supporting People living with and affected by Dementia in Essex can be found HERE

Objectives and Future Need - After extensive engagement with people living with/affected by Dementia, carers and partners the Southend, Essex & Thurrock (SET) strategic approach for supporting people affected by Dementia and the Southend, Essex & Thurrock Dementia Strategy 2022-2026 was adopted in Autumn 2022. The Strategy sets out the Southend, Essex and Thurrock mission 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 (February 2023) highlight that there are 24,291 people (over 65) in Southend, Essex & Thurrock (SET) living with dementia, with a 33% increase predicted, resulting in 32,307 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 8016 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.
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.

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.

Dementia prevalence is known to increase with age, the most recent figures from NHS Digital (February 2023) highlight that there are 24,291 people (over 65) in Southend, Essex & Thurrock (SET) living with dementia, with a 33% increase predicted, resulting in 32,307 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 8016 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.
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) aims 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.

The CDSS has seen a significant increase in the number of people reaching out for information and support throughout 2023 and this continues to date.

The current contract providing a countywide Community Dementia Support offer comes to an end in March 2024. Specific work is being undertaken

Essex Market
Spend	£814,000
No of Providers	1
Quality	Not assessed

The information shown in the table(s) above is correct as of 30th September 2024.

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. The council’s vision is to develop a flexible and local offer for Community Dementia Support for Essex residents living with dementia, their families and carers.

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.

The ninth commitment of the Southend, Essex and Thurrock dementia Strategy states “We will work with the care markets to encourage long-term care settings to promote improving knowledge, understanding and skills actively empowering activities and solutions that increase and retain their connections within their communities”.

Our key aims are:

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.

Covid-19 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 Inclusive Dementia Communities Networks.

Lived experience research and insight undertaken highlighted:

Continued 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.
Increasing levels of social isolation, loneliness and fear of being abandoned for people living with Dementia and their families/carers.
Physical & Emotional deterioration of people living with dementia or cognitive decline.
Increase in risky behaviours, self-neglect and risk of premature admission to residential care.
Increase in digitisation of services.
unpaid carers role increasing, with more people becoming carers and those already in a caring role doing more, by way of caring than they did before.

Current market risks:

Complex system and interdependencies with other market sectors. – Professionals, People living with/affected by dementia and carers find it challenging to navigate the health and social care systems. Where people are living with multiple conditions this can present additional challenges in access to appropriate care and support.
Limited specialist Dementia Community Support providers. Wider systems 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.

The need for a greater understanding of the cost of care to support those living with dementia.

Data does not support the NHS & Social Care systems to explicitly identify the cost of care services provided to support adults living with dementia.
Sharing data/Insights - to enhance diagnosis, support and understand the impact of dementia for organisations and partners.

Workforce awareness & understanding incl. how to manage distressed behaviours and caring for someone with dementia with a focus on complex needs. Survey findings are HERE

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

Our areas of focus, in support of delivery of the SET Dementia Strategy and as articulated in commissioning intentions, define a 7 year delivery plan until April 2030 and will support delivery of the nine strategic priorities within the SET Dementia Strategy, informed by ongoing stakeholder engagement.

Last updated: 31/03/2024

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