The development of a delirium and dementia outreach team in a district general hospital

Abstract

The structure of NHS services nationally means that there is enormous variation in the availability and content of specialist dementia and delirium services to patients in acute hospitals. The Dementia Action Alliance estimate that over 25% of beds in acute hospitals are occupied by people with dementia and their stays are longer with difficulties discharging in a timely way. 42% of unplanned admissions are people over 70 with dementia and there are high re-admission rates. The NIHR report by Gwernan-Jones et al. (2020) emphasises the need for a transformation of organisational and ward culture to improve the experience of people with dementia in hospital. For Warwick Hospital, a district general in the South Warwickshire NHS Foundation Trust (SWFT) there is enormous pressure for beds and an emphasis on flow through the hospital, including a need to reduce acute admissions and shorten length of stay. A pilot project was developed to seek to review the current data on patients with dementia in hospital, consider the assessment and interventions for delirium and advise on interventions that could both improve patient care and influence discharge. The initial findings for the project are shared alongside a review of the psychology role and challenges faced.