Abstract

**Dementia Support UK: Connect, Consult** is an accessible dementia consultancy service that builds a support infrastructure for the care of people with dementia across the care home sector during COVID-19. Using videoconferencing, this non-pharmacological and person-centred model will provide care home staff with dedicated one-to-one time with a dementia consultant to:

* Better understand the behaviour of the person living with dementia
* Problem solve
* Build capacity within the sector

This highly innovative approach was developed in Australia by Dementia Support Australia (DSA). Since its commencement in 2016, this Australian Government-funded programme led by HammondCare has supported over 14,000 people with dementia in care homes, domestic homes and hospitals. DSA builds sector capacity through consultancy. A KPMG analysis focused on carer distress, medication use, health resource utilisation and clinical outcomes reported that the model achieves significant reduction in clinical symptoms (without recourse to antipsychotic medication) and significant reduction in carer stress. KPMG’s economic analysis revealed that the model is more effective and less costly than comparable programs and, importantly, there are also savings to downstream health service utilisation, e.g. hospitalisations.

There is no comparable service in the UK. As such, it adds value to the current system and does not require input from already stretched health and social care services. The innovation is unique in that it:

* Offers a nationally consistent infrastructure;
* Can be accessed by any care home;
* Provides direct access to a dementia specialist consultant – there is no reliance on third party authorisation;
* There are no clinical restrictions on referral, other than confirmation that a person is living with dementia.

We know that the care sector has been severely impacted by COVID-19; services feel isolated and routines and taken-for-granted support networks have been interrupted. However, if people with dementia and care partners are **supported in times of disruption, helped to develop resilience,** have plans in place to **mobilise assets and resources**, and are **supported in times of stress and distress within their own care homes and communities**, we can reduce the need for more costly health resources, such as hospital care. By avoiding crisis responses in the lives of people with dementia, and seeing ageing with dementia as a task of understanding complexity, we believe we can significantly impact on the wellbeing and quality of life of the people we serve and reduce the inequalities that people with dementia presently face within the health and social care system.

**Extension for Impact**

Dementia Support UK, Connect Consult has used the current Innovate UK Business Led Response to COVID-19 Grant to test a new model of care workforce support in relation to dementia. The current grant has facilitated new understandings about the types of support people with dementia need during this pandemic and the support the care workforce requires to meet these needs. Our early impact data finds that we are already seeing positive outcomes for both people living with dementia and care home staff. From the responses received to date, 82% of respondents report a reduction in the behaviours that they were seeking assistance with and 73% reported a reduction in stress caused by the behaviours. There is strong evidence of capacity building within care teams, with 73% of staff reporting that they would feel confident using our advice and resources with another resident in the same situation. There is also early evidence that Dementia Support UK may reduce the use of statutory services, with 73% of referrers indicating that the resident would have been referred to a more expensive service, such as a mental health team without the input of Dementia Support UK. We recognise that this impact has to be tested over time and we would plan to use the extension grant to explore impact in more detail.

In addition, we have been able to identify our USP in the current health and care system, in offering real-time, problem solving solutions for care staff, who are under pressure, with a fragmented infrastructure of support. It is the combination of these factors which have led to our focus on an app-based subscription model of support for any sector working with people living with dementia. We believe this has the potential to save downstream health and social care costs and will use the grant extension to build an app, develop demonstration capabilities, gather impact data and secure beta customers. We have used the current grant to explore new and emerging markets for this service and will use the extended time to consolidate this early scoping.

There are no comparable service offerings. The care sector uses existing NHS resources to address need. These are subject to lengthy delays or are currently unavailable, due to COVID-19 restrictions. The current workforce has also had a year like no other, with burn-out and mental health issues now of concern given the duration of the pandemic to date, and no clear end in sight. In addition, new markets have emerged. For example, the prison service and the domiciliary care sector, where support is not available in meeting real-time behavioural issues that staff can experience without the available expertise to respond. Charities that specialise in dementia support for families are available but under significant demand.

In summary, this change of scope is a focus on real-time, mobile, accessible responses to the needs of any workforce that supports a person living with dementia. The aim being to support staff as they are experiencing a problem, to promote better care for people living with dementia, and to reduce the costs of potential downstream health resource use. Secondary savings are expected in preventing workforce burnout and associated costs to individuals, organisations and society.