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20th Day of Lent: Going without the Dementia Intensive Support Team (DIST) that NSFT promised

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Sham Shui Po

Just as the last of the public consultation meetings took place in Beccles, it emerged that Norfolk & Suffolk NHS Foundation Trust (NSFT) is closing its Dementia Intensive Support Team (DIST) at the James Paget University Hospital. The DIST is a key component of the sham consultation proposals on which Great Yarmouth & Waveney Clinical Commissioning Group has forced NSFT to consult.

We’ve previously highlighted that the ‘consultation’ is worthy of Kim Jong Un in North Korea, with beds closed and staff moved or made redundant in the year before the consultation even started. What does the sham consultation say about DIST?

“10.2 Proposal Two: Dementia and complex care in old age services

This proposal is to permanently close the 12 dementia assessment beds at Larkspur Ward in Carlton
Court and to continue to develop a dementia intensive support team (DIST) who would work with
patients within the community.

10.2.1 Beds at Carlton Court

NSFT has 12 dementia assessment beds at Larkspur Ward in Carlton Court, although currently there
are no patients in these beds, whilst NSFT is piloting the DIST. Since the start of the pilot the demand
for these beds has reduced and only those patients with very complex needs would require an
inpatient assessment. Up to four specialist beds in Blicking Ward at the Julian Hospital on Bowthorpe
Road in Norwich will be available for these patients when needed.

NSFT has 12 older people’s beds for people with conditions such as bipolar disorder, depression and
schizophrenia at Laurel Ward, Carlton Court. Currently there are no patients in these beds. The
savings here are being used to support the new dementia intensive support team (DIST).”

No beds at Carlton Court and no DIST at the James Paget. What is left to sham consult upon? Without DIST and beds, what happens to the elderly in Great Yarmouth and Waveney?

The Operations Director of NSFT was very visibly shocked when a brave member of staff blew the whistle on the unannounced closure of the James Paget DIST team at the last public consultation meeting on Tuesday of this week, 25th March 2014. News was obviously not supposed to leak out before the public meetings were over. With typically-incompetent NSFT people management and workforce planning, James Paget DIST staff were told in February that the service had funding for the following year; in March they were told there was funding until the end of May; last week the James Paget DIST team was told the team would close this week.

The James Paget DIST team met and exceeded all its targets, supporting elderly people to get back to their own homes as soon possible and freeing beds at the James Paget hospital, but this is how the hard-working staff are rewarded. Of course, there was funding for two years but DIST took nearly a year to emerge from the Hellesdon Hospital bureaucracy.

Either the Operations Director knew the James Paget DIST was closing and chose to mislead the CCG and the public during the consultation process or the Operations Director is incompetent for not knowing what was happening in the services being consulted upon. No wonder the colour drained from the face of the Operations Director when confronted with the truth by a member of this campaign.

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5 thoughts on “20th Day of Lent: Going without the Dementia Intensive Support Team (DIST) that NSFT promised

  1. Si says:

    Such as shame I wasnt at the Beccles meeting ! Let me just mention a couple of additions to the above story. At present both Laurel & Larkspur’s wards doors are firmly closed, the beds remain but no staff or patients are in residence. Last year staff on these wards had to apply for new posts – community (the old CMHN team), DIST at carlton court (formally IST) and the opportunity to be seconded to a new 2 year funded CEQUIN DIST team based at the JPUH. In general staff went through the trauma of interviews to justify the jobs they were already doing, then placed into these new posts. Some staff took up the seconded post at the JPH, CEQUIN DIST to support patients arriving in the A&E, SSMU & EADU, Community HOspitals with a diagnosis of demntia and or suspected dementia to provide diagnostic testing with support from Consultant Psychiatrists employed by NSFT. Probable diagnosis, memory testing, patient and family support, medication advise has been provided on a wide scale.

    At the end of 2013 the CEQUIN DIST at the JPH were told it is looking so good that the team will carry on for another year ! Horray they all said. In jan 2014, the team were told – No the porject ends, why? dont know, where has the money gone for year two? Dont know !

    Then they were told the team can work till the end of May 2014, Horray they said, stats were gathered, quantative and qualitative stats. Ohh dear after we told the JPUH the end of May, the carpet was pulled and we now end the 31st March … horror, shock, the team had two weeks to end the project !

    Those who have taken up posts with the Carlton Court DIST team have worked hard under the changes inflicted upon the staff, some having to move from ward based to community – approx 6 more staff are now working in the team, where as on the two wards around 40 staff were supporting acutely unwell patients. Over 30 staff on the site have taken early retirement, many have been employed again via agency staffing rules. One question is asked if NSFT have shut/closed? these two wards and used the monies to spend on Carlton Ct DIST, surely an extra 6+ staff to support more patients in the community is not going to stop admissions of very unwell patients nor provide the depth of support/knowledge needed. Closing the CEQUIN funded DIST team is also reducing the number and amount of support NSFT gives to those with dementia who end up at the JPUH –  approx 1 in 4 patients have a dementia in the Paget ! the number of dementia’s is increasing, the number of resdential home places is reducing, budgets for social services, health is reducing,; it dosnt take much thought to see that in a few months time the JPUH will have no ability to move patients on safely and supportively.

    Im sorry I may have rambled on a bit, but there are so many more stories to tell. Please NSFT talk to those who work at the ‘coal face’ we have a very good idea how to support our patients and we are dedicated, enthusiatic, informed (well not by NSFT) staff.

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  2. Anna K says:

    How much more of this? What is the CCG’s response? Is it by now not painfully obvious that the NSFT Board is chopping and changing, ducking and diving, robbing Peter to pay Paul……
    This is incompetent and harmful! Harmful for the Taxpayer, harmful for the Service, harmful for the staff and most of all harmful for any patient who dares to need clarity, stability,calmness and kindness to improve…..
    Human cost does not show up on balance sheets and therefore its a factor that can easily be disregarded; especially when performance is mainly measured by how well the books appear to be balanced at the end of a financial year. Its time for an independent investigation of the NSFT Board’s performance!

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  3. Dave says:

    I was lucky enough to be asked to work on the Dementia Intensive Support Team at JPUH.  I remember how the team worked hard in a small, cramped and very hot portacabin for the first few months.  We all worked well and were really dedicated to building up a team that could support the dementia patients on their discharge from JPH.  We loved the job and now its all being stopped despite promises that we’d be kept going for another year only to be informed that would not  happen.  However, we were then told we’d be staying for another 2 months and even that was taken away from us.  I just want to say to my colleagues on the team that it was a very happy experience for me and such a privilege to have worked with them all.  I know when I do retire, I’ll look back on the happy times and the laughs we shared.  We all know we did a good job and that we can be proud of what we achieved in such a short time.  Well done team and thanks for putting up with me ha ha.

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  4. mike says:

    ….And nothing has yet been said about how all the many referrals that the JPH hospital generated will now be treated.  There are no extra staff, no new team…..where will they go for treatment, who will treat them, and how long will they wait.??  The team has finished, and the staff redeployed, but no one has yet publically said what will happen to those poor patients requiring mental health assessment /  treatment.?

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  5. psy says:

    Having worked as a nurse for 26 years, in and out of the Trust, what never ceases to amaze me is the sheer level of wasted money. Functional and organic assessment beds are being shut or closed, whether in Lowestoft or Kings Lynn. Staff are being pushed into applying for their own jobs, purely so that the Trust can get staff protected by old style iron clad contracts, into shiny do as you are told new ones. And if you dont agree then you dont get a job. If you are lucky enough to be able to be given a voluntary redundancy package of several tens of thousands of pounds, ( and lots of staff were), they are then recruited back as NHSP staff, because the very wards they were asked to leave are now short staffed !!! The Trust, by getting rid of experienced staff, are now run with newly qualified nurses, some of which dont know how to fill out a blood form or take a BP!!!! And of course, newly qualified staff work for less money than experienced staff, can be bullied due to lack of experience, by the trust. One of the reasons that wards are shutting, is that for people being looked after by the trust, on a ward, means that the trust has to put out money for that person, with maximun outlay of staff, buildings, utilities etc. If you are seeing people at home, you can bill the GP for time spent caring for a patient, you are getting money in with minimal outlay to you.  Bearing in mind that just for dementia, the number of people needing to be seen and cared for by professionals doubles every twenty years, can we stop wasting taxpayers ( and yours and My money) money, and create, support and reinforce proper assessment units, with the right sort of staff and the right staffing levels to ensure that people get the care they have already paid for.  You dont pay for a coffee, and then expect the coffee shop to want it back and to split it between others and then ask you to pay for everyone having a slurp? !!!!

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