Connecting People, Connecting Support
Programme logic model forConnecting People, Connecting SupportTransforming the allied health professionals’ contributionto supporting people living with dementia in Scotland 2017-202023rd April 2018Review October 20181
Our aimsThe executive summary of Scotland’s National dementia strategy 2017-20201 describes the context in which Connecting People, Connecting Support will beimplemented:“Over the last ten years there has been progress around improving diagnosis rates, post-diagnostic support, [and] workforce development and inimproving the experience of people with dementia and that of their families and carers in hospital and other settings. However, we know there is more todo [.] At the heart of this strategy is a recognition of the need to ensure a person-centred and flexible approach to providing support at all stages of thecare journey.“Our shared vision is of a Scotland where people with dementia and those who care for them have access to timely, skilled and well-coordinated supportfrom diagnosis to end of life which helps achieve the outcomes that matter to them”The implementation of Connecting People, Connecting Support is commitment 10 of Scotland’s Dementia Strategy and aims to: Increase awareness and understanding of how AHP-led contributions can enable people to live well with dementia after diagnosis. Improve access to a range of AHP’s regardless of a person’s age or place of residence, early in their diagnosis and throughout the illness Influence & integrate the AHP contribution to living with dementia, aligned to other national transformational changes in Scotland.Purpose of this documentThis document provides a logic model for the Connecting People, Connecting Support programme. The logic model components set out how the programmeis supposed to work and regular progress review of its elements will be used to evaluate the effectiveness of the programme. By definition of the Situation,Need, Inputs, Assumptions and External factors, the logic model seeks to illustrate why the programme is a good solution to the identified need. The modeldefinition process has allowed a programme of work to be planned and will support the Alzheimer Scotland AHP Dementia Forum to realise their ambitionsand support policy to practice. A mapping of the 4 ambitions to the NHS Scotland Health & Social Care Outcomes can be found athttps://www.alzscot.org/assets/0002/9408/AHP Report 2017 Web.pdf and in appendix 1 of this document.Connecting People, Connecting Support Ambitions & Principles1PrinciplesAmbitionsA human-rights based approachEnhanced AccessA biopsychosocial approach to rehabilitationPartnership and IntegrationDementia is every AHP’s businessAHP workforce skilled in dementia careAHPs will adapt and tailor their rehabilitation interventionsInnovation, Improvement & ResearchScotland’s National Dementia Strategy 2017-2020 http://www.gov.scot/Publications/2017/06/77352
Components of our Logic Model22Evaluation Support Scotland Logic Model Support Guide ces/127/3
Situation/Need The context & drivers for change Scotland’s Health & Wellbeing Outcomes demand atransformational change to how services work with people. 3rd National Dementia Strategy (2017-2020) contains a specificcommitment for AHPs to deliver a key contribution. An estimated 90,000 people in Scotland have a diagnosis ofdementia and they tend, along with the wider ageing population,to also be living with other complex needs. There is inequitable access to AHP services across Scotland forpeople with dementia and their family carer’s. Public and H&SC partnerships often lack awareness of thecontribution AHPs can make to dementia care. People with dementia continue to experience unintendeddiscrimination resulting in lack of access to AHP services whenthey need them. An increased focus on personal outcomes would provide a morepositive and effective experience. AHPs already see people with multiple complex health conditions,many of whom also have dementia, with improved knowledge ofthe impact of dementia there is an opportunity to better supportrehabilitation and enablement towards better clinical andpersonal outcomes for individuals. The current Health & Social Care drivers articulate the need forchange and offer opportunities. There is potential for AHPs to make a real difference to morepeople’s lives by spreading the evidence informed practice that isalready happening in many areas.Inputs/Resources Who and what do we have or need? People living with dementiaFamilies / Friends /Supporters/ CarersEach of the Allied Health Professional BodiesAlzheimer Scotland link workers & dementia advisors & nurseconsultants Post diagnostic dementia link workers / practitioners Health Improvement Scotland including Focus on Dementia Scottish Ambulance Service, Police, Scottish Fire and Rescue Health & Social Care Partnership management and clinicians General Practice, Housing, leisure and third sector partners AHP Dementia champions NHS National Education for Scotland The Care Inspectorate AHP Directors Other Access programmes and subject matter experts Higher Education Institutions Colleagues from Active and Independent Living programme Local AHP Dementia Forum in board areas with reps fromappropriate stakeholders Other Local contactsResources Community of Practice Alzheimer Scotland website Promoting Excellence Communication plan WEBEX Alzheimer Scotland AHP Dementia Forum4
Outcomes – CPCSShort Term Term Ensure visible routes for peopleto access AHP services. Increase awareness of the Alliedhealth professional’scontribution to dementia care inScotland Promote early interventions intoAHP services. Produce evidence based selfmanagement information. Integrate needs of people withdementia into the national AHPprogrammes inc falls, vocationalrehabilitation, redesign ofparamedic services. Utilise most up to date researchto underpin any servicedevelopment where appropriate.Medium Term Ensure timely access intoservices to promote earlyintervention. Simplify processes for inter AHPreferrals. Utilise technology to supportaccess and approaches to selfmanagement and well-being. Contribute to a personaloutcomes approach enhancingquality of care. Identify innovative ways ofservice delivery to providebetter outcomes for peopleliving with dementia. Develop and implement newintegrated models of care andsupport in multiagencypathways in health and socialcare.Long Term Support AHP workforce toundertake culturaltransformational changerequired to drive the AHPcontribution to dementia inhealth and social care. Support staff development toensure promoting excellenceframework integrated intodevelopment of a skilled AHPworkforce. Develop partnerships betweenacademic institutions and AHPservices that support dementiaawareness and skills acrossundergraduate and professionaldevelopment.5
Overall OutputsActivities Ambitions 1 & 3Activities Ambitions 2 & 4ParticipantsENHANCED ACCESSPARTNERSHIPWho needs to be involved1. Work with Alzheimer Scotland and AHP servicesto increase awareness of the AHP contribution todementia care & visible routes to access AHPservices.8. Define (across professions) what is meant by: Universal, Targeted, Specialist for the needs ofpeople living with dementia1. Local teams and Alzheimer ScotlandAHP Dementia Forum2. Develop (more) inter-AHP Direct Referral optionsa) Inter AHP pathways – capture example(s)of how it is nowb) Map how many people are involved in anindividual’s carec) Agree and implement new referralopportunities3. Early intervention and enablementa) Develop Top Tips (key, simple AHPmessages) to support more independentdaily livingb) Proactively offer more earlyintervention/input during post diagnosticsupportSKILLED WORKFORCE4. Baseline then monitor promoting excellenceuptake by AHP professions5. Increase AHP uptake of Personal Outcomestraining6. Undertake engagement exercise with HigherEducation Institutions, Colleges and HCPC reconsistency of registration PE level (skilled)7. Develop further the highest level of PE (Expert).9. Find / capture good examples of: Falls &Dementia, vocational rehabilitation & Dementia,Paramedics & Dementia, children & youngpeople & Dementia10. Develop and embed human rights basedapproach (PANEL) in the CPCS programme e.g.engagement & training education awareness11. Increase practice placement in partnership withlocal services & Alzheimer Scotland2. Local teams and Alzheimer ScotlandAHP Dementia Forum3. a) Profession leads and AlzheimerScotland AHP Dementia Forum3. b) Local teams and Alzheimer ScotlandAHP Dementia Forum4. Local teams and Alzheimer ScotlandAHP Dementia Forum5. Local teams and AHP DirectorsINNOVATION, IMPROVEMENT & RESEARCH6. National team, NES and HEIs12. Home Based Memory Rehabilitation7. National team and NESa) Assess effectiveness of pilotprogrammes using ICHOM framework8. Professional leads and Forumb) Scale and Spread9. National Team with Active &Independent Living and AS AHP Forum13. Supported Self-Management10. National Team and NESa) Pilot SSM programmesb) Scale and Spread14. Integrated approacha) Tailored Activity Programmeb) Scale and Spread11. National Team, NES, AS & AHPDirectors12. National Team, ICHOM, Pilot areas13. National Team, Forum, Pilot areas14. National Team, Forum, Pilot areas6
Outputs – Phase 1Activities Ambitions 1 & 3Activities Ambitions 2 & 4ParticipantsENHANCED ACCESSPARTNERSHIPWho needs to be involved1. Work with Alzheimer Scotland and AHP servicesto increase awareness of the AHP contributionto dementia care & visible routes to access AHPservices.8. Define (across professions) what is meant by: Universal, Targeted, Specialist for the needs ofpeople living with dementia1. Local teams and Alzheimer ScotlandAHP Dementia Forum2. Develop (more) inter-AHP Direct Referral optionsa) Inter AHP pathways – captureexample(s) of how it is nowb) Map how many people are involved inan individual’s carec) Agree and implement new referralopportunities3. Early intervention and enablementa) Develop Top Tips (key, simple AHPmessages) to support more independentdaily livingb) Proactively offer more earlyintervention/input during post diagnosticsupportSKILLED WORKFORCE4. Baseline then monitor promoting excellenceuptake by AHP professions5. Increase AHP presence on Personal Outcomestraining6. Undertake engagement exercise with HigherEducation Institutions, Colleges and HCPC reconsistency of registration PE level (skilled)7. Develop further the highest level of PE (Expert).9. Find / capture good examples of: Falls &Dementia, vocational rehabilitation &Dementia, Paramedics & Dementia, Children& young people & Dementia10. Develop and embed human rights basedapproach (PANEL) in the CPCS programme e.g.engagement & training education awareness11. Increase practice placement in partnership withlocal services & Alzheimer Scotland2. Local teams and Alzheimer ScotlandAHP Dementia Forum3. a) Profession leads and AlzheimerScotland AHP Dementia Forum3. b) Local teams and Alzheimer ScotlandAHP Dementia Forum4. Local teams and Alzheimer ScotlandAHP Dementia Forum5. Local teams and AHP DirectorsINNOVATION, IMPROVEMENT & RESEARCH6. National team, NES and HEIs12. Home Based Memory Rehab7. National team and NESa) Assess effectiveness of pilotprogrammes using ICHOM framework8. Professional leads and Forumb) Scale and Spread9. National Team with Active &Independent Living and AS AHP Forum13. Supported Self-Managementa) Pilot SSM programmesb) Scale and Spread14. Integrated approacha) Tailored Activity Programmeb) Scale and Spread10. National Team and NES11. National Team, NES, AS & AHPDirectors12. National Team, ICHOM, Pilot areas13. National Team, Forum, Pilot areas14. National Team, Forum, Pilot areas7
OUTPUTS – Phase 2Activities Ambitions 1 & 3Activities Ambitions 2 & 4ParticipantsENHANCED ACCESSPARTNERSHIPWho needs to be involved1. Work with Alzheimer Scotland and AHP services toincrease awareness of the AHP contribution todementia care & visible routes to access AHPservices.8. Define (across professions) what is meant by: Universal, Targeted, Specialist for the needs ofpeople living with dementia1. Local teams and Alzheimer ScotlandAHP Dementia Forum2. Develop (more) inter-AHP Direct Referral optionsa) Inter AHP pathways – capture example(s)of how it is nowb) Map how many people are involved in anindividual’s carec) Agree and implement new referralopportunities3. Early intervention and enablementa) Develop Top Tips (key, simple AHPmessages) to support more independentdaily livingb) Proactively offer more earlyintervention/input during postdiagnostic supportSKILLED WORKFORCE4. Baseline then monitor promoting excellenceuptake by AHP professions5. Increase AHP presence on Personal Outcomestraining6. Undertake engagement exercise with HigherEducation Institutions, Colleges and HCPC reconsistency of registration PE level (skilled)7. Develop further the highest level of PE (Expert).9. Find / capture good examples of: Falls &Dementia, vocational rehabilitation &Dementia, Paramedics & Dementia, childrenand young people & Dementia10. Develop and embed human rights basedapproach (PANEL) in the CPCS programme e.g.engagement & training education awareness11. Increase practice placement in partnershipwith local services & Alzheimer Scotland2. Local teams and Alzheimer ScotlandAHP Dementia Forum3. a) Profession leads and AlzheimerScotland AHP Dementia Forum3. b) Local teams and AlzheimerScotland AHP Dementia Forum4. Local teams and Alzheimer ScotlandAHP Dementia Forum5. Local teams and AHP DirectorsINNOVATION, IMPROVEMENT & RESEARCH6. National team, NES and HEIs12. Home Based Memory Rehab7. National team and NESa) Assess effectiveness of pilotprogrammes using ICHOM frameworkb) Scale and Spread13. Supported Self-Managementa) Pilot SSM programmesb) Scale and Spread14. Integrated approacha) Tailored Activity Programmeb) Scale and Spread8. Professional leads and Forum9. National Team with Active &Independent Living and AS AHP Forum10. National Team and NES11. National Team, NES, AS & AHPDirectors12. National Team, ICHOM, Pilot areas13. National Team, Forum, Pilot areas14. National Team, Forum, Pilot areas8
AssumptionsExternal Factors (risks)What do we assume will be the case, or will be happening in tandemWhat might happen to change our plans, or affect our progress/impact. Any further reorganisation affecting decision makingstructures within health board areas. Support from AHP professional body representative todevelop a professional network to support integration of theambitions and awareness of the policy documentAny alteration to the priorities of Health & Social Careorganisations. Leadership by an AHP Consultant based in AlzheimerScotland with support from a national team to oversee theprogramme integration into practice.Any reductions in the availability of allied healthprofessional staff within health and social careorganisations. Lack of willingness or capacity for engagement from theHigher Education Institutes. Lack of suitable infrastructure to record and report oneducational/CPD attainment within the workforce. Lack of support by the health board areas for an alliedhealth professional representative on the AlzheimerScotland AHP Dementia ForumSupport from a local dementia forum in each Board/healthand social care area for the efforts of the Board nominatedAHP CPCS lead. Support from AHP Directors to participate at both a national& local levels in the leadership, advocacy and planningefforts to integrate policy ambitions to local practice. National Team and Alzheimer Scotland AHP Forum will proactively capture and share good practice and QI resources. The Board nominated Alzheimer Scotland AHP DementiaForum members will be allowed sufficient time each monthto plan, lead and coordinate improvement efforts withintheir health board organisation. QI expertise can be made available in each board area toadequately support project development, e.g. to supportprocess mapping and measurement for improvement.9
APPENDIX 1 – CPCS Ambitions mapped to Health and Social Care OutcomesThe four ambitions for change outlined inConnecting People, Connecting SupportThe nine National Health and WellbeingOutcomes that apply to integrated health and social care1. Enhanced AccessPeople are able to look after and improve their own health and wellbeing and live in goodhealth for longer.People living with dementia will experience visible and easy access to AHP expertise andservices at the earliest time to derive maximum benefit to address the symptoms of theillness, now and in the future. This will include the availability of, and access to, AHP-ledself-management information and supported self-management advice. It will also featureevidence-informed AHP-led targeted interventions from integrated and co-ordinated AHPservices that integrate the five key elements of the AHP approach.People, including those with disabilities or longterm conditions or who are frail, are able tolive, as far as is reasonably practicable, independently at home or in a homely setting in theircommunity.Health and social care services are centred on helping to maintain or improve the quality oflife of people who use those services.People who provide unpaid care are supported to look after their own health and wellbeing,including measures to reduce any negative impact of their caring role on their own healthand wellbeing.2. Partnership and IntegrationPeople living with dementia are the experts on the impact of the disease on their dailylives and will experience AHP services delivered in a partnership approach across teams,voluntary agencies, community resources, and the third and independent sectors(including housing associations), providing the right support for individuals in the rightplace and at the right time.3. AHP workforce skilled in dementia carePeople living with dementia will experience services that are led by AHPs who are skilled indementia care (as defined by the Promoting excellence framework) and committed to aleadership and quality-improvement approach that drives innovation, shares best practice,and delivers high-quality, personal outcome-focused and AHP-led therapies.4. Innovation, improvement and researchPeople who use health and social care services have positive experiences of those servicesand have their dignity respected.Health and social care services contribute to reducing health inequalities.People using health and social care services are safe from harm.People who work in health and social care services are supported to continuously improvethe information, support, care and treatment they provide and feel engaged with the workthey do.Resources are used effectively in the provision of health and social care services, withoutwaste.People living with dementia will experience AHP services delivered by therapists who arecommitted to an approach that drives improvement, innovation and research in thedelivery of high-quality, responsive, rights-based and person-centred AHP rehabilitation.10
APPENDIX 2 – Active and Independent Living Programme OutcomesSHORT TERMMEDIUM TERMLONG TERMShort term outcomes (Phase 1)Medium term outcomes (Phase 2)Long term outcomes (Phase 3) Engagement of ScottishGovernment departments,H&SC partnerships, BoardAHP Directors, and otherstakeholders in theprogrammes of the key workstreams Children & Young People(Ready to Act) Dementia (ConnectingPeople, Connecting Support) Falls & Frailty Musculoskeletal Vocational Rehab LifeCurve Survey Operational Measures Population will have directaccess to an AHP whereappropriate. Population will have accessto once for Scotlandevidence based resources tosupport self managementand early intervention forHealth & Wellbeing. Population will benefit fromtechnologies to support selfmanagement, earlyintervention for H&WB. AHPs will work inpartnership with the peopleof Sc
2 Our aims The executive summary of Scotland’s National dementia strategy 2017-20201 describes the context in which Connecting People, Connecting Support will be implemented: “Over the last ten years there has been progress around improving diagnosis rates, post-diagnostic support, [and] workforce development and in improving the experience of people with dementia and that of their .
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