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Thursday 19 July 2018
Derbyshire Healthcare NHS Foundation Trust
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Dementia Rapid Response Team - north Derbyshire

Person with dementia

We are extending our Dementia Rapid Response Team (DRRT) to the north of Derbyshire during 2018, following the outcome of the Better Care Closer to Home consultation.

The DRRT is a community-based service that aims to improve the health and well-being of people with dementia at times of crisis, by delivering rapid assessment and intensive support.  By providing support in people’s homes, the team aims to reduce the need for admission into specialist dementia hospital beds, reducing the disruption and confusion that can be created by hospital admission.

The DRRT is provided by a multi-disciplinary team which includes mental health nurses, psychiatrists, occupational therapists and health care assistants. 

Development of the DRRT

The service will be developed in two phases. There will be an initial team for the High Peak and North Dales commencing on 5 February 2018, followed by a team for Chesterfield, Bolsover and North East Derbyshire in April 2018.

Initially, the teams will be available between 9am – 5pm Monday to Friday. They will develop to a seven day a week service (between 8am – 8pm during the week and 9am – 5pm during the weekend) once fully operational. 

Subject to successful recruitment, it is anticipated that the service will be fully operational across High Peak and North Dales by September 2018 and across Chesterfield, Bolsover and North East Derbyshire by November 2018.

Read the frequently asked questions (FAQs) below for more information. Or view the news item on the north Derbyshire DRRT.

The service is delivered in an individual’s home, wherever that home may be. The team is flexible and highly responsive, providing a same-day response.

The service starts with a specialist assessment. From there, an individual person-centred plan of care is developed, in collaboration with the service receiver and their carer. Where home treatment is part of the plan, intensive support will be provided, although frequency of visits will be very much led by the individual's needs.

The assessments, interventions and treatments offered by the team are informed by evidence-based best practice (from research and associated guidance including that provided by the National Institute for Clinical Excellence – NICE).

Specific interventions, or actions, the team may offer include:

  • Focusing on an immediate crisis, identifying the source and treating it – for example through behaviour mapping, psychotherapeutic intervention and medication review
  • Identifying and intervening to meet an individual’s needs in challenging situations – for example by ensuring daily activities are maintained
    Building on the steps above to enable carers to meet these needs through modelling (learning through observation and imitation), support and education
  • Collaborating to develop a care plan including the use of advance statements (written statements setting down an individual’s preferences, wishes, beliefs and values regarding their future care)
  • Working with caring relationships to build resilience – such as through cognitive reframing (looking at your thoughts from a different point of view) 
  • Offering education, advice and support to enable resilience and re-ablement
  • Exploring factors which might cause stress and ways to prevent and manage relapse
  • Encouraging individuals to develop a range of coping strategies and ways to keep safe
  • Enabling individuals and carers to access other support services which may be of help.


The team is a key part of the dementia care pathway, working closely with community mental health teams (the triage and access point), and in an integrated way with key partners – including adult social care, integrated care services, GPs and primary care, and the voluntary sector.

The team also has a strong role in enabling people who are admitted to hospital to return home as soon as possible, to reduce the impact of negative outcomes that can result from being in hospital. Consequently the team works closely with inpatient services.

The aim is to improve services to people with dementia by enabling them to be supported at home rather than be admitted to a dementia ward, which we know can have adverse outcomes for people with dementia.
Yes. The Dementia Rapid Response Team model has been in operation in Sheffield for a number of years.  In 2015 it was introduced across Derby and Southern Derbyshire and has successfully supported a number of people to remain living within their own homes, with appropriate support. The team have also worked to successfully discharge people with dementia from hospital environments, by ensuring that they have appropriate support arrangements in place to continue living within their own home.

Individuals requiring the service will be experiencing a breakdown to the point of crisis as a result of their having dementia, or suspected dementia. Other community services will be unable to support them safely at home and hospital admission is a likely pathway for their care.

Others who will benefit from the service include individuals who are in hospital but who could be discharged sooner with a short period of intensive support.  The team will help to ensure a rapid discharge back home.

The service will be developed in two phases with an initial team for the High Peak and North Dales commencing on 5 February 2018, followed by a team for Chesterfield, Bolsover and North East Derbyshire in April 2018.

From these dates, the teams will be available between 9am – 5pm Monday to Friday.  This is because the service continues to be in development as a full complement of staff is recruited.  Once full staffing is in place, the teams will develop into a seven day a week service (between 8am – 8pm during the week and 9am – 5pm during the weekend).  Subject to successful recruitment, it is anticipated that the service will be fully operational across High Peak and North Dales by September 2018 and across Chesterfield, Bolsover and North East Derbyshire by November 2018.

In the meantime, the team for the High Peak and North Dales have successfully started to see a small number of patients in their own homes, preventing unnecessary admissions into hospital.

Due to the small number of staff currently in place to develop the service, the DRRT has restricted hours within which the service is available.  Therefore if a patient needs more intensive support than is currently available, it may still be necessary for an individual to be admitted following a deterioration in their condition.  As the service continues to develop and employ more staff, its hours will extend and enable those who require daily support to benefit from the DRRT.

The High Peak and North Dales DRRT will, when it is fully staffed, be made up of 20.7 Whole Time Equivalents (WTE). The Chesterfield, Bolsover and North East Derbyshire DRRT will, when it is fully staffed, be made up of 26.4 WTE. The final make-up of both teams will include a range of qualified and registered clinicians across a range of professions including consultant psychiatry, nursing, occupational therapy, physiotherapy and pharmacy.

Derbyshire Healthcare NHS Foundation Trust will monitor the make-up of the DRRT as we roll out implementation to ensure we have the right skills mix to deliver the outcomes we expect and our patients need. Non-registered staff will have undertaken recognised qualifications in the specialist area of care.

To date there are a small number of staff laying the groundwork for the service for the High Peak and North Dales DRRT, which is the first of the two DRRT teams for North Derbyshire. In February staffing levels will increase to 9.7 WTE, which will allow the service to operate Monday to Friday 9am to 5pm. During this initial phase, the service will focus on supporting people at home, who are at risk of hospital admission.

An equivalent service is due to launch in Chesterfield, Bolsover and North East Derbyshire from April 2018.  The two teams will then continue to expand in number and the anticipation is the team for the High Peak and North Dales will be fully operational and fully staffed by September 2018, with Chesterfield, Bolsover and North East Derbyshire following in November 2018.  These timescales are subject to satisfactory recruitment taking place.

The DRRT is for people with a diagnosis of dementia or symptoms consistent with a diagnosis of dementia.  If you are concerned about someone with dementia, please speak to your GP. Your GP will then be able to contact the relevant Community Mental Health Team (CMHT), to discuss whether a referral into the team would be appropriate.
GPs can access the DRRT through their local Community Mental Health Teams (CMHTs) – this is a system that GPs in the area currently use to make referrals for adults and older adults with mental health conditions.

During 2018 there will be two new Dementia Rapid Response Teams developed in the north of the county.   One team will serve High Peak and North Dales, and the other team will serve areas including Chesterfield, Bolsover and North East Derbyshire.

Initial accommodation for the High Peak and Dales DRRT has been identified at Newholme Hospital in Bakewell. An exact location for the Chesterfield, Bolsover and North East Derbyshire DRRT is in the process of being identified, but is likely to be within the existing NHS estate in the area.

The Better Care Closer to Home consultation looked at new ways in which care could be provided to people with dementia who currently received support from community hospitals provided by Derbyshire Community Hospitals NHS Foundation Trust (DCHS).  Evidence suggests that people with dementia are best supported within their home environment where possible and that admission to hospital can be confusing and have a detrimental effect on an individual.

As a result of the Better Care Closer to Home consultation, Derbyshire Healthcare NHS Foundation Trust was commissioned to develop two new Dementia Rapid Response Teams for North Derbyshire, to achieve this aim.  The timescales and processes outlined in this document are consistent with the services commissioned as a result of the consultation.

The Better Care Closer to Home consultation took place 29 June 2016 – 5 October 2016 and put forward a number of proposals to make better joined-up care closer to home a reality for many older people in northern Derbyshire. 

The consultation focused on care closer to home in place of services for:

  • Older people receiving inpatient care in a community hospital, usually following a spell in an acute hospital because of an illness or accident, and
  • Older people with dementia who currently receive services in community hospitals.


For more information, please visit http://www.joinedupcare.org.uk/