Introduction by Sarah McClinton
I was so impressed when I heard about the Live More initiative in Greater Manchester and would like to thank Neil Crowther for this blog, which I am delighted to introduce.
It is particularly timely, as I am pleased to be one of the co-chairs for the Frailty and Dementia Modern Service Framework (MSF) and privileged to work with my fellow co-chairs Jugdeep Dhesi, President of the British Geriatrics Society, and Jeremy Isaacs, NHS England’s National Clinical Director for Dementia. The introduction of MSFs was heralded in the Government’s 10 year health plan and the MSF for Frailty and Dementia embraces both health and social care services.
This is a great opportunity to be ambitious about what is most important to people and how services should best support people living with dementia and/or frailty, and their carers, to live fulfilling lives. We have now held the first task and finish group with a wide range of partners. The Frailty and Dementia MSF is due to be published by the end of this year and I will update on this site as the work progresses.
The Live More programme is designed to help people living with dementia by helping them stay active, connected and well through Shared Lives arrangements. Neil’s blog highlights some of the challenges faced by people with dementia and their families, emphasising the need for early and creative support to maintain wellbeing and reduce pressures on health and social care systems. It is a model that operates on a human scale with relationships and reciprocity at its heart.
Live More – supporting people living with dementia to stay active, connected and well through Shared Lives by Neil Crowther Pictured: Jean and John in Bury. John has Alzheimer's and with his shared lives carer goes to a DYI club and does various joinery projects. Jean is his wife who has described the support for them both as invaluable in allowing her to continue to support John at home. Photographer: Lindy Rogers PhotographyWhat matters?
In 2024 Think Local Act Personal asked people with dementia and their families what mattered to maintaining their wellbeing. People emphasised having a life beyond dementia, feeling recognised and having opportunities to be helpful, staying connected and not feeling alone, while family carers point specifically to the importance of time out of regular, meaningful time out. Yet across much of the country there is an absence of good support for people to do so, with too many people and families living with dementia struggling alone. The cost to them is disconnection, isolation and fast declining health and wellbeing, often only appearing on the radar of the NHS and adult social care when they reach crisis-point.
The cost of delay in reaching people is significant avoidable system pressures. For example:
An estimated 70–80% of residents in residential and nursing homes have dementia People with dementia visit their GP up to three times more often each year than someone of the same age without dementia Around 25% of acute hospital beds are occupied by people with dementia at any given time (Alzheimer's Society (2024) The Economic Impact of Dementia)It’s clear then, given the scale of this challenge, that the ambitions of the NHS Ten Year Plan and those related to adult social care will only be realised through concerted action to reach people and families living with dementia earlier, with targeted, flexible and creative support. Yet, as the Nuffield Trust observed in 2024 ‘there has been only patchy development of new or innovative services to meet changing needs, preferences and individual circumstances (of people living with dementia).’
Pictured: Jean and John in Bury. Photographer: Lindy Rogers PhotographyAct early, live more
A unique partnership across Greater Manchester (GM) is hoping to buck this trend, pioneering a new way of harnessing Shared Lives support to help people with dementia and their families to be or stay connected to their communities and do things they value. As part of Greater Manchester’s commitment to supporting people to live well with dementia, the support is designed to reach people earlier than typically reached by adult social care at present, with the hope that this redirection of resources to support early action will reduce pressure on the health and care system later on.
While Shared Lives is a well-established and leading approach to care and support, it is not yet widely offered to people with dementia and their families. In the Live More pilot, local Shared Lives schemes across GM are carefully matching and bringing together people with dementia with approved ‘shared lives carers’ to spend time together each week, being and doing the things that matter to them. Already in GM this includes everything from going to watch Oldham’s football and having a post-match pint, to visiting the Transport Museum, doing some gardening, or buying ingredients to make a family-favourite meal together and treat their spouse again. It’s connections like these which are helping people maintain their identity and sense of belonging, at a time when life and relationships go through a disorientating transition, and which simultaneously offer families some time out.
Pictured: John and Jean in Bury. Photographer: Lindy Rogers PhotographyMeasuring impact
In partnership with GM Association of Directors of Adult Social Services, Shared Lives Plus are facilitating and guiding the ten GM schemes to deliver this test and conducting a robust evaluation. We are using Treasury-compliant social return on investment methodology to identify economic value and cost-avoidance alongside participatory methods to capture people’s own account of the impact of the support for their health and wellbeing. We will share the findings this summer.
A number of other areas are mounting their own local Live More experiments, including Liverpool, Stoke-on-Trent and Hartlepool and we hope these sites will continue to grow in number. Ultimately, we believe Shared Lives will work best when it’s connected to and helps stitch together wider local neighbourhood ecosystems of support and connection at every stage of people’s experience of dementia. We are in the early stages of Planning phase 2 of Live More, with a view to securing sites to pilot such an ‘ecosystem’ approach, so if you if you are interested, please get in touch.
Life, and living life with dementia, gets better when it’s shared.
For more info about Live More
seen at 10:40, 8 April in Social work with adults.