Dementia NICE quality standard

1. Dementia NICE quality standard August 2011

2. What this presentation covers • Background to quality standards • Publication partners • Dementia quality standard • The quality statements • Find out more • NICE Pathways • NHS evidence

3. Quality standards • A quality standard is a set of specific, concise statements that: • act as markers of high-quality, cost-effective patient care across a pathway or clinical area, covering treatment and prevention • are derived from the best available evidence such as NICE guidance or other NHS evidence accredited sources • are produced collaboratively with the NHS and social care, along with their partners and service users

4. Publication partners • These organisations share NICE's commitment to improve quality by making it clear what quality care is. • Some of the organisations who have been involved in the development process, and who endorse the dementia quality standard, have become partners in its publication. • These organisations are: • Alzheimer’s Society • Royal College of Psychiatrists • Social Care Institute for Excellence

5. Dementia quality standard • This quality standard provides clinicians, managers and service users with a description of what a high-quality dementia service should look like • It describes markers of high-quality, cost effective care that, when delivered collectively, should contribute to improving the effectiveness, safety, experience and care for adults with dementia • The quality standard consists of 10 quality statements

6. Quality statement 1 • People with dementia receive care from staff appropriately trained in dementia care Quality measure Process: Proportion of staff working with people with dementia who have dementia care training

7. Quality statement 2 • People with suspected dementia are referred to a memory assessment service specialising in the diagnosis and initial management of dementia Quality measure Process: Proportion of people with suspected dementia who are referred to a memory assessment service specialising in the diagnosis and initial management of dementia

8. Quality statement 3 • People newly diagnosed with dementia and/or their carers receive written and verbal information about their condition, treatment and the support options in their local area Quality measure Process: Proportion of people newly diagnosed with dementia receiving written and verbal information about their condition, treatment and the support options in their local area

9. Quality statement 4 • People with dementia have an assessment and an ongoing personalised care plan, agreed across health and social care, that identifies a named care coordinator and addresses their individual needs • Quality measure • Process: • Proportion of people with dementia whose individual needs are assessed and whose care plan states how those needs will be addressed. • Proportion of people with a named health or social care coordinator

10. Quality statement 5 • People with dementia, while they have capacity, have the opportunity to discuss and make decisions, together with their carer/s, about the use of: • advance statements • advance decisions to refuse treatment, • lasting power of attorney • preferred priorities of care

11. Quality statement 5: continued • Quality measure • Process: • Proportion of people with dementia while they have capacity and their carer/s, who are given the opportunity to discuss with health and social care professionals, the use of: advance statements, advance decisions to refuse treatment, lasting power of attorney and preferred priorities of care

12. Quality statement 6 • Carers of people with dementia are offered an assessment of emotional, psychological and social needs and, if accepted, receive tailored interventions identified by a care plan to address those needs • Quality measure • Process: • Proportion of carers of people with dementia who are offered an assessment of their needs • Proportion of carers of people with dementia receiving interventions tailored to their needs

13. Quality statement 7 • People with dementia who develop non-cognitive symptoms that cause them significant distress, or who develop behaviour that challenges, are offered an assessment at an early opportunity to establish generating and aggravating factors. Interventions to improve such behaviour or distress should be recorded in their care plan

14. Quality statement 7 continued • Quality measure • Process: • Proportion of people with dementia who develop non-cognitive symptoms that cause significant distress, or who develop behaviour that challenges, who receive an assessment to establish likely factors that may generate, aggravate or improve such distress or behaviour.

15. Quality statement 7: continued • Quality measure • Process: • b) Proportion of people with dementia who develop non-cognitive symptoms that cause them significant distress, or who develop behaviour that challenges, with an individualised care plan identifying actions to address the distress or behaviour.

16. Quality statement 7: continued • Quality measure • Process: • c) Proportion of people with dementia with mild-to- moderate non-cognitive symptoms who are prescribed anti-psychotic medication. (Goal to be 0% reflecting the Department of Health report on the use of anti-psychotic medication for people with dementia and its aim to reduce the use of anti-psychotic medication for people with dementia.)

17. Quality statement 8 • People with suspected or known dementia using acute and general hospital inpatient services or emergency departments have access to a liaison service that specialises in the diagnosis and management of dementia and older people’s mental health

18. Quality statement 8: continued Quality measure Process: Proportion of people with suspected or known dementia using acute and general hospital facilities that are assessed by a liaison service that specialises in the diagnosis and management of dementia and older people’s mental health

19. Quality statement 9 • People in the later stages of dementia are assessed by primary care teams to identify and plan their palliative care needs Quality measure Process: Proportion of people in the later stages of dementia whose palliative care needs are assessed by primary care teams and the resulting information is communicated within the team and with other health and social care staff

20. Quality statement 10 • Carers of people with dementia have access to a comprehensive range of respite/short-break services that meet the needs of both the carer and the person with dementia Quality measure Process: Proportion of carers of people with dementia who access respite/short-break services when required

21. Find out more • Visit www.nice.org.uk/guidance/CG42 for the following NICE dementia guideline products: • the NICE guideline • the quick reference guide • ‘Understanding NICE guidance’ • costing report and template • clinical audit tool • memory assessment service commissioning guide • end of life care for people with dementia commissioning guide

22. NICE Pathway • The NICE Dementia pathway covers supporting people with dementia and their carers in health and social care. It includes the quality standard statements and all NICE products on Dementia. • The pathway looks at: • Dementia diagnosis and assessment • Dementia interventions Click here to go to NICE Pathways website

24. NHS Evidence Visit NHS Evidence for the best available evidence on all aspects of Dementia Click here to go to the NHS Evidence website