How NICE guidance and resources can support delivery of mental health objectives and priorities
Making the case for action
People are now living far longer, but extra years of life are not always spent in good health. They’re more likely to live with multiple long-term conditions or live into old age with frailty or dementia.
Five year forward view
The Five Year Forward View and the Department of Health and Social Care’s Prime Minister’s Challenge on Dementia 2020 highlight the importance of good dementia care. They set out to achieve and maintain a dementia diagnosis rate of at least two-thirds of the estimated number of people with dementia. This includes working with local plans to improve treatment after diagnosis, and support for people with dementia and their carers.
NHS Long Term Plan
The NHS Long Term Plan commits to further improving the care for people with dementia, identifying dementia as an improvement priority. It aims to improve the care provided to people with dementia and delirium, whether they are in hospital or at home.
The National Collaborating Centre for Mental Health’s dementia care pathway outlines how services can ensure that people with dementia or mild cognitive impairment get timely access to a diagnosis and evidence-based post-diagnostic support and treatment. A key element of the dementia care pathway is the delivery of high-quality, NICE evidence-based recommendations in each phase of the well pathways: preventing well, diagnosing well, supporting well, living well and dying well.
Finding the right information
Our guidelines make evidence-based recommendations on topics ranging from preventing and managing specific conditions to planning broader services and interventions to improve the health of communities. They guide decisions about health and care by practitioners, providers, commissioners, service planners and users, and promote integrated care if appropriate.
The easiest way of finding all our guidance related to dementia is on the topic page on dementia. You can also use NICE Pathways, which bring together everything we’ve said on a topic in an interactive flowchart. The main NICE Pathways for this topic are:
The following video explains how to use NICE Pathways.
Making decisions can be affected by things like learning disability, dementia and mental health conditions. The NICE guidance on decision-making and mental capacity and NICE Pathway decision-making and mental capacity can help staff use the Mental Capacity Act.
Using quality standards to make an impact on care and support
Quality standards contain a list of quality statements, each describing a priority area for quality improvement. They include metrics that can be a useful source of key performance indicators or performance metrics for system-wide performance dashboards. They help you identify areas to make high impact improvements in dementia. See how to use quality standards for more information.
The most important quality standards to help you improve care and support for people with dementia are:
Support for improving quality
We publish a range of tools and resources to help with putting our guidance and quality standards into practice. You can find these on the ‘Tools and resources’ tab for each piece of guidance or standard. They include:
- baseline assessment tools (for all guidelines) and a quality standard service improvement template (for all quality standards) to assess whether your services are in line with our guidelines and quality standards
- shared learning case studies showing how organisations have used the guidance or quality standards in practice.
Shared learning case studies
Our shared learning collection contains over 800 case studies showing how organisations around the UK have used NICE guidance and standards to improve the quality of health and social care services. Examples relating to dementia include:
- Stop, look, care.
- How training on positive lifestyle changes can benefit health and social care staff.
- Running cognitive stimulation therapy groups as part of core community mental health teamwork.
- Audit for care homes to show their performance against NICE quality standards.
In the example on audit for care homes above, the Orders of St John Care Trust translated NICE quality standards into audit tools. These were used by 68 care homes to help provide evidence of their performance and to inform their practice. The aim was to deliver care that was consistent with the standards and guidance.
More awareness in the St John Care Trust of NICE guidance and quality standards means that the organisation is now more proactive in responding to NICE quality standards relating to social care.
There are various other tools and resources that support implementation of NICE guidance. These resources differ depending on need for additional implementation support.
We have endorsed these tools produced by other organisations as supporting our guidance.
- Royal Liverpool & Broadgreen University Hospitals NHS Trust Nurse Programme Core competency framework, which supports the recommendations for inpatient nursing care in the NICE guidelines on dementia.
- Alive’s Making a difference: building positive relationships between care staff and residents - care home best practice guides.
- Living well through activity in care homes - The College of Occupational Therapists has produced a toolkit that supports statements on participating in meaningful activity and personal identity.
- Valproate: summary of NICE guidance and safety advice
- Dementia – discussing and planning support after diagnosis.
Patient decision aids
Our NICE guideline on dementia is accompanied by 2 patient decision aids on:
- managing non-cognitive symptoms for those starting antipsychotics and those at risk of harming themselves or others or those who experience agitation, hallucinations or delusions causing distress
- decisions for those who are having problems with eating and drinking.
Other useful tools to improve care and support for people with dementia:
- support for commissioning for mental wellbeing of older people in care homes
- mental wellbeing of older people in care homes video
- NHS England’s dementia overview page has details of resources to support the delivery of good dementia care, including the well pathway for dementia
- NHS England's Dementia: good care planning – information for primary care and commissioners, which has been developed by people with dementia, their carers and health and social care professionals, to enable more effective care planning that is personalised and responsive to peoples’ needs and preferences.
We’ve developed a set of outcome indicators for dementia. Visit our standards and indicators page for more information.
Indicators can be particularly useful to local partnerships when:
- identifying where improvements are needed
- setting priorities for quality improvement and support
- creating local performance dashboards
- benchmarking performance against national data
- supporting local quality improvement schemes
- demonstrating progress that local health systems are making on outcomes.