4. Improve monitor review

Drive improvement; monitor and review

Questions to consider

  • what levers can be used to drive quality, innovation, prevention, productivity, and performance?

DRIVER: Incentives

ActionsResourcesExamples
Introduce incentives to promote focused action to improve recognition, screening, and access to diagnosis in primary and secondary care, community services, and local communities (LES, DES, CQUINs).
  • Bristol dementia practice incentive scheme

    An NHS Bristol incentive scheme which has achieve over 50% sign up and from those practices, nearly 250 people were identified as having dementia and added to the registers. The biggest improvement was 37 people in one practice (2012-13). Read more »

  • Stockport local enhanced scheme 2012-13

    This scheme, led by Stockport Clinical Commissioning Group, offers examples of partnership working between primary care, secondary care, social care and third sector organisations, to assist people with dementia and their carers/family in living healthily and well in the community. Read more »

  • Torbay Local Enhanced Scheme 2011-12

    This programme has helped practices to use examination of their patient register to identify patients with confusion or memory problems who might be in the early stages of dementia and/or whose condition may have deteriorated. Read more »

  • Wirral Local Enhanced Service for Dementia

    This sets out Wirral Clinical Commissioning Group’s shared care arrangements for people diagnosed with dementia through a GP Local Enhanced Service for Dementia Care. Read more »

Ensure care pathways, systems, information and training are in place to support local implementation of national dementia CQUIN.

With local stakeholders, track progress, address challenges. Monitor referrals to memory assessment services in order to measure impact and outcomes.

Quality assure processes, delivery and outcomes.

Enable and support stakeholders to access pump priming monies to support local innovation, and implementation of innovations in dementia in order to accelerate change and improvement.

DRIVER: Quality improvement

ActionsResourcesExamples
Work with pharmacists, primary, community, and secondary care providers to improve prescribing of (a) anti-dementia drugs; and (b) antipsychotics
Design, facilitate and promote engagement with general practices and primary health care teams to develop, implement and review general practice dementia care improvement plans.

Link this to education and training initiatives and opportunities (Key Step 6: Educate; promote)

  • Gloucestershire dementia strategy

    The Gloucestershire dementia strategy recognises the pivotal role of primary care staff, and GPs in particular, in diagnosing dementia and in subsequently co-ordinating care across a range of services. Read more »

  • Quality outcomes tool for general practice

    The NHS London quality outcomes tool for general practice provides bundles of outcome indicators for general practices to promote transparency, manage performance, and identify opportunities for improvement. Read more »

  • Somerset dementia strategy

    Somerset dementia strategy provides a framework to implement improved, responsive and quality services for people with dementia and their carers across Somerset. The accompanying action plan outlines work underway to achieve the strategy objectives. Read more »

DRIVER: Performance management

ActionsResourcesExamples
Monitor delivery of local diagnosis improvement trajectories at General Practice, and/or CCG level. With stake holders, consider

  • variation and range
  • factors affecting the capture and recording of dementia diagnosis
  • action to close gaps.

Set trajectories/ambitions, driving improvement via General Practice Contract, quality schedule, training plans.