Dementia - National strategies and standards

Each country within the UK has an active dementia programme. You can use this page to familiarise yourself with the national strategies for dementia and national standards and guidelines specific to dementia care for each of the UK countries. Related strategies for carers and for end-of-life care are also included.

In other sections of this website you can also:

The resources are arranged by country:

Some of the resources on this page are in PDF format - see how to access PDF files.

England

Department of health (2012) Dementia challenge champion groups report on progress
This progress report Delivering major improvements in dementia care and research by 2015: a report on progress (PDF 4527.2KB) provides an update on the dementia challenge and outlines the aims, achievements and ambitions of the challenge’s three champion groups. The accompanying annex summarises the progress made by the champion groups on the key commitments and actions included in the Prime Minister’s Challenge on Dementia document. See: Summary of progress against key commitments and actions (PDF 350.6KB).

Department of Health (2012) The Prime Minister's challenge on dementia
The Prime Minister has launched a programme of work which aims to deliver major improvements in dementia care and research by 2015. The challenge builds on the achievements of the national strategy and focuses on improvements in awareness, quality care and research.
The challenge is set alongside the annual report published by the Alzheimer's Society which presents new evidence from a survey and draws on existing research to explore how well people are living with dementia in 2012 in England, Wales and Northern Ireland. To read the Alzheimer's Society report see Dementia 2012 a national challenge.

Department of Health (2009) Living well with dementia: a national dementia strategy
The strategy highlights three key areas - improved awareness, earlier diagnosis and intervention, and higher quality care. It identifies 17 key objectives which when implemented locally should bring about significant improvements in services and greater understanding of the causes and consequences of dementia.

Department of Health: National dementia strategy
This page within the DH website brings together key documents supporting the strategy.

Department of Health (2011) Dementia Commissioning Pack
The Dementia Commissioning Pack provides practical resources for health and social care commissioners to work together to improve the quality of both specialist dementia services and general health and care services for people with dementia and their carers. It highlights four aims: early diagnosis and interventions; better care at home or care home; better care in hospital; and appropriate use of antipsychotic medication.

Department of Health (2011) National dementia strategy: Equalities action plan
This Equalities action plan sets out a series of planned actions in relation to the implementation of the national dementia strategy and the Dementia Commissioning Pack. It supplements the equality impact assessment published alongside the national dementia strategy in 2009 and has been compiled in line with the requirements of the Equality Act 2010.

National Audit Office (2010) Improving dementia services in England – an interim report
This report assesses the responses to a report published by the Audit Commission in 2007 which concluded that dementia services in England were not providing value for money, and also assesses the robustness of the National Dementia Strategy and Implementation Plan. The report makes a series of recommendations identifying key risk areas and how they can be addressed.

NHS Choices: Dementia. If you’re worried, see your doctor
This campaign raises awareness of the early signs and symptoms of dementia. It is aimed at encouraging more people to seek an early diagnosis of dementia, the campaign targets the family and friends of people at risk of dementia who are likely to be the first to see the signs and can encourage their loved one to see their GP. 

Royal College of Psychiatrists (2011) National Audit of Dementia
The National Audit of Dementia is working with hospitals in England and Wales that provide general acute inpatient services, to measure criteria relating to care delivery which are known to impact on people with dementia admitted to hospital. The first round of audit took place in 2010, and the second round of audit is due to take place in the Spring of 2012. The first report has found that hospitals in England and Wales are falling short in the care given to dementia patients, with not all hospital staff having the skills to cope with the demands of some dementia patients. View: Report of the National Audit of Dementia Care in General Hospitals 2011 (PDF 3.1MB). An executive summary (PDF 493KB) is also available.

Related strategies

Department of Health (2010) Recognised, valued and supported: next steps for the Carers Strategy
This strategy identifies the actions that the Government will take over a four year period to support its priorities to ensure the best possible outcomes for carers and those they support. It updates the strategic vision and outcomes for carers set out in the carer’s strategy published in 2008. See: Carers at the heart of 21st-century families and communities.

A report from CIRCLE (Centre for International Research on Care, Labour and Equalities) published in November 2011, presents the findings of the national evaluation of the Department of Health’s Demonstrator Sites (DS) programme which aimed to improve carers’ health and well-being in line with the 2008 strategy. The report looks at the impact and effectiveness of 25 multi-agency projects which were set up to explore new ways of supporting carers in England - see New approaches to supporting carers’ health and well-being: evidence from the National Carers’ Strategy Demonstrator Sites programme. 
 
Department of Health (2008) End of life care strategy: promoting high quality care for all adults at the end of life
This strategy sets out a care pathway to provide people approaching the end of life with more choice about where they would like to live and die. It encompasses all adults with advanced, progressive illness, including dementia.

Standards and guidelines

National Institute for Health and Care Excellence (2013) Commissioning guide CMG48: NICE support for commissioners of dementia care
This resource supports commissioners, clinicians and managers to commission high-quality evidence-based care for people with dementia and their carers. Making commissioning decisions based on NICE guidance and standards and other NICE accredited evidence can help commissioners use their resources effectively to improve the quality of health and social care for people with dementia. This guide updates and replaces the previous NICE commissioning guides on memory assessment services (2007) and end of life care for people with dementia (2010).

National Institute for Health and Care Excellence (2013) Supporting people to live well with dementia (QS30)
This quality standard covers the care and support of people with dementia. It applies to all social care settings and services working with and caring for people with dementia. It should be read alongside the NICE Dementia quality standard (QS1) which covers care provided by health and social care staff in direct contact with people with dementia in hospital, community, home-based, group care, residential or specialist care settings.

National Institute for Health and Clinical Excellence (2010) Dementia quality standards
This NICE quality standard defines a high standard of dementia care. It provides specific, concise quality statements, measures and audience descriptors to provide patients and the public, health and social care professionals, commissioners and service providers with definitions of what a high-quality dementia service should look like.
 
National Institute for Health and Clinical Excellence Clinical guideline (2006) Dementia: supporting people with dementia and their carers in health and social care (CG42)
This guideline makes specific recommendations on Alzheimer's disease, dementia with Lewy bodies (DLB), frontotemporal dementia, vascular dementia and mixed dementias, as well as recommendations that apply to all types of dementia.

Northern Ireland

Department of Health, Social Services and Public Safety (2011) Improving dementia services  in Northern Ireland: a regional strategy (PDF 481KB)
The strategy identifies areas where improvements need to be made in the way services for people with dementia and their carers are delivered. Key messages in the strategy are on: prevention and delay of onset; raising awareness and addressing stigma; access to early diagnosis and enhancing memory services; a staged approach to care; improving staff awareness and skills; redesign of services to provide care and support, as far as possible in people’s own homes.
See also the news item: Dementia strategy will improve services in Northern Ireland.

Related strategies

Department of Health, Social Services and Public Safety (2006) Caring for carers:  recognising, valuing and supporting the caring role (PDF 440KB)
This strategy document has been developed around six key areas: identification and interface with carers; information for carers; support services for carers; young carers; training; employment. For related documents and further information see also the page on the DHSSPS website for Carers.

Department of Health, Social Services and Public Safety (2010) Living matters, Dying matters: a palliative and end of life care strategy for adults in Northern Ireland (PDF 1.92MB)
The strategy sets out “a vision for palliative and end of life care across all conditions and care settings, based on what people value most and expect form such care”. It recommends the concept of a Model for Palliative and End of Life Care as a vehicle for delivering high quality care.

National standards

Department of Health, Social Services and Public Safety: Service framework for mental health and wellbeing
The Framework, one of a series of service frameworks, sets out 58 standards in respect of the prevention, assessment, diagnosis, treatment, care, and rehabilitation of individuals and communities who currently have, or are at greater risk of developing, mental illness. Standards specific to dementia focus on early assessment, investigation and treatment and the provision of information, education and support to people with dementia and their carers.

Scotland

Scottish Government (2010) Scotland’s national dementia strategy
The strategy adopts the principles set out in the Charter of Rights for People with Dementia and their Carers in Scotland and identifies five key challenges that need to addressed if improvements in outcomes for people with Dementia are to be achieved. It sets out a model for change and key action points which include the development of standards and a skills and knowledge framework. The strategy has long-term objectives but focuses on action over a three year period.
Dementia Demonstrators
Delivering the improvements promoted by this strategy within the current financial context, “will require significant pathway redesign work to move resources around the current system”.  A range of national programmes are working together with three health and social care partnerships; Midlothian CHP, North Lanarkshire CHP and Perth & Kinross CHP, to demonstrate how a whole system redesign project can work and deliver real improvements within the current financial climate. Information about this initiative is made available via the Dementia Managed Knowledge Network. A briefing about the Dementia Demonstrator sites published in December 2012 is also available.

Scottish Government: HEAT standard for dementia
The standard supports a commitment to achieve improvements in the early diagnosis and management of people with dementia. This is measured by the number of people with a diagnosis of dementia on the Quality and Outcomes Framework (QOF) dementia register and other equivalent sources. "The number of people on this register increased from 40,195 in 2010/11 to 41,525 in 2011/12, an increase of 3.3 per cent.". See also: Mental Health Collaborative: dementia.

Related strategies

Scottish Government (2012) Mental health strategy 2012-2015. The strategy brings the mental health improvement work in Scotland and work to improve mental health services together for the first time in a single strategy. It sets out a range of key commitments across the full spectrum of mental health improvement, services and recovery to ensure delivery of effective, quality care and treatment for people with a mental illness, their carers and families. The strategy has been republished in November 2012 with corrections.

Scottish Government (2010) Caring together: The carers strategy for Scotland 2010-2015
This strategy document from the Scottish Government and COSLA (Convention of Scottish Local Authorities) sets out ten key action points to improve support for carers. The focus is on “improved identification of carers, assessment, information and advice, health and wellbeing, carer support, participation and partnership”.

Scottish Government (2008) Living and dying well: a national action plan for palliative and end of life care in Scotland
The plan aims to ensure that good palliative and end of life care is available in a “consistent, comprehensive, appropriate and equitable manner across all care settings in Scotland”. It uses the concepts of assessment and review, planning and delivery of care, and communication and information sharing as a framework to support a person-centred approach, and harnesses the skills, knowledge and experience of related initiatives.

Standards and guidelines

Scottish Government (2011) Standards of care for dementia in Scotland: action to support the change programme, Scotland's national dementia strategy
These standards have been developed to help people with dementia and their carers understand their rights and receive the support they require to "stay well, safe and listened to". They are intended to ensure that the quality of dementia is in line with the Charter of Rights for People with Dementia and their Carers and apply to people living in their own homes, care homes or hospitals, especially general hospitals. The standards are measurable and example measures are included. Case studies are also included which demonstrate how the standards can inmprove care. The standards document needs to be used in conjunction with the skills framework  developed for health and social care staff. See: Promoting excellence.

Scottish Intercollegiate Guidelines Network (2006) SIGN 86: Management of patients with dementia
The guideline considers investigations and interventions in which direct benefit to the patient can be demonstrated. It covers all stages of dementia excluding mild cognitive impairment. The guideline does not address palliative care in advanced disease, risk or prevention.

NHS Quality Improvement Scotland (NHS QIS) (2007) Standards for integrated care pathways for mental health
This provides process standards, service improvement standards, generic care standards and condition-specific standards which include standards for dementia. The actions set out in the national dementia strategy highlighted the need to accelerate implementation of the dementia integrated care pathway. The accompanying toolkit aims to provide support to local care pathway developments and implementations that meet national mental health care standards. As well guidance on generic care the toolkit has condition-specific guidance on an ICP for dementia. This cross refers to the relevant standards in 'Standards for integrated care pathways for mental health'. See: Toolkit for Integrated Care Pathways for Mental Health: dementia.

Wales

Health in Wales: Dementia
Health in Wales aims to provide people in Wales including NHS staff with information and links to key information about the health of the population in Wales and services provided by NHS Wales. This page on dementia brings together the policy context, service planning and delivery and publications.
 
Welsh Assembly Government (2011) National dementia vision for Wales
This document presents the Welsh Assembly Government's long term vision to create 'Dementia Supportive Communities'. Four priority areas for improvement have been identified: better joint working across health, social care, the third sector and other agencies; improved early diagnosis and timely interventions; access to better information, support and advocacy for people with dementia and their carers; improved training for those delivering care including research. The document sets out a series of commitments describing what will be done in each of these areas.
Dementia stakeholder groups – action plans
Four stakeholder groups have developed action plans for the four priority areas.

Related strategies

Welsh Government (2012) Together for Mental Health - A Strategy for Mental Health and Wellbeing in Wales
This is an all age, cross-Governmental strategy for improving the lives of people using mental health services, their carers and their families. At the heart of the strategy is the Mental Health (Wales) Measure 2010, which places legal duties on Health Boards and Local Authorities to improve support for people with mental ill-health.

Welsh Assembly Government (2007) Carers strategy for Wales action plan 2007 
This 2007 action plan represents a refocused and contemporary carers’ strategy updating the original strategy of 2000. The document describes areas of progress made since 2000 and sets out the Welsh Assembly Government’s strategic direction for carers. It identifies key action points to be undertaken between 2007 and 2009.

1000 Lives Plus: Dying Well Matters
The Dying Well Matters initiative will invite patients and families to share their experiences through a number of methods including the internet and by letter. Improvement in palliative and end of life care are being driven forward by the Palliative Care Strategy Implementation Board.
Further information is available in a report from the Wales Palliative Care Implementation Board: Dying Well Matters. 3 years on (2008-2011) (PDF 1.81MB).

Standards and guidelines

National Institute for Health and Clinical Excellence (2010) Dementia quality standards
This NICE quality standard defines a high standard of dementia care. It provides specific, concise quality statements, measures and audience descriptors to provide patients and the public, health and social care professionals, commissioners and service providers with definitions of what a high-quality dementia care service should look like.
 
National Institute for Health and Clinical Excellence Clinical guideline (2006) Dementia: supporting people with dementia and their carers in health and social care (CG42)
This guideline makes specific recommendations on Alzheimer's disease, dementia with Lewy bodies (DLB), frontotemporal dementia, vascular dementia and mixed dementias, as well as recommendations that apply to all types of dementia.