NICE publish dementia commissioning guide: practical advice for commissioners

NICE have published a new guide to help commissioners provide evidence-based care for people with dementia.

Providing care for our ageing population seems not to have been out of the news in recent years and rightly so, especially as the headline stories are frequently not positive. A recent Care Quality Commission report found that people living in a care home and suffering from dementia are more likely to go to hospital with avoidable conditions such as urinary infections. Once there, they are more likely to stay longer, be readmitted or die than those without dementia (Care Quality Commission, 2013).

This new commissioning guide draws on the existing quality standards for dementia (NICE, 2010) and focuses on the following areas:

Improving early intervention, assessment and diagnosis

If you missed Martin Brunet's blog on dementia screening back in December, read it now.

If you missed Martin Brunet’s blog on dementia screening back in December, click on the grizzly and read it now.

Over 50% of people with dementia never receive a diagnosis, which inhibits their access to health and social care services. The message from NICE is that early diagnosis will help people plan and receive treatment and care earlier, preventing future crises.
Clearly this needs to be set in context and the practicalities of how we improve diagnosis rates needs to be carefully considered. As we know, dementia screening doesn’t work and many health professionals are vehemently opposed to elements of the Prime Minister’s challenge on dementia (Department of Health, 2012).

Supporting people to live well with dementia

Increased investment in the identification of people with dementia has meant that greater numbers of people are being diagnosed with the condition, often at an early stage.
The commissioning guide makes it clear that significant investment in services for people to live well and independently with dementia, will help prevent crises and in turn may avoid distressing hospital admissions and reduce the avoidable use of residential care.
This is no small commitment. It is estimated that dementia costs the English economy about £20 billion every year and that this will increase to over £27 billion by 2018.

Improving support for carers

A key component of the Prime Minister’s challenge on dementia. There are around 670,000 people in the UK acting as primary carers for people with dementia and they save the economy millions each year. However, carers often need greater emotional, psychological and social support.

The commissioning tool (Excel spreadsheet) that accompanies this guide enables commissioners to show how well they are performing against a range of outcome measures that together demonstrate how well the whole system is working. Where data is available, the tool also demonstrates where improvements against outcome measures have prevented or reduced avoidable expenditure in the health and social care system.

So, just a few thousands pages to read for anyone tasked with the responsibility of commissioning dementia care. Good luck!