- National Audit of Dementia Care in General Hospitals 2018-2019: Round Four Audit Report (PDF)
- Round four hospital local reports
- Round four regional reports
- Round four report for Wales (PDF)
- Round four report for Wales in Welsh (PDF)
- Accessible report (PDF)
- Commissioners' report (PDF)
- Casenote Audit national data summary (doc)
- Carer Questionnaire national data summary (doc)
- Carer Questionnaire coding framework (doc)
- Organisational Checklist national data summary (doc)
- Staff Questionnaire national data summary (doc)
- Staff Questionnaire coding framework (doc)
- Eligible ICD10 codes (doc)
- Inter rater reliability analysis (doc)
- Round Four standards (PDF)
- Round 4 standards (pdf)
- Participating hospitals in the fourth round of audit (pdf)
- Outlier Policy (docx)
- Casenote audit data table (England) (csv)
- Casenote audit data table (Wales) (csv)
- Organisational checklist data table (csv)
Data collection tools
- A hospital level organisational checklist (pdf)
- A retrospective casenote audit (pdf) with a target of a minimum of 50 sets of patient notes
- A survey of carer experience of quality of care (pdf)
- A staff questionnaire (pdf) on providing care and support to people with dementia
Guidance for data collection tools
- Sampling for casenote audit (pdf)
- Using the online data entry system (pdf)
- Organisational checklist (pdf)
- Casenote audit questions (pdf)
- Staff questionnaire (pdf)
- Carer questionnaire (pdf)
- Scoring guidance (pdf) - scoring is used for easy comparison between hospitals across different themes of the audit
Other notifications to Trusts
The National Audit of Dementia collects feedback directly from staff working in hospitals and carers for people with dementia. This information includes comments on aspects of care, both positive and negative. Comments which give rise to cause for grave concern may mean that we need to get in touch with a hospital immediately. The procedure we follow in these cases is set out in this guidance prepared by HQIP. When we do this, we do not pass on any details that may lead to the person who made the comment being identified.
All comments from carers are collated and fed back to hospitals immediately data collection closes so that they can start planning actions they need to take straight away, before receiving their local reports with their complete data.
Round 4 includes a spotlight audit on the 'Prescription of Psychotropic Medication', this module forms part of the Quality Account in 2019.
Data collection for the spotlight audit is now closed.
NICE guideline CG42, section 18.104.22.168: People with dementia who develop non-cognitive symptoms or behaviour that challenges should be offered a pharmacological intervention in the first instance only if they are severely distressed or there is an immediate risk of harm to the person or others.
This module was developed based on the advice contained in NICE guideline CG42 (now updated) and aims to explore prescriptions of any psychotropic medication to people with dementia in hospital, ascertaining:
- the number of people with dementia taking already prescribed medication
- the number of people with dementia whose prescription originated in hospital
- the number of people with dementia who were discharged with a prescription in place
- the dosage, dosage route and target symptoms recorded for each medication prescribed
- the number of prescriptions that were reviewed on discharge
- for prescription of antipsychotic medications, whether there is any record that a non-pharmacological intervention was attempted prior to prescription.
Reporting will examine variance in prescribing practice and to look at whether the decrease nationally in prescription of antipsychotic medications has led to an increase in prescription of other medications for behavioural and psychological symptoms of dementia.
Participating hospitals in the spotlight audit on 'Prescription of Psychotropic Medication' (PDF)
The optional casenote audit allows hospitals who wish to participate to build a year on year record of performance to submit further cases.
Data collection for the optional casenote audit is now closed.
Throughout September and October 2019, the NAD team facilitated quality improvement (QI) workshops around England and Wales. The aim of these workshops was to develop practical applications to address hospital-specific shortfalls identified in the round 4 report.
These workshops were open to audit leads, clinicians, QI and governance personnel and any other interested staff. Based on feedback from the workshops we would like to make more resources available for hospitals involved in the audit to help with developing QI projects and facilitate idea sharing between hospitals.
Round 4 action plans
The main focus of the workshops was developing QI projects based on problems identified by the hospitals and making action plans for which we have made an action planning toolkit (see below).
The action plans are for hospitals involved in the audit to write up some of the ways to tackle the problems and QI projects discussed at the workshops. The toolkit includes an action plan template which hospitals can follow but if there are other priority areas of dementia care to work on then please feel free!
We would like to circulate an e-bulletin in the new year containing different cases of best practice and to encourage shared learning. Please could you return completed action plans to the NAD inbox by the 15 November 2019.
We are keen to include case studies in our e-bulletins so if you would like to submit a case study about a successful QI project you have carried out in relation to dementia care in hospitals, then please send a completed case study template form to the NAD inbox. Illustrative case studies from the Round 3 action plans can be found in our e-bulletin below.
- QI workshop hospital presentations
- E-bulletin from round 3 (PDF)
- Improvement Academy - Bronze Level Quality Improvement Training
- Round 4 QI workshop feedback (PDF)
- Future learn QI course
- Quality Improvement in Practice conference, RCPsych, 18 November 2019