National Audit of Dementia Round 5 & 6
Round 5 of the audit (reporting 2023) used a new sampling methodology and guidance, following successful piloting. This was repeated for Round 6, reporting end of 2024.
The National Report for Round 6 (PDF) of the audit has now been published.
Audit standards, tools and guidance
Standards for Round 5 & 6 (PDF)
Round 6 tools and guidance
Data collection for the mandatory period of the audit took place between August and January 2023. Data collection for the optional flex period of the audit took place between March and May 2024.
For this round of audit, the sample will be identified by prospective identification of patients with dementia or possible dementia as they are admitted to the hospital.
Casenote audit components
1. Identification of eligible patients.
Taking a period of at least 4 weeks (14 August- 10 September) identify all patients with dementia (or probable dementia) admitted to your hospital, submitting demographic and admitting condition information. You may take beyond 4 weeks to identify patients if you have less than 40-80 patients who have dementia admitted during that time.
Casenote audit part one (PDF)
2. Data entry using a focussed data set for a sample of patients.
From 14 August onwards, you can submit data on your sample (first 40-80 patients based on consecutive admissions). By 13 November complete all Part 1 and 2 data.
Casenote audit part two (PDF)
3. Discharge information
By 12 January, complete all records with discharge date and destination.
For this round of audit, the sample will be identified by prospective identification of patients with dementia or possible dementia as they are admitted to the hospital.
Casenote audit components
1. Identification of eligible patients.
Taking a period of at least 4 weeks (29 January - 25 February) identify all patients with dementia (or probable dementia) admitted to your hospital, submitting demographic and admitting condition information. You may take beyond 4 weeks to identify patients if you have less than 20-40 patients who have dementia admitted during that time.
For the Flex Period, please number your patients newly identified from 29 January beginning NAD301 onwards.
2. Data entry using focussed data set for a sample of patients.
From 29 January onwards, you can submit data on your sample (first 20-40, depending on your Autumn entry). The deadline for all Part One and Two data is 11 April 2024.
3. Discharge information
By 31 May, complete all records with discharge date and destination.
Items from the casenote audit have been provisionally selected for outlier analysis with the approval of the Steering Group. See measures approved by the October 2022 meeting of the Steering Group. (PDF)
Patient feedback
Carer questionnaire
The Annual Dementia statement collects information about your hospital relating to care provision and monitoring of the quality of care for people with dementia.
The output is a series of statements demonstrating the achievement and progress your hospital has made in its work to ensure a good standard of care.
ADS guidance document (PDF)
1. Is the audit part of the Quality Account and are hospital Trusts expected to take part?
Yes, this audit is part of the Quality Account and therefore participation is expected for general acute hospitals.
2. Is this audit UK-wide?
The audit is for general acute hospitals in England and Wales. Contact us if you want to discuss participation/use of audit tools for hospitals elsewhere.
3. Is data collection per site, or across the Trust?
This audit remains a site level audit.
4. How long will the data collection tool/period be open for?
The mandatory data collection period is 14 August until 10 September 2023.
5. How many patients do we need to identify in the four-week period?
We are asking for a minimum of 40 in the mandatory data collection period. We have reviewed the sample sizes for this round of audit in relation to the selected sample (parts 2 and 3). Please see Round 6 Varying Sample Size Guidance (PDF)
If you think that you will have less than 40 patients over the four-week period, please get in touch with us to discuss your options.
6. If a patient is admitted with more than one subtype of dementia, which one is selected?
In these instances, please provide the first recorded subtype.
7. If a patient is admitted with more than 1 condition (e.g. delirious with a UTI) which do we record?
In these instances, please report the primary admitting condition.
8. Is the Annual Dementia Statement per hospital site, or per Trust?
We require one Annual Dementia Statement per hospital. Please note some of the questions are at Trust level.
9. If we have a digital system what information should we be requesting?
Your digital system may contain a field which identifies (via selection of a screening tool or other means) patients with a recorded (or probable) diagnosis of dementia. The patient list can be extracted from this data field.*
10. What if we do not have a digital system in our hospital?
The audit co-ordinator will require information forwarded to them when people with dementia are identified, eg a weekly list from wards.*
11. Do we need to apply National Data Opt Out for NAD Round 6?
The National Data Opt Out only applies for processing confidential patient data where the Duty of Confidentiality is met via S.251 approval.
As this audit is not collecting any identifiable data requiring Section 251 approval then it is out of scope of the NDOO.
12. Part 1 of the Casenote Audit tool asks whether the patient has been in hospital for 24 hours or more. Does this include time in Emergency Department?
Patients who have only attended A&E/ED should not be counted. Patient time in ED may be counted, but only if there is a Decision to Admit and from that point onwards.
13. For Dementia/Delirium Assessment and Pain Assessments, if these were done in Emergency Department, would they be recorded as “Yes, done within 24 hours”.
Assessments done in ED immediately prior to admission should be recorded as ‘Yes within 24 hours’ (and the date given will be the date of admission).
14. What level of training is required for ADS question 6.3. 'Please give the number of AHPs in your Trust who have a subspeciality/ specific special interest in dementia.'
This should be a qualification amounting to a specialism in dementia, which may be multi-component dependent on the discipline as we understand, beyond tier 2 training.
15. We do not know what our NHS code is – where can we find it?
All sites have a designated NHS site code that can be found here.
We advise sites to select ‘NHS Trust site’ from the ‘Type’ drop down menu and input their hospital site name and postcode.
You will be presented with a list of options:
The ‘type’ should be NHS Trust site and the ‘state’ should be open. (If your service is in Wales, choose ’Local Health Board Site' from the drop down menu).
To view a result more closely, click on the link and more information will appear. The ‘parent’ should be the name of your NHS Trust. If these details match, provide us with the hospital code assigned to that link.
*If you would like to discuss information available to you for prospective ID, please contact the NAD team.
Round 5 tools and guidance
Data was collected between September 2022 and January 2023. Audit tools and guidance can be found below.
The National Report for Round 5 of the audit was published on 10 August 2023. Please use our special NAD feedback page to provide any comments.
Acute hospitals are eligible to participate if they have more than one ward admitting adult patients for 24 hours or longer.
Guidance on the new data collection tool, including login and data submission (PDF) is available
(PDF)Timeline for the next round of audit
Information about the timeline, content and tools (PDF) is available.
Audit preparation webinars - 7 and 8 July 2022
We held webinars in preparation for the next round of audit. These included the rationale behind the new components of the audit and the difference the new prospective audit will make.
- View the webinar recording.
- View the webinar PowerPoint slides (PPT).
For this round of audit, the sample will be identified by prospective identification of patients with dementia or possible dementia as they are admitted to the hospital.
- Timeline and Content Summary (PDF)
- Casenote Sampling Guidance (PDF)
- Example spreadsheet to aid patient identification and data collection
Casenote audit components
1. Identification of eligible patients
Over a 4-week period (19 September – 14 October), identify all patients with dementia (or probable dementia) admitted to your hospital, submitting demographic and admitting condition information.
Casenote audit part one (PDF)
2. Data entry using focussed data set for a sample of patients
Between 17 October and 3 January, submit data using the focussed data collection tool and new data entry platform. Depending on whether you are submitting all your data at this time, the minimum sample is 40 or 80 patients. The patients will be the first 80 admitted during your sampling period.
Casenote audit part two (PDF)
3. Discharge information
Complete all records with discharge date and destination.
For this round of audit, the sample will be identified by prospective identification of patients with dementia or possible dementia as they are admitted to the hospital.
- Casenote Sampling Guidance- Flex Period (PDF)
- Example spreadsheet to aid patient identification and data collection
Casenote audit components
1. Identification of eligible patients.
Over a 4-week period (6 March – 5 April), identify all patients with dementia (or probable dementia) admitted to your hospital, submitting demographic and admitting condition information.
For the Flex Period, please number your patients newly identified from 6 March beginning NAD301 onwards.
Casenote audit part one- Flex Period (PDF)
2. Data entry using focussed data set for a sample of patients.
Part Two sample size depends on how many further records you decide to enter towards your yearly target. The deadline for all Part One and Part Two data submission is 29 May.
Casenote audit part two- Flex period (PDF)
3. Discharge information
Complete all records with discharge date and destination. Part Three data entry is from 1 June- 14 July.
Casenote audit part three- Flex Period (PDF)
Items from the casenote audit have been provisionally selected for outlier analysis with the approval of the Steering Group. See measures approved by the October 2022 meeting of the Steering Group. (PDF)
The Annual Dementia statement collects information about your hospital relating to care provision and monitoring of the quality of care for people with dementia.
The output is a series of statements demonstrating the achievement and progress your hospital has made in its work to ensure a good standard of care.
ADS guidance document (PDF)
1. Is the audit part of the Quality Account and are hospital Trusts expected to take part?
Yes, this audit is part of the Quality Account and therefore participation is expected for general acute hospitals.
2. Is this audit UK-wide?
The audit is for general acute hospitals in England and Wales. Contact us if you want to discuss participation/use of audit tools for hospitals elsewhere.
3. Is data collection per site, or across the Trust?
This audit remains a site level audit. Each hospital site is requested to aim for a yearly sample based on 80 patients. Please note you can split this across both data collections points – find out more (PDF).
4. How long will the data collection tool/period be open for?
The mandatory data collection period is 19 September until mid-December.
5. We don’t think we will identify 80 patients in the four-week period. Does this mean our hospital is not eligible to participate?
No, we are asking for a minimum of 40 in the Autumn data collection period. We would recommend that you submit the patients that you do have, and consider whether you want to add to your sample in the flex Spring period to bring you to the yearly target of 80. We are expecting that smaller hospitals will be able to identify 10 patients per week.
If you think that you will have less than 40 patients over the four-week period, please get in touch with us to discuss your options.
6. If a patient is admitted with more than one subtype of dementia, which one is selected?
In these instances, please provide the first recorded subtype.
7. If a patient is admitted with more than 1 condition (e.g. delirious with a UTI) which do we record?
In these instances, please report the primary admitting condition.
8. Is the Annual Dementia Statement per hospital site, or per Trust?
We require one Annual Dementia Statement per hospital. Please note some of the questions are at Trust level.
9. If we have a digital system what information should we be requesting?
Your digital system may contain a field which identifies (via selection of a screening tool or other means) patients with a recorded (or probable) diagnosis of dementia. The patient list can be extracted from this data field.*
10. What if we do not have a digital system in our hospital?
The audit co-ordinator will require information forwarded to them when people with dementia are identified, eg a weekly list from wards.*
11. Do we need to apply National Data Opt Out for NAD Round 5?
The National Data Opt Out only applies for processing confidential patient data where the Duty of Confidentiality is met via S.251 approval.
As this audit is not collecting any identifiable data requiring Section 251 approval then it is out of scope of the NDOO.
12. Part 1 of the Casenote Audit tool asks whether the patient has been in hospital for 24 hours or more. Does this include time in Emergency Department?
Patients who have only attended A&E/ED should not be counted. Patient time in ED may be counted, but only if there is a Decision to Admit and from that point onwards.
13. For Dementia/Delirium Assessment and Pain Assessments, if these were done in Emergency Department, would they be recorded as “Yes, done within 24 hours”.
Assessments done in ED immediately prior to admission should be recorded as ‘Yes within 24 hours’ (and the date given will be the date of admission).
14. What level of training is required for ADS question 6.3. 'Number of allied healthcare professionals who are specialists in dementia working in your TRUST (WTE)'?
This should be a qualification amounting to a specialism in dementia, which may be multi component dependent on the discipline as we understand, beyond tier 2 training.
15. We do not know what our NHS code is – where can we find it?
All sites have a designated NHS site code that can be found here.
We advise sites to select ‘NHS Trust site’ from the ‘Type’ drop down menu and input their hospital site name and postcode.
You will be presented with a list of options:
The ‘type’ should be NHS Trust site and the ‘state’ should be open. (If your service is in Wales, choose ’Local Health Board Site' from the drop down menu).
To view a result more closely, click on the link and more information will appear. The ‘parent’ should be the name of your NHS Trust. If these details match, provide us with the hospital code assigned to that link.
*If you would like to discuss information available to you for prospective ID, please contact the NAD team.
Items from the casenote audit have been provisionally selected for outlier analysis with the approval of the Steering Group. See measures approved by the October 2022 meeting of the Steering Group (PDF).
