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Scotland's National Dementia Strategy: One Year On Report


4. Improved Management and Outcome Information

4.1 The strategy recognises that, as part of providing integrated support for change, improved local and national information systems are required to help service providers, those receiving services and those scrutinising services to see the impact of the strategy's implementation on local outcomes and efficiencies; and on a national level in enabling an accessible and transparent comparison of services. The dementia benchmarking work is also forming the basis of the strategy's monitoring framework which will track change and improvement over time and in doing so inform the work and oversight of the strategy's Implementation and Monitoring Group.

4.2 When developing the strategy there was a broad consensus that, while there were some good sources of outcomes information, for example in relation to the HEAT target and the dementia Integrated Care Pathway ( ICP), more consistent information was needed throughout dementia services and at all stages of the illness.

4.3 This work has been taken forward overseen by a benchmarking group (including statisticians and analysts from NHS National Services Scotland information division), with the group and subgroup meeting to work up a draft dementia balanced scorecard, or benchmarking framework. The scorecard is structured in alignment with the 5 key challenges identified by the strategy, including its two key improvement areas - post-diagnosis support and improving service response in general hospital. This work should be completed in the early autumn.

4.4 Within each area of the scorecard, data presented will utilise pre-existing health and/or social care data sets, such as the Quality Outcomes Framework ( QOF) dementia register; data related to ICP standards including on matched interventions and on advanced care planning; and care home and general hospital registers. By way of example, in the section on post-diagnosis support data will be drawn from the generic ICP data on the requirement to record a diagnosis and from QOF register on the percentage of dementia patients who have had a clinical care review in the previous fifteen months. The section on general healthcare services will draw on data on admissions, readmissions, length of stay, the number of ward transfers and on discharges - but this part of the dementia benchmarking work presents more challenges in reading and interpreting data due to the under-recording of dementia as a secondary cause of admission in general hospital settings.

4.5 With regard to accessing pre-existing data sets collected from social care services, the dementia benchmarking group have also linked their work with the review of the Community Care Outcomes Framework to explore including additional data in the final scorecard as indicators or proxy indicators, for example data relating to over-65s receiving care at home.

4.6 Rather than extending the reach of the dementia benchmarking work into collecting data on the range of areas such as housing, environment and transport as indicators, the benchmarking group have refined their remit so as to focus the scorecard around areas where the dementia strategy can demonstrably effect change.