National audit of dementia care in general hospitals published

A new National Audit of Dementia (care in general hospitals) (NAD) has been published. The audit examines aspects of care received by people with dementia in general hospitals in England and Wales. In addition, NAD provides national and local reports to support hospitals to identify areas for quality improvement and share good practice, helping to improve outcomes for patients. NAD has carried out three rounds of audit, reporting in 2011, 2013 and 2017.A spotlight audit on delirium has been carried out to look in more detail at an area where hospitals have seemingly been underperforming and to clarify inconsistencies in the data.This report is designed to inform:

• People who receive care or provide care for someone – people with dementia and their families
• People involved in providing care – professional staff, managers and trust boards working in general hospitals in England and Wales
• People involved in commissioning care – NHS England, Welsh Government, clinical commissioning groups
• People who regulate care – including the Care Quality Commission, clinical audit and quality improvement professionals.

Data for this round of audit were collected between September and November 2017.Key findings from the audit include:

• A high proportion of patients with dementia admitted as emergencies to hospital did not receive an initial assessment for delirium, even after adjustment.
• Questions about initial screen or assessment for delirium are inconsistently interpreted.
• Over a quarter of patients have no confusion or cognitive tests recorded.
• Delirium not included in discharge correspondence.

The Dementia Academy’s Interactive Care Pathway Toolkit specifically flags delirium as an issue for dementia patients and addresses its management. The toolkit maps out the care pathway a dementia patient will follow and provides a roadmap for the services and support needed from diagnosis to end-of-life care, including assessment for, prevention and avoidance of delirium. It is essential that healthcare professionals are aware of the signs of delirium, understand how to manage these patients and ideally prevent delirium from occurring with proactive identification and reduction of predisposing factors where possible.To download the full National Audit of Dementia report click here