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NICE launches new quality standards on stroke, dementia, and venous thromboembolism (VTE) prevention

The National Institute for Health and Care Excellence (NICE) has today (Wednesday 30 June) presented the Health Secretary Andrew Lansley with advice on new, national, evidence-based quality standards on the care and treatment of stroke, dementia and venous thromboembolism (VTE) patients in the NHS in England.

The new quality standards are a set of concise statements that show what high-quality care should look like for these conditions. The standards are sourced from the best available evidence such as NICE guidance, or evidence accredited by NHS Evidence. Produced in collaboration with the NHS and social care, as well as their partners or service users, they have been developed with the following audiences in mind:

  • Patients and the public
  • Clinicians
  • Public health practitioners
  • Commissioners and
  • Health and social care professionals

The quality standards on stroke, dementia and VTE prevention make a number of key recommendations, including:

  • Patients who have suffered a stroke should be offered a minimum of 45 minutes appropriate active therapy for at least five days a week for as long as they continue to benefit from it.
  • All patients who have suffered a stroke are screened within six weeks of diagnosis, to identify mood disturbance and cognitive impairment.
  • People with dementia receive care from health and social care staff that have been adequately trained in dementia care.
  • Carers of those with dementia receive an offer of needs assessment to ensure they have the adequate support they require.
  • Patients/carers receive verbal and written information and advice on VTE prevention at the time of admission and discharge.

Health Secretary Andrew Lansley, said: “I am extremely pleased to welcome NICE's advice on the first three quality standards and will consider this advice alongside that of the National Quality Board.

“I want the NHS to focus on better health outcomes, providing a service that better reflects what is important to patients, and builds upon clinical evidence. Quality standards give an authoritative statement on what high quality NHS healthcare should look like in relation to dementia, stroke and venous thromboembolism (VTE). It will, in future, support a service which is focused on outcomes and looks for the evidence on how to achieve continuously improving outcomes.

This advice will be used by the NHS to commission and provide high-quality and cost-effective services. It will increasingly, with other quality standards in future, be a basis for commissioning, for designing incentives for quality, and in relation to quality inspection. Whilst these standards identify processes, they will not be seen as processes in isolation from each other, or from the outcomes achieved. With clinical sign-up, they are a basis for supporting clinical judgement, not distorting it."

Val Moore, NICE Implementation Director, said: “We are pleased to be advising on these three quality standards. From the feedback we received during the consultation and field testing, I'm sure they will be welcomed as robust, clear and evidence-based, not just by all those affected by these often debilitating conditions, but also by the health and social care professionals who treat them.”

Professor Alistair Burns, National Clinical Director for Dementia, Department of Health, said: "Dementia is one of the most important issues we face as the population ages. The quality standard programme will help support the delivery of the National Dementia Strategy and ensure that best practice is shared across health and social care."

Jane Ingham, Director of Clinical Standards, Royal College of Physicians, and Stroke Quality Standard Programme Board Member, said: “Having a stroke can be a life-changing experience for many people, who may need much help and support to get them through this difficult period in their lives. But strokes are both preventable and treatable, with evidence showing that active intervention and care after the onset of symptoms can have a hugely beneficial effect. The Royal College of Physicians welcomes this standard, which complements the National Sentinel Audit for Stroke guidelines, and provide clinicians with clear guidance on the best available care and practice for those who have had a stroke. The NICE standards will in future be included in the National Sentinel Audit.”

Amanda Edwards, Deputy Chief Executive, Social Care Institute for Excellence (SCIE), said: “SCIE fully supports the publication of these standards, and we are particularly pleased to see the launch of the dementia quality standard. At present there are no known cures for most forms of dementia, but evidence shows that the quality of care and support provided can have a great impact on people with dementia and their carers. These standards show clear pathways of the best care for those with this condition.”

Beverley J Hunt, Professor of Thrombosis and Haemostasis, King's College, London, and Medical Director of Lifeblood, the Thrombosis Charity, said: “Evidence shows us that hospital-acquired venous thromboembolism (blood clots) is a significant public health problem. Implementation of improved prevention in hospitals will prevent thousands of individuals being admitted to hospital every year in England. Lifeblood is very happy to support the publication of this standard, which will set the benchmark of quality in the prevention of hospital-acquired VTE.”

Ends

Notes to Editors

About the quality standards

1. The quality standard on stroke is derived from the following evidence sources:

    • Royal College of Physicians, National Clinical Guideline for Stroke (2008) which incorporates NICE Clinical Guideline 68 Diagnosis and initial management of acute stroke and transient ischaemic attack.
    • Department of Health, National Stroke Strategy (2007).
    • National Audit Office, Department of Health: Reducing Brain Damage: faster access to better stroke care (2005).
    • National Audit Office, Department of Health: Progress in Improving Stroke Care (2010).

2. The quality standard on stroke should be considered alongside the National Stroke Strategy (Department of Health, 2007).

3. The quality standard on stroke includes a number of recommendations such as:

    • Patients needing ongoing inpatient rehabilitation after diagnosis should be treated in a specialist stroke rehabilitation unit.
    • Patients with stroke should be offered a minimum of 45 minutes appropriate active therapy for at least five days a week for as long as they continue to benefit from it.
    • All patients who have suffered a stroke are screened within six weeks of diagnosis, to identify mood disturbance and cognitive impairment.
    • Carers of patients with stroke have a named point of contact for stroke information, written information about the patient's diagnosis and management plan, and sufficient practical training to enable them to provide care.

4. The standard calls for stroke services to be integrated and coordinated across all relevant agencies to encompass the whole stroke care pathway.

5. The quality standard on stroke can be found on the NICE website at: http://www.nice.org.uk/aboutnice/qualitystandards/stroke/

6. The quality standard on dementia is derived from the following evidence sources:

    • NICE and the Social Care Institute for Excellence's (SCIE) Clinical Guideline 42, Dementia: Supporting people with Dementia and their carers in health and social care (2006, NHS Evidence accredited).
    • Department of Health, Living well with Dementia: a National Dementia Strategy (2009).
    • National Audit Office, Improving services and support for people with Dementia (2007).
    • National Audit Office, Improving Dementia services in England: an Interim report (2010).
    • Department of Health, The use of antipsychotic medication for people with Dementia: Time for action (2009).

7. The quality standard on dementia should be considered alongside: Living well with Dementia: a National Dementia Strategy (Department of Health, 2009).

8. The quality standard on dementia includes a number of recommendations such as:

    • People with dementia receive care from health and social care staff appropriately trained in dementia care.
    • People with suspected dementia are referred to a memory assessment service specialising in the diagnosis and initial management of dementia.
    • People newly diagnosed with dementia and/or their carers receive written and verbal information about their condition, treatment and the support options in their local area.
    • People with dementia have an assessment and an ongoing personalised care plan, agreed across health and social care that identifies a named care coordinator and addresses their individual needs.

9. The quality standard on dementia can be found on the NICE website at: http://www.nice.org.uk/aboutnice/qualitystandards/dementia/

10. The quality standard on VTE prevention is derived from the following evidence sources:

    • NICE Clinical Guideline, Venous Thromboembolism - reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) in patients admitted to hospital (2010, Clinical Guideline 92).
    • NICE Clinical Guideline, Venous Thromboembolism: reducing the risk of venous thromboembolism (deep vein thrombosis and pulmonary embolism) within in-patients undergoing surgery (2007, Clinical Guideline 46).
    • Department of Health, Venous Thromboembolism Prevention: A Patient Safety Priority (2009).
    • Department of Health, Risk assessment for Venous Thromboembolism (updated March 2010 to comply with CG92).

11. The quality standard on VTE prevention should be considered alongside: Venous Thromboembolism Prevention: a Patient Safety Priority (Department of Health, 2009).

12. The quality standard on VTE prevention includes a number of recommendations such as:

    • Patients/carers are offered verbal and written information on VTE prevention as part of the admission and discharge process.
    • Patients who are provided with anti-embolism stockings (designed to exert pressure to the ankles and legs to help prevent blood clot formation in the legs) have them fitted and monitored in accordance with NICE guidance.
    • Patients to be re-assessed within 24 hours of admission for risk of VTE and bleeding.

13. The quality standard on VTE can be found on the NICE website at: http://www.nice.org.uk/aboutnice/qualitystandards/vteprevention/

About NICE

  • The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance on the promotion of good health, and the prevention and treatment of ill health.
  • NICE produces guidance in three areas of health:
    • public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector.
    • health technologies - guidance on the use of new and existing medicines, treatments and procedures within the NHS.
    • clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

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This page was last updated: 30 June 2010

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Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions

Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.