It is important that the quality standard is considered alongside current policy and guidance documents listed in Development sources.
NICE quality standards are not mandatory. They can be used for a wide range of purposes both locally and nationally, to improve outcomes, including to:
improve quality in practice and outcomes
support the provision of care that has been shown to work and to be cost effective
increase the national consistency of social care provision
support the development of inter-agency and inter-professional working.
demonstrate to people with dementia what they can expect from high-quality care.
NICE has produced a support document to help commissioners and others consider the commissioning implications and potential resource impact of this quality standard. Full guides for commissioners on dementia that support the local implementation of NICE guidance are also available. Information for people with dementia using the quality standard is also available on the NICE website.
The quality measures accompanying the quality statements aim to improve the structure, process and outcomes of care for people with dementia. They are not a new set of targets or mandatory indicators for performance management.
Expected levels of achievement for quality measures are not specified. Quality standards are intended to drive up the quality of care, so achievement levels of 100% should be aspired to for quantitative measures where numerators and denominators are given. However, NICE recognises that this may not always be appropriate in practice when taking account of safety, choice and professional judgement and so desired levels of achievement should be defined locally.
We have shown where national indicators currently exist and measure the quality statement. National indicators may include those developed by the Information Centre for Health and Social Care through their Indicators for Quality Improvement Programme. For statements for which national quality indicators do not exist, the quality measures should form the basis for audit criteria developed and used locally to improve the quality of care. The Healthcare Quality Improvement Partnership is planning to pilot a new, nationally agreed, care audit for local use in 2013 and 2014, with a focus on dementia care in residential care settings to enable providers to improve the quality of care.
For further information, including guidance on using quality measures, please see What makes up a NICE quality standard.
During the development of this quality standard, equality issues have been considered and equality assessments are published on the NICE website.
Good communication between social care and healthcare services and people with dementia is essential. Care and support, and the information given about it, should be culturally appropriate. It should also be accessible to people with additional needs such as physical, sensory or learning disabilities, and to people who do not speak or read English. People with dementia should have access to an interpreter or advocate if needed.
Commissioners and providers should aim to achieve the quality standard in their local context, in light of their duties to avoid unlawful discrimination and to have regard to promoting equality of opportunity. Nothing in this quality standard should be interpreted in a way that would be inconsistent with compliance with those duties.