Dementia Benchmarking Toolkit consultation

Published 12 February 2022

The Mental Health Benchmarking project was set up to support the improvement of mental health services by using a range of comparative information to compare key aspects of performance, identify gaps, identify opportunities for improvement and monitor progress.

In Scotland's National Dementia Strategy there is a clear need for improved dementia specific management and outcome information. The Dementia Benchmarking Toolkit aims to provide the monitoring framework to track change and improvement in the five key challenges over time which are noted below.

What was PHS consulting on?

The consultation on the Dementia Benchmarking Toolkit intended to allow PHS to connect with a wider group of stakeholders, seek their input and learn what information we can provide that would be most meaningful to them. There are indicators in the current dashboard that we assume are still useful to users (e.g. acute admissions) but we needed to explore whether all the indicators are still relevant, and whether some of the definitions used should be updated to reflect changes in dementia care provision.

Current status

The Dementia Benchmarking Toolkit provides information to support the five key challenges of the Scottish Government’s Dementia Strategy, published in 2010 then updated in 2013:

Scotland's National Dementia Strategy – 2013-16 (external website)

This strategy was relevant when the toolkit was first produced, however dementia policy has been updated since this strategy was published, consequently the toolkit in its current form does not reflect this new policy landscape.

Scotland’s National Dementia Strategy: 2017-2020 – (external website)

Consultation

The consultation was made available on the PHS website account and was sent to approximately 350 stakeholders from a variety of sectors with an interest in dementia, including the NHS, Scottish Government, local authorities and third sector organisations. The consultation was also publicised via the Public Health Scotland Twitter account.

The consultation was open from 29 November 2021 to 14 January 2022, and received 18 responses, which included 12 from NHS Boards, 2 from Health and Social Care Partnerships, 1 Third Sector organisation and 3 from unknown respondents.

Consultation response

Key Findings

• The vast majority of respondents indicated that they do not currently use the toolkit.
• Despite the majority of respondents indicating that they do not use the toolkit, most people found the indicators to be very or somewhat important.
• The majority of respondents agreed that the indicator on number of patients and carers recruited to the research interest register could be removed.
• Some respondents indicated that information on research is useful but that the indicator may need to be updated.
• Most respondents were happy for the indicator on the Quality Outcome Framework to be removed.
• One respondent commented that all indicators are a priority as they will enable commissioners to develop appropriate services and ensure staff are skilled and placed into areas of most need.
• The responses generally indicated that data needs to be more up to date, and that not all indicators adequately supported the 5 key challenges of the dementia strategy.
• The responses generally indicated that dementia policy has moved on since the toolkit was originally developed so it is not relevant to the current landscape.

Proposed changes to specific indicators:

Include data for patients <65 years of age

• All respondents agreed that data for dementia patients under 65 should be included in the toolkit.
• The general consensus was that there are increasing numbers of younger dementia patients and that data on this is useful for service planning.

Readmission within 365 days: Proposed change to add a measure of readmission within 28 and 133 days.

• The majority of respondents agreed with this change.
• Some respondents questioned why the particular measures had been chosen, but agreed that additional measures would be helpful.

Are there any additional indicators or information related to dementia patients and their care that you would like PHS to include in the dementia toolkit?

There were several suggestions for additional indicators to add to the toolkit, including:

• Information on delayed discharges, including Adults With Incapacity (AWI) legislation and guardianships
• Ideal bed numbers for per capita population for dementia wards
• Additional demographic data, e.g. sex
• More data on readmissions, e.g. reason for readmission and mean duration
• Information on access to allied health professionals (AHPs)
• Information on people discharged from hospital to long term care

Additional data user engagement

In response to the consultation being launched representatives from Alzheimer Scotland approached PHS to discuss the toolkit, and the following points were made that we are taking into consideration:

• The format of the toolkit, with data set against the "five key challenges" means it is rooted in policy that is around 10 years old. 
• The data does not report service delivery in context in which services are delivered. The toolkit needs to be set within a context of integration.
• It does not feel that there is good correspondence between what is being measured, and the challenge each measure is set against.
• The unit of delivery for dementia support and care is Health and Social Care Partnerships (HSCPs), and so the toolkit should present data at HSCP level rather than board level.
• The toolkit "doesn't really tell us anything about what makes a successful care and support system".

Next Steps

After reviewing the feedback from the consultation, the following conclusions have been made for the benchmarking toolkit:

• The toolkit in its current form will be discontinued and will not be published in March 2022. PHS is prioritising releases that are well engaged with data user needs, and we can reasonably conclude that is not the case for this release.
• The Public Mental Health team will no longer produce the toolkit. Instead we will liaise with stakeholders including Scottish Government to understand what parts of the information provided in the toolkit may continue to be required as management information. Information can also be produced as information requests for customers who require it.
• A new information release should be developed in collaboration with stakeholders to better meets their information needs, this release should be set properly in the current service delivery and policy context. This should involve teams within PHS that deal with elderly care, mental health and primary and community care.

Contact:

Craig.Collins@phs.scot – Organisational Lead, Public Mental Health – Data & Intelligence

Kathryn.Burt@phs.scot – Principal Information Analyst, Public Mental Health Team