Dementia toolkit for GP commissioners aims to improve quality and cut costs

The DoH has launched a commissioning toolkit for GPs to improve the quality of dementia services and cut costs as part of the government's £20bn efficiency savings target.

The department wants GPs on clinical commissioning groups (CCGs) to redesign dementia services to cut the 'unsustainable' rise in costs to the NHS and social care, in line with the Quality, Innovation, Productivity and Prevention (QIPP) programme.

The Dementia Commissioning Pack says commissioners should focus on patient outcomes and improving cost effectiveness of services ‘across the whole spectrum of dementia, from early diagnosis to end-of-life care’.

Commissioners must also ensure GPs review all 180,000 patients with dementia taking antipsychotic drugs to reduce potential harm from inappropriate prescribing, as GP exclusively revealed in June.

Launching the toolkit on Thursday, care minister Paul Burstow said: ‘It will help CCGs avoid reinventing the wheel each time they provide a new service, will give patients the best outcomes and use money effectively’.

Guidance to the toolkit claims it will allow commissioners to focus on improving care ‘rather than on bureaucracy’.

The strategy highlights three areas of dementia care: early diagnosis, care for people at home and in care homes, and for those in hospital.

CCGs are also required to sign up a ‘call to action’ from the Dementia Action Alliance (DAA), a group of 50 organisations including the RCGP, the Alzheimer's Society and the government.

The group had called for the reduction in use of prescribing of antipsychotics in line with NICE guidance.

Watch National Clinical Director for Dementia Alistair Burns introducing the Dementia Commissioning Pack

Service redesign
Dementia services need to be better integrated between the NHS, social care and local government against a backdrop of ageing population and NHS and local government budget cuts, the guidance states.

CCGs will be required to collaborate with social care and health and wellbeing boards on dementia services to inform the Joint Strategy for Health and Wellbeing, to be published by the boards.

The toolkit sets out details that commissioners will need to consider, including how to adhere to the national outcomes frameworks in NHS, adult social care and public health that will be used to hold commissioners to account.

Commissioners will also need to publish data on progress to reduce antipsychotic prescribing, as required by the NHS Operating Framework.

A ‘Commissioning Framework and Assessment Tool’, included in the toolkit, shows commissioners an indication of performance in these four areas relative to other areas.

It uses a traffic lights system to alert them to any area that may require ‘further local investigations’ to improve services.

The Alzheimer’s Society has produced patient leaflets to inform patients and carers what to expect from services.

Andrew Chidgey, head of policy and public affairs at the charity, said it hoped the toolkit will help ensure dementia care is prioritised locally.

He said: ‘The National Audit Office and the All Party Parliamentary Group on Dementia have both identified that only offering care and support for people with dementia at crisis point is far too late.

‘Millions of pounds are wasted on poor quality care when earlier intervention would save money in the long-term. By investing well in the right services across a wide range of sectors, good quality commissioning will improve the lives of people with dementia and bring long term savings across the health and social care sectors.’

Around 820,000 people live with dementia in the UK. Estimated costs are set to jump 135% from £14.8bn in 2007 to £34.8bn by 2026.

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