The November 2015 data for the Dementia Assessment and Referral data collection in England by NHS England were released on 3rd February 2016 according to the arrangements approved by the UK Statistics Authority.

The collection’s purpose is to improve the identification of older patients with dementia and delirium, to monitor appropriate assessment and to support effective communication between providers and general practice as part of Commissioning for Quality and Innovation (CQUIN).

The Dementia Assessment and Referral collection changed at the start of April 2015 to reflect the extension of the 2015/16 CQUIN to include community service providers (community and mental health trusts) as well as acute trusts for the Find and Assess/Investigate measures and to provide an overview at Clinical Commissioning Group (CCG) level for the Refer/Inform measure.

Three measures are reported – the number and proportion of patients aged 75 and over admitted as an emergency for more than 72 hours:

1. who have a diagnosis of dementia or delirium or to whom case finding is applied; [Find]
2. who, if identified as potentially having dementia or delirium, are appropriately assessed; and, [Assess/Investigate]
3. where the outcome was positive or inconclusive, have a care plan on discharge meeting locally agreed standards and shared with general practice. [Refer/Inform]

Measures 1) and 2) are reported by Acute Trusts and Community Service Providers, measure 3) is reported by CCGs using data obtained from trusts and providers, as detailed in the 2015/16 CQUIN Guidance. CQUIN is an incentive scheme in which additional payments are made to trusts and providers; for these measures, payments are made for achievement of at least 90% at specified times in the year.

Note on Data Quality
The data presented cover both Acute Trusts and Community Service Providers. Acute Trusts have maintained a good response rate similar to previous months. The response from Community Service Providers has been low but deemed sufficiently complete to publish results for those organisations which responded.
The response from CCGs has been deemed too low quality both in terms of coverage and completeness to publish at this stage (hence there are no published data associated with measure 3)).

Monthly Publication – November 2015

Key points – Acute Trusts – November 2015
The total number of data returns submitted by NHS Foundation and Non-Foundation Trusts providing acute funded care was 144 in November 2015. This total includes 3 nil returns, one less than in October. The nil returns are excluded from the results presented below.

The key results for acute trusts on the number and proportion of patients aged 75 and over admitted as an emergency for more than 72 hours 1) who have been identified as having dementia or delirium or asked the dementia case finding question and 2) who are appropriately assessed are as follows:

•  Overall, 90.4% of admitted patients were initially identified or given case finding for potential dementia in November 2015, the same as in in October.
• Of the patients initially identified or found as potentially having dementia, 94.9% were further appropriately assessed in November 2015, compared with 95.2% in October.
• The percentage of acute trusts in November 2015 achieving at least 90% in measures 1) and 2) was as follows:
  • 82.3% of the trusts (116 trusts) achieved at least 90% in carrying out initial identification (using case finding) for potential cases of dementia, compared with 80.7% (113 trusts) in October.
  • 86.5% (122 trusts) achieved at least 90% in carrying out further appropriate assessments, compared with 87.9% (123 trusts) in October;
• 107 acute trusts (75.9%) achieved at least 90% in both measures in November 2015, an increase from 73.6% (103 trusts) in October.

Key points – Community Service Providers – November 2015
Only a small number of Community Service Providers have been able to submit data so far and are presented in the data. The total number of data returns submitted by Community Service Providers was 16 in November 2015, two more than in October. The totals included 0 nil returns, the same as in October. Nil returns are excluded from the results presented below.

The key results for community service providers on the number and proportion of patients aged 75 and over admitted as an emergency for more than 72 hours 1) who have been identified as having dementia or delirium or asked the dementia case finding question and 2) who are appropriately assessed are as follows:

• Overall, for patients, 86.7% of admitted patients were initially identified or given case finding for potential dementia in November 2015, up from 84.7% in October.
• Of the patients initially identified or found as potentially having dementia, 97.9% were further appropriately assessed in November 2015, an increase from 94.5% in October.
• The percentage of community service providers in November 2015 achieving at least 90% in measures 1) and 2) was as follows:
  • 56.3% of the providers (9 trusts) achieved at least 90% in carrying out initial identification (using case finding) for potential cases of dementia compared with 57.1% (8 trusts) in October.
  • 81.3% (13 trusts) achieved at least 90% in carrying out further appropriate assessments compared with 64.3% (9 trusts) in October.
• 8 providers (50.0%) achieved at least 90% in both measures in November 2015.

The full data tables can be found on the NHS England website:
http://www.england.nhs.uk/statistics/dementia/