Introducing the national dementia CQUIN

In this blog Alistair introduces the National Commissioning for quality and innovation (CQUIN) plan. The CQUIN will be introduced in April with the aim of improving some areas of dementia care in hospital.

The CQUIN aims to increase awareness around dementia as people are admitted to hospital. A flowchart has been developed for healthcare staff to use.

The CQUIN has three main aims:

  1. Identifying people with dementia – members of staff will ask members of the family or friends of a person admitted to hospital if the patient has suffered any problems with their memory in the last 12 months
  2. Asses people with dementia – if there is evidence to suggest a problem with their memory,  that person will be given a dementia risk assessment
  3. Refer on for advice – a referral would be made for further support either to a liaison team, a memory clinic or a GP.


 

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23 Responses to Introducing the national dementia CQUIN

  1. Jamie Cochrane says:

    Please can we have a transcript of this as hospital policy does not allow access to the video blog. Thank you.

    • webteam-rr says:

      Unfortunately we can’t provide transcripts of these videos at this time. We try and summarise the main points underneath the video for staff who cannot view them.

      - DH Digital team

    • Bala says:

      You could get a referral to a lecpiasist, either a psychologist or a psychiatrist. There are some very good meds out today for dementia, but he still should or may have to forfeit his drivers license if he has this. Dementia is very easy to diagnose and it progressively does get worse, but medicine will slow down the process. If this is his only symptom, I would not be overly concerned, but keep an eye on him anyway. Starting this process could send him into a depression and make things much worse. I only say this from my own experience as a home-care provider for the elderly. It would take its toll on him if he lost his license and could not continue doing what he loves to do. Make him a part of this and allow him to choose, until he cannot. He is still quite young to have this. Take care and God Bless

  2. Heather Keane says:

    When the National VTE CQUIN was introduced Trusts were given until Q4 to achieve the 90% standard. Is this the same with this Dementia CQUIN?

  3. helen myers says:

    This CQUIN appears to be screening for dementia.
    I thought a screening test should only be put in place if it could do more good than harm i.e that there was a good treatment that one could offer.
    I don’t think there is a cure for alzheimers, and in fact many meds on offer for it seem to cause as much harm as good.
    Thus, when the NHS is seeking to use it’s limited budget to maximum benefit, how can the DOH be spending on promoting this screening.
    Often people become very anxious at the suggestion that they have a degree of dementia, and fear loosing their independance.

    When hospital inpatients have been “screened” for memory problems, what ” treatment” will you give them?

  4. Gina says:

    There is no cure for Alzheimers at this present time although there is effective treatments for slowing the disease and managing symptoms to a degree. This is part of our nursing interventions and is important for patients and family to get an early diagnosis so they will be refered to the appropriate service ( Mental health dementia treatment services ) . Early screening is essential for a diagnosis that will allow early treatment to commence. Dementia is recognosed in The National Framework for Older People as far back as 2001.
    So why do i still read comments describing screening for dementia as not a priority ,as diagnosis has the same impact upon patients and their family/carers as cancer does .There is still a need for nurses to be educated in dementia care especially as the population grows there will be more patients presenting with dementia.
    I am concerned that nurses feel dementia is not a priority

    • Malik says:

      There is no cure for Alzheimers at this present time alhuotgh there is effective treatments for slowing the disease and managing symptoms to a degree. This is part of our nursing interventions and is important for patients and family to get an early diagnosis so they will be refered to the appropriate service ( Mental health dementia treatment services ) . Early screening is essential for a diagnosis that will allow early treatment to commence. Dementia is recognosed in The National Framework for Older People as far back as 2001.So why do i still read comments describing screening for dementia as not a priority ,as diagnosis has the same impact upon patients and their family/carers as cancer does .There is still a need for nurses to be educated in dementia care especially as the population grows there will be more patients presenting with dementia.I am concerned that nurses feel dementia is not a priority

      • Nikos says:

        Nice words, nice intentions, but in ptacrical terms unachievable. My mother-in-law has alzheimers and the quality of support for her and the people who care for her is absolutely appalling. The Social Services personnel we have encountered are more of a hindrance than a help, the level of incompetence is astounding. Blogs and tag clouds are all very nice but until you employ properly trained staff at ground level and join up the various agencies involved you are doomed to fail

  5. Rebecca says:

    I am hearing The ‘Risk’ of the patient being on a general ward is more apparent than the wellbeing of the patient
    I am not hearing that Mental health services are going to get more staff or support to cope with this new essential criteria of assessment? Will liaison nurses be able to cope with the extra referrals? Also will it enhance negative attitudes of the General nurses toward the liaison nurse if they have to work hand in hand more with the extra work load?

    • Krhizy says:

      What’s the difference bweeten forgetting things and early signs of Alzheimer’s disease?Some loss in memory function is an inevitable consequence of aging. Eighty percent of seniors complain of some memory trouble. As we age, it takes more time to process information and retrieve memories. The ability to remember a name, where we put the keys, whether we locked the door, missed one item from a 10-item shopping list, etc., is called ‘benign forgetfulness of aging.’ These episodes are usually infrequent, and relate to stress, anxiety, being very busy or not being well rested. These individuals don’t have difficulty with reasoning and problem solving and these episodes don’t affect day-to-day functioning.Memory issues of Alzheimer’s affect a person’s ability to function over time. The patient with Alzheimer’s has trouble with short-term memory and becomes unable to learn new information. It’s simply gone and cannot be retrieved. Episodes occur frequently and interfere with social and work function. We hardly ever see Alzheimer’s patients in stages 2 and 3 because they often don’t have enough symptoms to seek treatment.The Alzheimer’s patient in stages 4-7 forgets they made a list. They may forget how to get home. They may forget that family looked for them for eight hours before finding them. These patients also have problems with calculations and complex brain functions. Balancing a checkbook would be impossible at stage 4.I hope this helps you some.

  6. Alison Raycraft says:

    Hi
    Please can you advise on when guidance re Dementia Hospital based risk assessment will be available.
    Thank you

    • Sutaslnee says:

      I personally feel this is a fiaansttc step forward (as are most of the CQUIN measures) Yes they require time and effort on the parts of clinicians and nursing staff alike. Extra staff requirements would have to be assessed via business cases on increased work load. The nurses/clinicains doing the initial assessment would also feel this is extra work with no extra help but you justify this by the improvement in care and safety of the service users. Auditing of figures would add justification to extra support staff. I would not expect the attitudes towards fellow practitioners to alter as their specialist knowledge and guidance will shorten the length of stays and improve the management of potentially disruptive patients.

  7. Christopher Dyer says:

    This is a really good initiative. It is mid March so it would be helpful to have more detailed guidance on this, including the dementia risk assessment (odd phrase)- as it is intended to go live in 2 weeks.
    I feel there will be some exceptions to this and those who are admitted very briefly there is a risk of a tick box approach. Although I totally support increased diagnosis unfortunately this is likely to flood the system and lead to longer delays in memory services which are not at levels able to take on this extra work yet. But perhaps it is the push that is needed?

  8. Ian Aspinall says:

    I personally feel this is a fantastic step forward (as are most of the CQUIN measures) Yes they require time and effort on the parts of clinicians and nursing staff alike. Extra staff requirements would have to be assessed via business cases on increased work load. The nurses/clinicains doing the initial assessment would also feel this is extra work with no extra help but you justify this by the improvement in care and safety of the service users. Auditing of figures would add justification to extra support staff. I would not expect the attitudes towards fellow practitioners to alter as their specialist knowledge and guidance will shorten the length of stays and improve the management of potentially “disruptive” patients.

    • Shamim says:

      This is a really good intavtiiie. It is mid March so it would be helpful to have more detailed guidance on this, including the dementia risk assessment (odd phrase)- as it is intended to go live in 2 weeks.I feel there will be some exceptions to this and those who are admitted very briefly there is a risk of a tick box approach. Although I totally support increased diagnosis unfortunately this is likely to flood the system and lead to longer delays in memory services which are not at levels able to take on this extra work yet. But perhaps it is the push that is needed?

      • Fatme says:

        Dementia patients need “live” or “life” arnoud them to help remind them who they are and what’s going on arnoud them. When a “dark moment(s)” arrives take her to a garden of growth. It can be anything from flowers to fruits and veggies. Have her pick them and if it’s a garden of fruit and veggies, have her taste them. The picking should help her remember that she was picked as “her name” and that she is struggling but that she is still alive and well. Good luck.

  9. Jovair says:

    Dementia is a craziness, where the mind won’t toacle on a particular, but goes in all directions. This makes the person affected seem like another individual entirely.Alzheimer is a forgetting. The people can otherwise be as they always have been, except they cannot remember names or faces and often forget what they are doing in the middle of doing it. Their basic personality often remains as always ..either as kindness, or irritability ..My dear aunt got this disease but remained as sweet and loving as she had always been.Both very sad illnesses that attack elders.

  10. Hadil says:

    I rlaely beeilve that a person centered approach is needed in all types of care setting and that therapeutic activities need to be taken more seriously, In homes currently there are only guidelines on what activities need to be provided and very little in the way of training and support for activity providers, it is so much better for individuals to have some sort of activity provision for their well-being.

  11. Amira says:

    Hi, I feel that this initiative is a fantastic effort but it’s not clear to me who is responsible to apply it? nurses or physicians? and also i think this requires training and baseline knowledge regarding dementia and assessment skills

    • Eric says:

      What’s the difference bteewen forgetting things and early signs of Alzheimer’s disease?Some loss in memory function is an inevitable consequence of aging. Eighty percent of seniors complain of some memory trouble. As we age, it takes more time to process information and retrieve memories. The ability to remember a name, where we put the keys, whether we locked the door, missed one item from a 10-item shopping list, etc., is called ‘benign forgetfulness of aging.’ These episodes are usually infrequent, and relate to stress, anxiety, being very busy or not being well rested. These individuals don’t have difficulty with reasoning and problem solving and these episodes don’t affect day-to-day functioning.Memory issues of Alzheimer’s affect a person’s ability to function over time. The patient with Alzheimer’s has trouble with short-term memory and becomes unable to learn new information. It’s simply gone and cannot be retrieved. Episodes occur frequently and interfere with social and work function. We hardly ever see Alzheimer’s patients in stages 2 and 3 because they often don’t have enough symptoms to seek treatment.The Alzheimer’s patient in stages 4-7 forgets they made a list. They may forget how to get home. They may forget that family looked for them for eight hours before finding them. These patients also have problems with calculations and complex brain functions. Balancing a checkbook would be impossible at stage 4.I hope this helps you some.

  12. Donald McGowan says:

    Thanks Alistair for this CQUIN and your ongoing efforts to sort out dementia. You mentioned that you’d be publishing details of what a Dementia Risk/Diagnostic Assessment might look like. Any progress with that as the CQUIN period started 1 month ago. Regards, Don McGowan

    • Soni says:

      Thank you Lucy. You know the pain I’m going through right now and I’m just tniyrg to keep everything honest and straight. I was using my common sense also in saying my mother has dementia. But, due to the grief I received from family about the statement, I did what I thought was best and that was to print a retraction and admit that I am not qualified to diagnose my mother. But, yes like you, I do strongly believe she has dementia.

  13. Simone Bell says:

    We are now well into quarter 2, with processes established, however it was indicated that this CQUIN would be reported to the DH? have these plans been shelved or is there now a reporting process?

    thanks

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