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NICE publishes first joint health and social care standards

The National Institute for Health and Care Excellence (NICE) has published the first joint health and social care quality standards on the care of people suffering with dementia and the well-being of looked-after children and young people.(QS30 & 31 April 2013)

In this briefing we consider the standards for care of dementia sufferers.

The Health and Social Care Act 2012 sets out a new responsibility for NICE to develop quality standards and other guidance for social care in England. The Act outlines a vision for establishing quality as a defining factor for health and social care through the use of quality standards. The use of quality standards for health and social care can allow people to hold their local commissioners to account, can help guide the commissioning of efficient and effective services and can assist service providers and users to assess the quality of the services they are involved in. Quality standards support the role of Healthwatch as consumer champion.

Healthwatch is the new independent consumer champion created to gather and represent the views of the public.

Healthwatch England will work with local Healthwatch and will also:

advise the NHS Commissioning Board, English local authorities, Monitor and the Secretary of State; and
have the power to recommend that action is taken by the Care Quality Commission (CQC) when there are concerns about health and social care services.

From April 2013, local Healthwatch organisations will build on the knowledge and experience of existing Local Involvement Networks (LINks) that work to improve health and social care services in their area.

From April 2013, NICE will develop a library of quality standards and guidance to improve the quality of social care as part of an integrated approach to healthcare quality standards.

The quality standards should be read in the context of national and local guidelines on training and competencies.

QS30 is the quality standard for supporting people to live well with dementia. All professionals involved in caring for and supporting people with dementia should be sufficiently and appropriately trained to deliver the actions and interventions described in the quality standard.

Dementia is a term used to describe a collection of symptoms including memory loss, problems with reasoning and communication and a reduction in a person’s ability to carry out daily activities such as washing, dressing and cooking. The most common types of dementia are: Alzheimer’s disease, vascular dementia, mixed dementia and dementia with Lewy bodies. Dementia is a progressive condition, which means that the symptoms will gradually get worse. The degree to which symptoms affect each person will vary.

QS30 lists 10 quality statements, which should be considered when commissioning and providing a high quality service. It should be read alongside the NICE Dementia Quality Standard (QS1) which covers care provided by health and social care staff in direct contact with people with dementia in hospital, community, home based group care, residential or specialist care settings. The NICE Dementia Pathway presents information from both quality standards in an integrated format.

The quality standards are intended to contribute to the improvements outlined in the following frameworks:

The Adult Social Care Outcomes Framework – 2013-14

The NHS Outcomes Framework – 2013-14

Public Health Outcomes Framework for England – 2013-16

QS30 can be summarised as follows:

  • Quality Statement 1: discussing concerns about possible dementia
  • Quality Statement 2: choice and control in decisions
  • Quality Statement 3: reviewing needs and preferences
  • Quality Statement 4: leisure activities of interest and choice
  • Quality Statement 5: maintaining and developing relationships
  • Quality Statement 6: physical and mental health and wellbeing
  • Quality Statement 7: design and adaption of housing
  • Quality Statement 8: planning and evaluating services
  • Quality Statement 9: independent advocacy
  • Quality Statement 10: involvement in contribution to the community

It is noteworthy that NICE has prioritised dementia as requiring social care quality standards. The guidance is not mandatory however and it remains to be seen if real change follows.

Julia Appleton
T: 020 7227 6758

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