A new national dementia self-assessment tool, co-developed by NHS Midlands and Lancashire’s Improvement Unit, DHSC and NHSE, is enabling healthcare systems to improve services, reduce variation and drive strategic development.

Background

The dementia pathway is complex due to the various ways in which services are delivered and commissioned and the wide range of agencies and disciplines involved.  Added to this, policies, standards and recommendations are dispersed across a plethora of platforms and resources.

In January 2024, the Department of Health and Social Care (DHSC) commissioned NHS Midlands and Lancashire’s Improvement Unit to develop, test and roll out a national dementia self-assessment tool. The tool would bring these policies, standards and recommendations into one place to make them measurable. This would in turn enable a route for identifying opportunities for improvement, supporting strategy development and reducing variation across a healthcare system.

Action

The Improvement Unit worked alongside our clinical colleagues to produce a robust, well-evidenced, future-proofed resource to evaluate and improve dementia services. The ‘Dementia 100: Pathway Assessment Tool’ is completed at Place level and analysed at System level. It is made up of six pillars which incorporate 100 criteria for self-assessment. The resource was developed in collaboration with DHSC and NHS England (NHSE) policy leads, and endorsed by the Alzheimer’s Society, Dementia UK and the National Collaborating Centre for Mental Health.

• Research: We undertook a full literature review to understand existing guidance and set up mechanisms to collect qualitative data feedback as well.
• Resource development: The toolkit was originally created in collaboration with health and social care professionals in the Black Country. Our continued work with DHSC and NHSE enabled us to develop it into a product that can be applied to any System across England.
• Service user engagement: Working closely with carers services and the Alzheimer’s Society Lived Experience Group, we co-produced criteria to ensure a holistic approach that incorporated the perspectives of people who have experienced dementia.
• Trialling and testing​:  We supported a pilot programme to test and trial the toolkit with 14 Places across four Systems and established an Expert Advisory Group to oversee a wider desktop review process. We utilised the combined findings and experiences from each of these activities to inform the final design of the resource.
• Data analysis​: We created data packs for each System, highlighting strengths, gaps and opportunities for improvement​. We collaborated with our Business Intelligence team to undertake a statistical review on the possible correlation between criteria and outcomes.

In April 2025, we supported the national rollout of the toolkit through the development of a robust communication strategy, including written and verbal communications and engagement across a wide range of partners.

As part of the launch, we organised and co-presented a webinar to raise awareness of the new resource. The webinar was supported by DHSC and NHSE and attended by over 700 health and social care professionals. This event was well-received, and webinar attendees found the event informative and were enthusiastic about utilising the toolkit going forward.

Impact

The Dementia 100: Pathway Assessment Tool provides Places and healthcare Systems with a standardised and evidence-based framework to achieve the three shifts highlighted in the 10 Year Health Plan, particularly around “hospital to community” and “sickness to prevention”. It also enables Places to work towards a Neighbourhood Health approach across services for people living with dementia, supporting the integrated working required for frailty and older people pathways.

The toolkit provides a route for Systems to undertake quality assessment and assurance activities, as Places are able to conduct a comprehensive evaluation of dementia care provision, identifying strengths and areas for improvement.

One of the key uses of the resource is to help reduce variation and create economies of scale through identification and spread of best practice and maximising on system-level efficiency opportunities. Completion of the toolkit can also help to drive strategy development, providing an evidence base that enables Systems to focus their priorities on efficient resource allocation which can also inform future service development.

Feedback

“This tool provides a comprehensive benchmarking and improvement methodology that can only benefit outcomes for people living with dementia.”

Head of Local Systems Influencing, Alzheimer’s Society

“The tool has enabled us to understand the baseline in our services in order to know where to focus our efforts for improvement and reduce variation across the system. Our patients will gain the benefit of this which is our ultimate aim.”

Mental Health Programme Manager, Lancashire and South Cumbria ICB

For more information

For more information, visit our Improvement Unit section and contact us.