iSPACE and the Dementia Friendly Practices Assessment and Benchmarking Tool

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The Purpose

iSPACE is a quality improvement and innovation programme. It aims

• to help staff teams in GP (General Practice) surgeries, recognise that people with dementia need personalised care plans and access to resources to help them and their carers live better with dementia.
• to help more people with dementia live for longer in their own homes in dementia friendly communities.

The iSPACE model of dementia friendly primary care was developed from a hospital-based dementia care model and drew on the work of Alzheimer's Society, Dementia-Friendly Communities and Dementia Friends.

The assessment and benchmarking tool helps practices to measure the improvements they have made, and to identify what else they need to improve to be dementia-friendly. 

Preparation

Ahead of the tool being used for each assessment, the assessor meets with general practice staff. These are usually the Practice Manager, health professionals and administrators. They discuss dementia, the needs and difficulties people with dementia and their carers have when using primary care services.

What Happened

Practices in the Wessex area began to complete the steps identified in the iSPACE project to become dementia friendly. Evaluation including through focus groups with people affected by dementia at individual surgeries helped staff to understand the impact of the changes - what was working well and what still needed to improve. Quantitative data also showed benefits. Dementia Champions continue to share learning between practices with each other.

Practices were keen to continue to make improvements and adopt good practice from each other.  They wanted to be clearer about what being 'dementia-friendly' meant in a consistent way across the practices.

So work was done to develop the assessment and benchmarking tool.

• This began with consultation with the iSPACE leaders and practices that had taken part. It also considered external initiatives such as Dementia Friends and Dementia Friendly Communities. This led to a draft version of the tool being consulted on in Kent, Sussex and Surrey with the Clinical Network, primary care providers, people with dementia and carers.
• The prototype tool was tested at some of the sites taking part in the later stages of the iSPACE project.

The Results

The Assessment and Benchmarking tool was introduced as a more systematic way to measure improvement, complementing the original iSPACE work. 

Click here to see a blank version of the iSPACE benchmarking assessment tool. 

The tool is used by an assessor during a practice visit to help assess whether a practice is Dementia Friendly. 

• There are three levels of recognition/accreditation: bronze, silver and gold so a practice can be assessed and progress through to gold level over a period of time.
• As well as meeting all the criteria, cumulatively, in achieving the higher levels of accreditation, assessors look at practice culture and attitudes and this aspect can moderate the decisions about level of practice achievement significantly.

After the tool has been used to assess what's happening in the practice, the assessor has a follow-up meeting with practice staff to discuss:

• the results of the assessment such as what criteria the practice is meeting.
• what criteria still need to be met, and recommendations about actions to take to meet them.
• use of the Assessment and Benchmarking tool to enable the practice to track its progress.

What changed for people with dementia

The benchmarking assessment tool has helped to assess improvements in relation to quantitative measures of experience of GP practice such as:

• People with dementia have better experience of GP appointments: they miss fewer appointments, have longer appointments where they needed them, and have less need of appointments than previously.
• More people with dementia attend for dementia reviews and had care plans.
• More carers are registered, more carers receive health checks and carer health is improved.
• People with dementia have fewer inappropriate admissions to hospital.

Learning Points

Overall, the iSPACE project has led to learning that the principles and the changes that improved experience of people affected by dementia, also have helped people with learning disability, those with sensory disabilities (auditory, visual) and those with physical disabilities.

Key contacts to find out more

Dr Jill Rasmussen Email: [email protected]

Useful Links

Creating Dementia-Friendly GP Surgeries - iSPACE project