DEMENTIA PREVALENCE CALCULATOR. Guidance on using the online tool for improving dementia diagnosis and diagnosis pathways

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1 DEMENTIA PREVALENCE CALCULATOR Guidance on using the online tool for improving dementia diagnosis and diagnosis pathways 1st edition, April 2013

2 Dementia Prevalence Calculator v2 The Dementia Prevalence Calculator (v2) enables health and care communities to gain a better understanding of their local estimated prevalence of dementia in the community, and among people living in local care homes. The tool also enables health and care communities to: calculate local dementia diagnosis rates forecast local dementia prevalence view trajectories and set ambitions for improvement in diagnosis rates and compare diagnosis rates with other localities. You can also: View and compare diagnosis rates on the Ambition map Link to the Knowledge Portal to access a wealth of resources to improve dementia diagnosis rates, and diagnosis pathways. 2

3 Users can view data at four levels: General Practice Clinical Commissioning Group Local Authority and NHS England Area Team. Access to data via the Dementia Prevalence Calculator (v2) is not restricted. However, General Practices and Clinical Commissioning Groups have the option of identifying a registered user who manages any changes to: local dementia register diagnosis numbers (General Practices) local ambitions for improving dementia diagnosis rates (General Practices, and Clinical Commissioning Groups. What it does The Calculator allows users to estimate the prevalence of dementia for their group (or level) using the aggregated age and gender profiles of their General Practice patient list(s), and taking into account the number of older people living in local residential care and nursing homes. National Dementia Prevalence: the Calculator presents and profiles prevalence estimates using the Dementia UK Report (2007) prevalence figures. What is different? The Calculator provides a new model for dementia prevalence, called the Adjusted National Dementia Prevalence, by using General Practice patient list numbers (as opposed to ONS figures) and by estimating and including a higher estimated prevalence in local residential care and nursing homes. The Calculator uses the Adjusted National Dementia Prevalence figures to profile local dementia prevalence, and to calculate local dementia diagnosis rates. 3

4 Select tool Find out more about the Dementia Prevalence Calculator Project Select tool: Calculator Ambition Map Knowledge Portal 4

5 Select group, or data level Select group and view data at different levels : General Practice Clinical Commissioning Group Area Team Local Authority 5

6 Navigate to select and view: Quick view Service profile Estimated Prevalence (National Dementia Prevalence figures) Estimated Prevalence Community (Adjusted National Dementia Prevalence) Estimated Prevalence Care Homes (Adjusted National Dementia Prevalence) Severity Profile Diagnosis rates Results Benchmark data 6

7 What the Calculator illustrates Quick view This summarises: Age profile by gender. Estimated adjusted national dementia prevalence figures patients in the community; and patients in care homes. Latest dementia register figures (QOF DEM1) the Calculator gives General Practices the option of refreshing this data, on the Diagnosis page. These figures transfer to the Ambition Map, to provide real time data on diagnosis rates and delivery of local ambitions. The option to set trajectories for improvement of diagnosis rates. The change in numbers diagnosed with dementia in order to achieve an x% diagnosis rate, by Service profile This illustrates: Age profile by gender, and compared to all England figures. Latest QOF disease register figures. Estimated Prevalence (National Dementia Prevalence) This illustrates: National Dementia Prevalence figures expressed as a percentage Adjusted National Dementia Prevalence figures numbers, by age group 7

8 Estimated Prevalence Community (Adjusted National Dementia Prevalence) This illustrates: Adjusted National Dementia Prevalence figures estimated prevalence in community Estimated Prevalence Care Homes (Adjusted National Dementia Prevalence) This illustrates: Adjusted National Dementia Prevalence figures estimated prevalence in care homes) Note: General Practices can validate and refresh the care home patient numbers by running an audit on patient list addresses numbers of patients with postcodes of local care homes. Severity Profile The severity proportions have been taken from the report, Dementia UK (2007). As severity rates for early onset dementia have not yet been established, the Dementia Prevalence Calculator model assumes a 50/50 split between mild and moderate. As the patient numbers are small at this level this has no significant impact on the overall results. It is assumed that the majority of people with severe dementia will be being cared for in residential and nursing homes. Note: this profile should be used as a broad guide only; 'severity' of symptoms may vary according to the sub type of dementia. 8

9 Diagnosis rates This page enables you to: View the forecast 'diagnosis gap' and GP dementia register numbers using your local dementia diagnosis ambition rate of improvement. For General Practices, register to revise and/or update number of patients in care homes. View the forecast number of cases of dementia, change in diagnosis rate and dementia register numbers, by a) entering an ambition percentage diagnosis rate, or b) selecting the saved percentage ambition diagnosis rate. Results This section presents the outputs from sections 1-8, above. Benchmark data This section allows you to benchmark selected General Practice, CCG, Local Authority or Area Team data, viewing: General Practice list size(s) % patient population over 65 years Dementia Register as a % of list Estimated cases as a percentage of list The diagnosis rate. 9

10 Definitions The Dementia Prevalence Calculator (v2) uses the following definitions: Prevalence The expected or predicted number of people with dementia. True or actual prevalence The number of people in the population who actually have dementia. Local prevalence The expected number of people with dementia in the local area, adjusted through the DPC Tool, weighted by number of care home places. Prevalence rate 8 or prevalence proportion: The expected or predicted prevalence as a % of population. This is point prevalence, i.e. the percentage of population with dementia at a point in time. Diagnosis The number of people detected in the population that have dementia. Diagnosis is the same as detection. (The number of people diagnosed with dementia is captured via the Department of Health Primary Care Quality and Outcomes Framework (DEM1). Diagnosis rate Diagnosis as a % of prevalence. This is the same as the detection rate. Diagnosis gap Prevalence rate minus diagnosis rate. 10

11 Ambition Map The Ambition Map allows you to view and compare prevalence and diagnosis rates at different levels (GP, CCG, Local Authority, Area Team). Begin by selecting the group, or level at which you wish to run the Map. The Map illustrates: Diagnosis Rate (NDP) 2011/2012 Diagnosis Rate (Adjusted NDP) CCGs (and GPs) have the option of refreshing, or updating their diagnosis rate in order to demonstrate progress with delivering their ambitions for improvement 2013/14 and 2014/15. CCG Diagnosis Rate Ambition 2013/14 CCG Diagnosis Rate Ambition 2014/15 11

12 Knowledge Portal The Knowledge Portal presents a range of tools and resources to assist General Practices and Clinical Commissioning Groups to develop local improvement plans to deliver improvements in local dementia diagnosis rates, and diagnosis pathways. The Ten Key Steps to Improving Rates of Diagnosis, and Diagnosis Pathways sets out options for local partners, to deliver improvements, and resources to support delivery. 12

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