Reflecting on a Year of Progress in Dementia Care
By Michaela Morris, National Mental Health Services Improvement Manager and Dementia Lead
The end of March is a time where many of us in the NHS reflect and report on activity over the past year. It’s clear that significant strides have been made in dementia care across Wales. From groundbreaking community initiatives to the development of crucial roles, here are some highlights of our work over the last 12 months.
Community Engagement and Modifiable Risk Factors
One of our most impactful achievements has been the launch of community listening campaigns. These initiatives gave us the opportunity to understand what matters most to people living with dementia and the wider community and informed the creation of tailored action plans for each region. In 2025, we aim to showcase the success stories from these communities to inspire further progress.
In parallel, we ran our first workshop on modifiable risk factors for dementia. While much of our work focuses on supporting individuals who have already been diagnosed, we’re also committed to working to prevent dementia through health promotion. We are working hard to develop a national communications campaign that hopefully will roll out in 2025 to raise awareness and equip regions with resources to support risk reduction.
The Dementia Connector Role
In 2023, we concentrated on developing the dementia connector role, and by the autumn of 2024, each region had developed a plan to implement this service as outlined in the All-Wales Dementia Pathway of Standards. Dementia connectors serve as a key figure who help individuals navigate the complexities of health and social care. This year, we’ll work to refine this role, ensuring it meets both regional needs and the national vision.
Memory Assessment Services (MAS)
These specialised healthcare teams assess and diagnose memory problems, potentially related to dementia. The past year was transformative for the MAS teams, who have steadily increased diagnostic rates monthly across Wales In response to rising demand, workshops were held to evaluate current practices and drive standardisation. By improving data usage and collaboration, we developed a dashboard that helps teams monitor performance and track diagnostic rates, paving the way for greater transparency and continuous improvement.
Collaborative Initiatives and Professional Development
We’ve also worked closely with experts such as Professor Tony Bayer from Cardiff University on several key initiatives, including the development of the new All Wales Neuro-imaging Pathway. In partnership with other teams within Improvement Cymru, we’ve offered targeted training to enhance the capacity of our teams, particularly around quality improvement and demand-capacity management.
Our Dementia Faculty has been a hub for knowledge sharing, with multiple cohorts of Diagnosing Dementia training and masterclasses. This network is growing and will be pivotal in shaping the future of dementia care across Wales. The faculty achieved its 11th Cohort and has also focused on supporting assessment and diagnosis in primary care via a GP specific cohort. Numerous masterclasses have been held to support learning and development.
Lleisiau Dementia PODS (Positive Outcomes Dementia Spaces)
Lleisiau Dementia, a group focused on supporting those affected by dementia, has been facilitating virtual sessions where individuals can share experiences and seek reassurance. These sessions offer a safe space to discuss the challenges of dementia care. Looking ahead, Lleisiau Dementia plans to host additional PODS sessions with members of the Senedd and Health Board CEOs. They also aim to continue supporting regional dementia initiatives, contributing to local dementia boards across Wales.
In-hospital Care – Progress and Plans for 2025 in Wales
In 2024, significant developments in dementia care took place in Wales, driven by initiatives such as Care Fit for VIPS (an online tool based on a framework which breaks the delivery of person-centred care into manageable chunks), biographical tools like the “This is me” document (a support tool to record details about a person to enable person-centred care) and the dementia prison network. These efforts, along with the enhancement of the NHS Wales app’s “About Me” section, aim to improve care for people with dementia by enabling better communication with healthcare professionals.
A key project this year was the pilot of the Person-centred Observation and Reflection Tool (PORT), developed with Professor Claire Surr of Leeds Beckett University. PORT helps staff reflect on their care approach, enhancing the experiences of people with dementia. It complements Dementia Care Mapping and will be evaluated in 2025 for lessons learned.
Looking ahead, 2025 will focus on health boards adopting and embedding Care Fit for VIPS, designing a dementia measurement dashboard, and piloting a program on older adult mental health wards. The first phase of this will be to work with wards across Wales to understand the current situation and co-design a programme of work.
Shared learning
The Shared Practice Inventory, an online solution to share information about dementia projects will also continue to support shared learning across Wales. We as a team have and continue to support the regions and regional leads with their plans to achieve better outcomes for all citizens across the region.
There are many projects and initiatives happening at a national and regional level, with dementia a focus for key stakeholders across health, social care, the third sector and communities. This is due to the hard work and commitment of the regional dementia boards, programme leads and workstream members.
These efforts reflect ongoing commitment to improving dementia care and supporting those affected by dementia.
Strengthening partnerships
This year our focus will be on continuing to strengthen relationships with regional teams, ensuring that the lessons of 2024 are built upon.
Our goal is to make dementia care more accessible, more coordinated, and ultimately more effective across Wales, with a continued focus on learning from both successes and challenges. As a team we look forward to another year of innovation, collaboration, and meaningful progress in dementia care.
Access resources and find out more about the work of the Dementia Care programme here.