HSE - Implementation of National Clinical Guideline No. 21

National Clinical Guideline No. 21 (Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia) was published by the Department of Health in 2019.

An Implementation Programme for National Clinical Guideline No. 21 commenced in 2022 and some relevant updates are provided below for your information and circulation.

HSeLanD module: Support pathways for people with non-cognitive symptoms of dementia

A reminder that the 30-minute HSeLanD module “Support pathways for people with non-cognitive symptoms of dementia” is available on HSeLanD. This module, targeted at all staff who provide care to people with dementia, provides important information on non-cognitive symptoms of dementia, tailored person-centred support, and risks of psychotropic medication.

Resources for staff involved in the prescribing of psychotropic medication

As part of the Implementation Programme for National Clinical Guideline No. 21, a range of resources have been developed. This includes a prescriber information leaflet and a document to support comprehensive assessment. The prescriber information leaflet provides an overview of the recommendations and good practice points of National Clinical Guideline No. 21, as well as providing additional information on comprehensive assessment and signposting to additional resources and information.

Prior to considering any psychotropic medication in a person with dementia, a comprehensive assessment should be performed by an appropriately trained healthcare professional. A document to support comprehensive assessment has been developed to provide answers to a number of frequently asked questions in relation to this.  

Patient information leaflet

An information leaflet for people with dementia and their family carers and supporters was developed as part of the implementation of National Clinical Guideline No. 21. This is available in both a Plain English and Easy Read format. Both versions explain what psychotropic medications are and when they might be prescribed. The leaflet also provides information on the possible side effects of using these medications, highlights the importance of regular reviews of the medication, and signposts to additional information.

Facilitator Education Programme

A Facilitator Education Programme has been developed and has been piloted in a number of acute hospital sites and national roll-out is forthcoming. The Facilitator Education Programme is a one day programme of education (accredited by the NMBI) which will be delivered in sites by Project Facilitator(s) from the HSE National Dementia Services. Staff who attend this education programme will become Local Facilitators for the Implementation of National Clinical Guideline No. 21.

Following completion of the Facilitator Education Programme, the primary role of the Local Facilitator is to deliver the following education sessions (each of which have received NMBI accreditation):

• Delivering Person-Centred Care for Non-cognitive Symptoms of Dementia: This 90 minute session is targeted at all staff who provide care to people with dementia.
• Prescriber Education: Implementation of NCG No. 21: This 60 minute session is targeted at all staff who prescribe psychotropic medication.
• Using Quality Improvement Methodology to Support the Implementation of NCG No. 21: This 60 minute session is targeted at all staff who will conduct an audit of psychotropic prescribing within their setting.

Local Facilitators are provided with ongoing support from the Implementation Programme Team in the National Dementia Services. If you are interested in becoming involved as a Local Facilitator for the local implementation of NCG No. 21 in your setting, please contact the National Dementia Services on [email protected]