Achieving quality and effectiveness in dementia using crisis teams

INTERVENTION: This pre‐post group‐comparison multi‐centre RCT will be carried out with 30 dementia crisis teams (TMCDs) across England. Once consent has been obtained from each Team Managing Crisis in Dementia (TMCD), the TMCD will be entered onto a web‐based randomisation system and be randomly assigned to one of two arms, either RK (using the Resource Kit) or TAU (treatment as usual) with equal opportunity. The allocation will be determined by a computer‐generated pseudo‐random code using random permuted blocks of varying size, stratified by the population size (number of people with dementia) in each TMCD catchment area. The block size will not be disclosed. Patients, carers, outcome assessors and statisticians will be blinded to TMCD arm allocation until the data analysis is completed. Practitioners in the intervention arm (15 TMCDs) will receive training in the use of an online password‐protected Resource Kit and will use it with all instances of dementia crisis screened into their service over a 6‐month period. The Resource Kit has two elements: a 'Best Practice Tool' that TMCDs can use to evaluate their practice, and a collection of templates and documents (which can be downloaded by the team) to help practitioners improve their practice. TMCDs (15 TMCDs) in the control arm will not have access to the Resource Kit and will conduct Treatment as Usual (TAU) for the same period. CONDITION: People with dementia experiencing a mental health crisis and carers receiving clinical input from a dementia crisis team (Team Managing Crisis in Dementia ‐ TMCD) ; Mental and Behavioural Disorders ; Unspecified dementia PRIMARY OUTCOME: Number of mental health hospital admissions measured using hospital admissions records for people with dementia in the geographical catchment area covered by the TMCD (as defined by postcode) at baseline and 6 months SECONDARY OUTCOME: ; 1. Number of acute/general hospital admissions measured using hospital admissions records for people with dementia in the geographical catchment area covered by the TMCD (as defined by postcode) at baseline and 6 months; 2. Client satisfaction measured for people with dementia and carers using the Client Satisfaction Questionnaire (CSQ‐8) once post discharge from the TMCD; 3. Quality of life measured for people with dementia and carers using the Quality of Life Questionnaire (EQ‐5D‐5L) once post discharge from the TMCD; 4. General health measured for people with dementia and carers using the General Health Questionnaire (GHQ‐12) once post discharge from the TMCD; 5. Work acceptance and action measured for TMCD practitioners using the Work Acceptance & Action Questionnaire (WAAQ) at baseline and 6 months; 6. Work engagement measured for TMCD practitioners using the Work Engagement Scale (Utrecht – UWES) at baseline and 6 months; 7. General health measured for TMCD practitioners using the General Health Questionnaire (GHQ‐12) at baseline and 6 months; 8. Staff sickness levels measured for TMCD practitioners using TMCD staff sickness records at baseline and 6 months; INCLUSION CRITERIA: Teams (TMCDs) managing mental health crises in dementia in community settings, and practitioners, people with dementia and carers associated with these TMCDs. No age range criteria are set for any participants.