Dementia Pathways. For Health & Social Care Professionals

Implementation of National Clinical Guideline No. 21

The National Clinical Guideline (NCG) on “Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia” (hereafter referred to as NCG No. 21) was published by the Department of Health in December 2019 to guide the appropriate use of psychotropic medication for non-cognitive symptoms in a person with dementia (in any setting). This is complemented by a clinical algorithm for clinical staff and a “patient and family Information leaflet” for a person living with dementia or caring for a person with dementia, or the general public.

The National Dementia Office secured funding through the Health Service Executive (HSE) National Service Plan to implement NCG No. 21 over a two year period by a project implementation team. The primary aim of the programme is to implement the guideline on a phased basis across settings, in acute care, residential care, and within community settings. In addition, the project also aims to evaluate the impact of the implementation of the guideline. A national Steering Committee provides governance, guidance and direction in order to attain the overall objectives of the project. An Education Working Group has also been convened to provide input and guidance specifically on the development and rollout of the education and training programme.

The key objectives of the implementation programme are to:

  1. Raise awareness of the risks of psychotropic medications for people with dementia, and to raise awareness of NCG No. 21 as a key resource to guide clinical decision-making, among health care professionals, people with dementia and their families, and other key stakeholders.
  2. Develop a multi-component education programme to encompass facilitator education, an eLearning programme of education, and educational infographics.
  3. Provide training to relevant staff in acute hospitals, mental health settings, residential settings for older people, and community settings on the content of NCG No. 21, using a facilitator model of education.
  4. Develop, pilot and disseminate an audit tool and audit manual to assess compliance among doctors, nurses and pharmacists, and provide training on use of this audit tool as part of the education and training package.
  5. Undertake a comprehensive evaluation of the implementation of NCG no. 21 to assess the reach of the education and training package, namely that the guideline is widely disseminated and available for use in clinical areas caring for people with dementia, and that staff have access to the education programme and are released to participate or complete the online education module.

Additional resources developed by the project implementation team will be shared on the Dementia Pathways website in due course.

Recent Activities

Launch of HSeLand Module: Non-cognitive symptoms of dementia 

The HSE National Dementia Office has launched a new eLearning module to support all healthcare professionals who provide care to people with dementia across all settings. Available now on HSeLanD, the new eLearning module ‘Support pathways for people with non-cognitive symptoms of dementia’ will help to determine the best person-centred supports for a person with non-cognitive symptoms of dementia and to recognise the risks of unnecessarily prescribing psychotropic medication.

The module contains 3 key topics:

  • Non-cognitive symptoms of dementia
  • Tailored person-centred support
  • Risks of psychotropic medication

This module will take approximately 30 minutes to complete and includes an assessment and extend my learning pieces for those who wish to undertake further learning or who want practical activities to help transfer the learning into their local area of work. Please search “non-cognitive symptoms of dementia” on the HSeLanD website to find this module or you can access the module in “clinical skills” section of the course catalogue on HSeLanD.


Webinar on Non-cognitive Symptoms of Dementia

On 21st September, to coincide with World Alzheimer’s Day, the HSE National Dementia Office and National Safeguarding Office jointly hosted a webinar on non-cognitive symptoms of dementia, entitled “A focus on non-cognitive symptoms of dementia: Promoting a culture of safety”. Further information, including video recordings from the webinar, can be found here.


Irish Gerontological Society Podcast

To mark World Alzheimer’s Day, Edel McDaid from the Irish Gerontological Society recorded a podcast with Mairéad Bracken-Scally, Kate Brennan and Fiona Foley from the National Dementia Office. This podcast provides an update on recent activities within the National Dementia Office, including the implementation programme.


Meet the Team

Dr. Mairéad Bracken Scally

Mairéad joined the office in January 2022 as Senior Project Manager for the implementation of “Appropriate prescribing of psychotropic medication for non-cognitive symptoms in people with dementia” (National Clinical Guideline No. 21). Prior to joining, Mairéad worked for six years in healthcare research and audit with a specific focus on dementia. Most recently she was National Audit Coordinator for the Second Irish National Audit of Dementia care in acute hospitals (INAD-2). Prior to this, she worked as part of the evaluation team of a three-year HSE and Genio-funded dementia programme, based in both community and hospital sites.

Mairéad holds a PhD in Psychology from Maynooth University. Her PhD study explored the quality of life and trauma symptoms of older persons, namely retirees. She has an extensive research portfolio having worked on a variety of research projects since 2008, with a focus on healthcare research and mental health. She has been lead author and co-author on a large number of reports, journal articles and other publications.


Rachel Ward

Rachel joined the office in September 2022 as a Project Facilitator for the implementation of National Clinical Guideline No. 21. Previously she worked as a staff nurse and subsequently an enhanced nurse at Midlands Regional Hospital Tullamore, providing care to acutely ill patients with dementia.

She completed a Masters in Occupational Health and Safety with University College Cork in 2021 giving her knowledge and key skills required in research evidence to effectively address health and safety issues in the workplace and other environments, whilst also promoting and supporting staff/carers’ wellbeing.



Sheena Farrell

Sheena joined the office in October 2022 as Project Facilitator for the implementation of National Clinical Guideline No. 21. Sheena graduated from the University Of Bedfordshire in 1994 and has worked in the UK for many years. She has worked as a Clinical Tutor and Skills Facilitator in Portsmouth and has facilitated education and training from basic life support skills to multidisciplinary education and non-technical skills in places as diverse as Canada, Australia and Sweden, delivering a program of acute care skills.



Grace Bergin

Grace joined the office in June 2022 as Assistant Staff Officer.  Prior to joining the National Dementia Office, Grace worked in the acute hospital setting for 18 years in the Laois/Offaly area.  Grace holds a Certificate in Business Studies from Carlow Institute of Technology.



For any queries about the implementation of National Clinical Guideline No. 21, please contact Dr Mairéad Bracken-Scally: or 087-4372484