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 package to encompass “train the trainer” education, an eLearning programme of education, and educational infographics.
  3. Provide training to relevant staff (within and outside the HSE) in acute hospitals, residential settings for older people, and community settings on the content of NCG No. 21, using a “train the trainer” approach.
  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 all clinical areas caring for people with dementia, and that all doctors, nurses and pharmacists in acute, residential and community settings 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.

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