Dementia - Person Aligned Care Team (D-PACT).

The Dementia – Person Aligned Care Team (D-PACT) programme is a five-year project, funded by a National Institute for Health Research (NIHR) Programme Grant for Applied Research (PGfAR). Our project aims to develop and evaluate a system for dementia support based in general practice for people living with dementia and their carers. The project is a collaboration between the Universities of Plymouth and Manchester.

Currently, a range of dementia support services and roles exist to address the challenges faced by people with dementia and their carers. These services are often valued, but there are still questions in relation to the most effective type of support and where and how it is best delivered. Commissioners and providers can be reluctant to invest in services when there is limited evidence to support their effectiveness. The D-PACT programme is addressing this lack of evidence by developing and evaluating a system for dementia support based within general practice, providing post-diagnosis care for people with dementia and their carers.

Our programme has two distinct phases:

A feasibility phase: developing the intervention and examining what works, including what outcomes are valued by people with dementia and their carers. We are developing a theory of how the intervention will work by reviewing the literature and talking to experts including, importantly, people with dementia and their carers. We are recruiting patients and their carers through GP practices in the South West and North West to test out recruitment, acceptability, randomisation if possible, different outcome measures, and the infrastructure supporting research in general practice, including remote screening of records, remote approaches and consent of participants and remote research interviews and follow up.

A 'Stage 2' Intervention Study where we will develop the intervention further in response to the feasibility phase, consider recruitment in additional sites with general practices and, crucially test out recruitment of under-served populations to dementia care research. In the North West (Greater Manchester) this will be with people with dementia and their carers from south Asian backgrounds. We will work in Manchester with up to three Primary Care Networks (PCNs) recruiting participants to the intervention and monitor their outcomes over time: Quality of life, Functioning, Carer wellbeing, Cost.

Throughout the programme, we will study how to ensure the intervention can be put into practice in the challenging health and social care context – both during the study and following its completion. This will help us to understand how policy, organisations, training and commissioning can ensure that the results of the research are used.

Dr Paul Clarkson is the lead in the North West for DPACT, based at the University of Manchester; working with NHS Trusts and NIHR Clinical Research Network areas to ensure that recruitment of people with dementia and their carers can take place in GP practices.