Tameside & Glossop Integrated Care NHS Foundation Trust launched two new delirium pathways, one for community services and one for hospital care in July 2025 with the aim of having a more consistent, system-wide approach to delirium care.
A few years ago, a process mapping exercise was undertaken to better understand how delirium was being managed within our community services. The findings revealed significant variation in practice and highlighted a need for clearer guidance. As a result, a draft community delirium pathway was developed to standardise care and improve patient outcomes. Unfortunately, due to staff departures and service pressures, the pathway was never formally launched.
The issue came into sharper focus when the National Audit of Dementia identified our organisation as an outlier for three consecutive years. While the audit primarily measures delirium recognition and management in acute settings, it underscored the need for a more consistent, system-wide approach. Senior leaders recognised the urgency of the situation and took decisive action by creating a new role: Nurse Lead for Dementia and Delirium.
In July 2025, this commitment came to fruition with the launch of two new delirium pathways one for community services and one for hospital care. The pathways are comprehensive and include links to the GM delirium toolkits and related resources. Both were introduced during our inaugural Delirium Learning Event, a groundbreaking session designed to bring together multidisciplinary teams to share knowledge, best practice, and innovation. The event was such a success that it has now become a quarterly fixture in our calendar.
The three-hour learning event covers all aspects of delirium, from early recognition and prevention to management and post-delirium support. A key feature of the event is the group workshop, which enables staff to collaborate on developing practical ideas to improve patient outcomes. Feedback from participants has been overwhelmingly positive, demonstrating a clear increase in awareness and confidence in managing delirium across various clinical settings.
The Nurse Lead for Dementia and Delirium has been supported by two Advanced Clinical Practitioners (ACPs) based in the Frailty Unit and a Sister in the Emergency Department. These areas, often referred to as the “front door” of the hospital, are crucial in identifying and managing delirium early. Regular audits have been scheduled to monitor compliance and measure improvements in practice.
Our Intensive Care Unit (ICU) already had well-established guidelines for delirium management, but these had not been formalised into an organisational pathway. Work is now underway to develop an ITU-specific pathway aligned with national standards, ensuring a consistent approach across all care environments.
Some quick wins have already been achieved. Previously, staff lacked easy access to tools for assessing delirium. These resources are now widely available and actively used in practice. To support ongoing education, a short voice-recorded PowerPoint presentation has been developed and shared across clinical areas, allowing staff to access key learning in a flexible and engaging format. In addition, junior doctor training is now scheduled annually for each new intake to ensure they are familiar with the Trust’s delirium pathways from the outset.
While we recognise that there is still progress to be made, the foundations are firmly in place. We are optimistic that by the time of the National Audit of Dementia 2026, we will no longer be identified as an outlier—but rather as a Trust demonstrating excellence in delirium care.
Watch this space.
Kellie Smart, Dementia & Delirium Nurse Lead, Integrated Safeguarding Team, Tameside & Glossop Integrated Care NHS Foundation Trust
