Greater Manchester Hospital Delirium Toolkit

Download the toolkit: Greater Manchester hospital delirium toolkit

What is the hospital delirium toolkit?

The Greater Manchester hospital delirium toolkit is designed for hospital staff to use to help them identify and manage delirium in people over the age of 18 and not under the influence of drugs or alcohol. It is based on national evidence and includes resources for both clinicians and people with delirium and their families.

Contents of the hospital delirium toolkit

The individual documents which make up the toolkit can be found below, along with optional resources. The links will lead directly to the named documents.

1. Greater Manchester hospital process for identifying and managing delirium (Key Document 1)

2. 4 A’s Test for delirium screening (Key document 2)

3. GM hospital delirium TIME Bundle (Triggers, Investigations, Management, Engagement) (Key Document 3)

4. Greater Manchester hospital delirium management and engagement guidance

a) For medical teams GM hospital delirium management and engagement guidance –for medical teams (Key Document 4a)

b) For non-medical teams GM hospital delirium management and engagement guidance –for non-medical teams (Key Document 4b)

5. Greater Manchester delirium public facing resources

a) Greater Manchester Delirium Leaflet Long Version June 2023

b) Greater Manchester Delirium Leaflet Short Version June 2023

c) Greater Manchester delirium leaflet: translated versions

d) Delirium – top tips for carers or family members

e) Delirium, what to look out for and what to do for family members and carers. A short film starring lived experience members talking about the importance of knowing what delirium is and why it is so important to act on it.

Optional resources:

6. NEWS2: Additional implementation guidance (RCP London)

7. Abbey Pain Scale

8. Pain Assessment in Advanced Dementia Scale (PAINAD) – MDCalc

9. Greater Manchester nutrition and hydration material:

a) Paper Weight Arm band can be used to indicate malnutrition

b) Monitoring food, fluid intake, and oral hygiene Urine chart with fluid and food intake

10. Mouth Care Assessment (Health Education England)

11. Bristol Stool Chart (Bladder and Bowel Community)

12. Hints and tips for anticholinergic burden (ACB) medication reviews– Hertfordshire & West Essex ICB

13. UTI Assessment Tool (Bury CCG)

14. Newcastle Urine Collection pack which can be purchased via NHS Supply Chain item FSW1451

15. Fundamental needs in dementia – an animation from the CAIT and Newcastle Model series (YouTube)

16. Social Care Institute for Excellence video on practical approaches to minimising restraint

17. “This is Me” document (Alzheimer’s Society)

18. Dementia Friendly Hospital Charter 2020 

19. Eating and drinking well – supporting people living with dementia

20. Living well while waiting for a memory assessment

Bibliography for GM delirium community and hospital toolkits

What has been achieved with the hospital delirium toolkit so far?

 Salford Royal Hospital developed and implemented a digital tool to improve the detection and management of delirium, as part of the Global Digital Exemplar (GDE) in 2017-18.

  • Salford Royal Hospital increased screening for over 65-year-olds by 34% and the length of stay for these patients reduced by 11%, saving an estimated £1.7m.
  • Use of a digital delirium pathway in an acute hospital: Use of a digital delirium pathway and quality improvement to improve delirium detection in the emergency department and outcomes in an acute hospital
  • Salford Royal video hearing from patients and carers about what delirium is like. Dr Emma Vardy, Consultant Geriatrician, and colleagues at Salford Royal Hospital describing their electronic delirium assessment and management tool designed to identify and manage delirium early.

We would welcome your feedback. Contact Dementia United if you want to provide feedback or have any questions email:


Training resources 

Click here to find a range of resources that provide useful learning for those using the toolkit.

Community toolkit 

Click here for the Greater Manchester Community Delirium Toolkit – Dementia United (