Background inequalities and gaps in post-diagnostic support (PDS) for people with dementia persist despite a policy focus on dementia in England and Wales. Understanding and overcoming the factors contributing to these inequalities is vital to improve care for people living with dementia (PLWD) and their families. Objective to explore common barriers to the delivery of PDS in England and Wales and describe successful strategies to address them, drawing on examples from current practice. Design qualitative semi-structured interviews, focus groups and observation. Settings Phase 1: interviewees were drawn from multiple sectors across England and Wales, including NHS clinical commissioning groups and social care. Phase 2: six case study sites based in different sectors (primary care, secondary mental health and third sector) in England. Participants Phase 1: 61 professionals, including commissioners and service managers. Phase 2: 68 professionals, including frontline staff and those working in related services; 17 PLWD; 31 carers. Results barriers to implementing PDS in dementia were an unsupportive infrastructure, limited proactive review and limited capacity and capability particularly in primary care. Strategies used successfully in practice to address these challenges included creating opportunities for service development, improving joint working, supporting non-specialists and developing ongoing, holistic review and care planning. Conclusion a range of practical strategies have been identified to address many of the common barriers to PDS in dementia. To achieve policy goals of a task-shifted and task-shared approach to PDS, widespread use of these strategies is recommended.

中文翻译：

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在英格兰为痴呆症患者实施诊断后支持：对实践中用于解决这些问题的障碍和策略的定性研究

尽管英格兰和威尔士的政策侧重于痴呆症，但痴呆症患者在诊断后支持 (PDS) 方面的背景不平等和差距仍然存在。了解和克服导致这些不平等的因素对于改善对痴呆症患者 (PLWD) 及其家人的护理至关重要。目的是探索英格兰和威尔士实施 PDS 的常见障碍，并借鉴当前实践中的示例，描述解决这些问题的成功策略。设计定性的半结构化访谈、焦点小组和观察。设置阶段 1：受访者来自英格兰和威尔士的多个部门，包括 NHS 临床委托小组和社会关怀。第 2 阶段：位于英格兰不同部门（初级保健、二级心理健康和第三部门）的六个案例研究地点。参与者 第 1 阶段：61 名专业人员，包括专员和服务经理。第二阶段：68名专业人员，包括前线人员和相关服务人员；17 感染者；31 名照顾者。结果障碍在痴呆症中实施 PDS 是不支持的基础设施、有限的主动审查以及有限的能力和能力，特别是在初级保健中。在实践中成功用于应对这些挑战的策略包括为服务发展创造机会、改善联合工作、支持非专家以及制定持续的、整体的审查和护理计划。结论 已经确定了一系列实用策略来解决痴呆症中 PDS 的许多常见障碍。为了实现 PDS 的任务转移和任务共享方法的政策目标，