Taking an outcomes-focused approach to improving care for older people with dementia and other needs
This report shares the findings of a 15-month programme led by Social Finance, in partnership with The Dunhill Medical Trust and Alzheimer’s Society. The programme provided funding to five community-based service partners across England and Wales to test whether the care and support they delivered could make a tangible difference – for people living with dementia, for their unpaid carers, and for the wider health and care system.
The five funded partners were Dementia Support (Sage House), The Rainbow Foundation, Marie Curie, Shared Lives Plus, and Leicestershire County Council. Each delivered a different type of service, but all focused on the same question: can targeted, community-based support improve outcomes and reduce pressure on the system?
The programme looked at areas such as supporting people at key moments in their care journey, reaching underserved communities, offering respite for unpaid carers, and using care technology earlier in the dementia pathway.
What the report includes
Data: Why It Matters and Why It’s Hard
To show that a service is making a real difference, you need good data. The programme found that many services lack the tools, training and systems needed to collect and share meaningful outcomes data. Without this, it is hard to build the case for continued funding.
Strengthening Community-Based Services
Community organisations play a crucial but often undervalued role in supporting people with dementia. The report highlights practical ways to build their capacity – from equipping existing staff to deliver personalised care plans, to bringing volunteers into clinical service models.
Joining Up Care
People with dementia benefit most when support is joined up – before, during and after diagnosis. Services that also address wider needs like housing, social connections and financial stability deliver better results for individuals and the system as a whole.
Funding That Supports Long-Term Change
Short-term, activity-based funding often isn’t enough to drive lasting improvement. The report explores different funding approaches – including grants, social outcomes partnerships and blended finance – and when each is most appropriate to support sustainable, outcomes-focused services.
Supporting Unpaid Carers
Unpaid carers across England and Wales provide care worth an estimated £162 billion a year, yet they are often overlooked in service design. The report calls for unpaid carers to be recognised, supported and included from the start – and for their wellbeing to be measured and invested in.
The report also includes detailed case studies from each of the five funded partners, along with practical tools such as example outcomes pathways and frameworks.
Building blocks for investment in dementia care
The report sets out recommendations for funders, commissioners and service providers in the short, medium and long term. It identifies five things that need to be in place for investment in dementia care to succeed:
- Genuine partnership with voluntary and community organisations
- A focus on the wider factors that affect people’s health and wellbeing
- Strong data systems to track outcomes
- A clear plan for communicating impact
- A commitment from commissioners to long-term, system-wide funding
Key recommendations of the report
Sharing resources on – and examples of experiences with – different funding mechanisms and how they can be used, will ensure system stakeholders are aware of funding options available to them. This will support the wider principles of sustainability and efficiency.
Operational functions are critical to strengthening service delivery, user engagement and data sharing and collection. This includes awareness-raising and service promotion to diversify referral routes; to reach and support underserved communities; and to recruit and retain staff and volunteers. Data functions, including collection and analysis, also need to be bolstered. If the right data is captured and used effectively it can be a valuable asset; however, training and the agreement of data sharing protocols is needed to ensure this happens.
Our findings demonstrate how vital unpaid carers are to the ecosystem that supports older people living with dementia and other needs. They provide essential care which bolsters adult social care provision, often at the expense of their own financial, emotional and physical health. It is vital that the support infrastructure for unpaid carers is recognised and invested in throughout the system. This is an area which needs further testing and funding
The programme has seeded an energetic and knowledgeable Learning Community, the power of which can be harnessed to generate widespread and sustainable change in the funding and delivery of person-centred care. This is an opportunity to reduce duplication, consider scalability of interventions, and to test thinking on service development, its funding and evolution.
Evidence shows that considering the social determinants of health and taking a person-centred approach when planning the delivery of services is essential. This encourages care providers to coordinate their approach and to deliver better health outcomes.