Around 1,500 questionnaires were sent out to people in the population group aged 75-84 years.

  • 78% were completed and returned
  • 27% of those returned had risk scores on the self-report questionnaire which were high enough for the individuals to be offered a visit.
  • Of the people who were offered a visit, 70% accepted the offer and this resulted in about 150 visits being carried out for this population group.

For the population who were aged over 85 years and/or had dementia and/or who were housebound, all were offered visits and over 88% of these were accepted.

In total, around 700 visits were completed for the target population across the locality, with four practices visiting over 90% of their registered eligible cohort.


384 referrals were made as a result of the visits. The largest group of referrals, 215 in total, related to mobility issues, with 162 referrals to physiotherapy and/or occupational therapy and 53 referrals to the local falls service. A further 104 referrals were made to other health and care services, of which 49 were to other therapy services, 39 to the memory clinic, 14 to social services and just 2 were medical referrals. Finally, 65 referrals were made to the police and fire service for safety checks and advice.

The dementia diagnosis rate for this locality increased from 68% to 86% during the project. This compared very favourably to the average rates for Newcastle under Lyme (67%) and England as a whole (59%).

Across the locality, many people were identified as potentially eligible for benefits that they were currently not claiming. The project identified:

  • 70 people who were potentially eligible for attendance allowance
  • 26 for council tax rebate
  • 145 for blue badge
  • 4 for pension saving credit.

An audit in one practice found that of the 37 people they identified as potentially eligible for attendance allowance who were not already claiming the benefit, 21 people (57%) subsequently made a successful claim. Of the others, 9 (24%) decided they did not wish to submit a claim, 2 (5%) claims were unsuccessful and the outcome for the other 5 (14%) was unknown. If this same ‘success rate’ of 57% was extrapolated to the 170 people identified as potentially eligible for attendance allowance during the course of the project it would equate to 97 successful new claims. At the rate of £2,865 per year would amount to claims worth over £275,000 per year.

The rates with which potentially eligible people were claiming the various benefits prior to the assessment visit varied between practices, particularly for people with a diagnosis of dementia who were eligible to claim council tax rebate. In one practice, 64% of those eligible for this benefit were claiming it before the assessment visit, whilst in others the proportion of people not already claiming, and therefore advised to make new claims, was much higher. One practice achieved 19 successful new claims during the course of the project.

Regarding uptake of other services that were offered at the visits, in one practice, 95% of people visited took up the offer of a ‘Lions pot’, whilst 49% took up the offer of a ‘life-line’ call alarm and the same number had a key safe installed.

To read the full project report click here