Reducing stress and distress improvement programme update: October 2025

Progress update October 2025

Improvement programme

The programme aims to ensure people living with dementia have improved experience of and access to person-centred approaches to prevent and support stress and distress in hospital and care home settings.

The programme started in January 2025 and is jointly delivered by Healthcare Improvement Scotland, Care Inspectorate and NHS Education for Scotland. We are working with 58 teams delivered over four cohorts in 2025.

All 58 teams have completed the reducing stress and distress self-evaluation tool to evaluate current practice and identify improvement priorities.

What we do

  • Work with 27 hospital teams from 11 NHS boards and 31 care home teams from 18 HSCPs across Scotland.
  • Deliver a three month quality improvement support programme for each cohort of teams followed by one year coaching through an online collaborative.
  • Capture evidence and learning to enable spread.
  • Work in partnership with a range of national partners and lived experience networks.  

Examples of impact so far

Involving familes to support stress and distress

One hospital team are involving carers/families to support meaningful activity on the ward.

  • Families supported to complete Getting To Know Me forms on admission.
  • Meaningful activity trolley created with advice provided for families to use it.
  • A short video was developed to raise awareness and share learning on this activity across NHS board.

Project Lead, Megan Weir, has been shortlisted for a Scotland’s Health Award in recognition of this activity.

A whole system approach to meaningful activity

One care home team are involving staff in all areas across the home to support meaningful activity, such as reception and laundry. Impact observed includes:

  • all staff better understand residents’ needs
  • residents have increased opportunity and are more engaged in meaningful activity, and
  • improved staff wellbeing.

Staff training to support a change in practice

One hospital team used a questionnaire to identify and understand staff training needs. 90% of nursing staff have since completed TURAS e-learning modules.

To ensure this activity supports a change in practice next steps include:

  • additional bespoke training
  • test stress and distress care
  • develop range of meaningful activity and
  • work with unpaid carers and families to evidence impact of meaningful activity

Recently completed milestones

  • Delivered first reducing stress and distress collaborative session with teams that have completed the three month improvement programme.
  • Completed cohort 2’s three month improvement programme with teams sharing their learning and impact so far.
  • Completed cohort 3 and 4’s self-evaluation phase with teams identifying their improvement priorities.
  • Presented at Alzheimer Scotland’s Annual Conference to share learning and impact from the programme.
  • Published first case study focused on activity at Royal Infirmary Edinburgh.

Working together

A stress and distress activity plan that was developed by a team in cohort 1 is now being further tested by a team in cohort 2. The teams are in contact to share learning and support additional improvement.

Next steps

Programme evaluation is ongoing with participating teams and coaches. Findings will support improvement in design of our approach for 2026.

Applications to open in January 2026.