Social Trials: monitoring, evaluating and learning programme

The Social Approach to Dementia helps to better see and understand the needs of people with dementia and thus enables the provision of the appropriate support to improve the quality of life of these people. Studies on appropriate support that is meaningful to the everyday world and real needs of people with dementia and their loved ones are carried out in these Social Trials. The studies are conducted through an integrated approach using the medical, psychological as well as the social domain.

The Social Trial studies were started in four Dutch local authorities in September 2018 in collaboration with the Social Support Department (DMO) of the Ministry of Health, Welfare and Sport (VWS). As of 2019, these studies became part of the Social Trials Programme of ZonMw. The local authorities involved are Amsterdam, Rotterdam, Den Bosch and Amstelveen. In early 2021, the study was expanded to include four additional pilot local authorities, namely Roermond, Moerdijk, Bergen and Haarlem.

ZonMw’s ‘Social Trials: monitoring, evaluating and learning’ programme was set up to identify the active components of these Social Trial studies and gain a better understanding of the scalability and associated conditions. The programme has 4 parts: 1) Internal monitoring and evaluation (of the first four Social Trial pilots), 2) Expansion through implementation (the second four Social Trial pilots), 3) an external evaluation and 4) Social Approach to Dementia training activities. In January 2023, the programme was extended until the end of 2024 so that the projects under 1) and 3) could be extended.

The ultimate goal of the Social Trials and their evaluation is to achieve better support for people with dementia, different practices and a systemic approach, and to make the Social Approach to Dementia available for everyone in the Netherlands once it has been substantiated.

Social Trial studies being conducted at local authorities

Four local authorities are conducting the social approach studies: Amsterdam, Amstelveen, Rotterdam and Den Bosch. The focus in these Social Trials is on experimenting with appropriate support that is meaningful to the everyday world and real needs of people with dementia and their loved ones. The studies are conducted through an integrated approach using the medical, psychological as well as the social domain. The Social Trials were started in 2018 and will run for four years. In early 2021, the Social Trials were expanded to include up to 4 more local authorities with a population of no more than 150,000.

Social Approach to Dementia Teams

A Social Approach to Dementia Team (the SAD Team) provides the infrastructure to support people with dementia and their loved ones throughout the disease and focuses on the home environment. The SAD Team is composed of people with different backgrounds and experience. The SAD Team provides support from the period before a diagnosis of dementia has been made until after death. In addition, the SAD Team deploys people from the community, including volunteers, students, people with poor job prospects and permit holders. On the one hand, the team consists of professionals (e.g. case manager, district nurse, ambulatory supervisor); on the other hand, it consists of people who do not have a background in care
and/or welfare work.

Social Trials internal monitoring strategy

The strategy is to identify active components so as to be able to then scale up and connect with the existing services being offered. To this end, the impact of the Social Trials is monitored in terms of processes, quality and finances.

The vision on internal monitoring and evaluation is an integrated working procedure within the Social Trials, as also shown in the table below. Quantitative and qualitative methods and trend analyses are combined for each local authority. The internal monitoring of the pilot local authorities is carried out under the supervision of PwC and TAO of Care.

An independent central, evaluative assessment of the Social Approach to Dementia that is being experimented with in the local authorities’ Social Trial will take place. The assessment will be conducted by Erasmus School of Health Policy & Management (ESHPM). An important outcome measure is the quality of life of the patients within the Social Trials. Furthermore, emphasis will be put on making learning experiences and results of the pilots and the impact on the cost development and the healthcare system available, while taking the labour market into account. The assessment testing should provide a better understanding into whether the Social Trials strategy can be expanded and what is required to do so. This evaluation will use the data collected by the Social Trials project team, supplemented with own research and information sources. Questions will be focused primarily on effectiveness, cost-effectiveness and replicability of Social Trials. The call for grant applications is now closed.

In addition to Social Trial studies at local authorities, a call for grant applications has also been opened to provide professionals within a number of local authorities with a better understanding of working in accordance with the Social Approach to Dementia. The call for grant applications is now closed. 3 local authorities started a project in 2021, in which they provide training activities for professionals in the local authority. The local authorities are: Sint-Michielsgestel, Boxtel and Goeree Overflakkee.

The Social Trials programme started in 2019 based on the attached programme proposal for the period 2019-2021. A total of €1 million was made available by the Ministry of Health, Welfare and Sport. In 2020, the programme was expanded for the purpose of a second tranche of Social Trials and Social Approach to Dementia training activities, Social Trials; Expansion through implementation. A total of €1 million was again made available  by the Ministry of Health, Welfare and Sport. In addition, Alzheimer Nederland and the Gieskes Strijbis Fund have each donated €250,000 to the extension of the ZonMw programme. In early 2023, the Ministry of Health, Welfare and Sport once again requested that the programme be extended until the end of 2024 with an additional budget of €1,500,000, focusing on the extension of the first tranche of Social Trial regional pilots and the external evaluation.