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3. Structure and planning

Local and regional structures need to be properly resourced and have authority to take actions to realise the vision for learning and development in dementia care.

Local and regional plans need to make sure everyone works together to develop learning and development in line with the vision and its goals. Structures and plans are essential to achieving good value for money.


Evidence shows institutional structures, a lack of staff on rotation and clinical routines that prioritise physical care all limit the opportunity for person-centred care.

(Skaalvik et al. 2010), Hayajneh and Shehadeh 2014

To remove these barriers to ‘good’ care, practice develop-ments should focus on:

  • social interaction and engagement
  • including carers and other family members.

What good looks like

Planning and design of learning and development is co-produced with people living with dementia and their families. It takes account of the diversity of those living with dementia.

A workforce group has responsibility for planning and providing learning and development in dementia care. This group:

  • agrees learning and development priorities – the knowledge and skills that need to be developed, improved and kept up to date
  • has the support of partners across health and social care
  • develops a plan of what needs to be done and how they will be done
  • has access to learning and development staff, programmes, practical resources and an adequate budget to put the learning and development in place.

Workforce learning and development plans:

  • are based on the needs of the local population. Information can be found in your local population needs assessment
  • are comprehensive, and cover:
    • the needs of all the staff, volunteers and carers in the region who are in contact with people living with dementia on a day-to-day basis
    • all five RCN SPACE principles
  • are strengths-based and tailored for different staff groups based on knowing what works in practice
  • are co-produced with people living with dementia, families and local communities
  • develop local influencers to help bring about the changes. The influencers will:
    • own and support for the vison and actions
    • need to be from across the system and at all levels. For example, carers, clinicians and practitioners with experience of putting person-centred care in place who are open to change.
  • include a plan (often called a framework) showing how dementia learning and development needs will be met in line with the Good Work framework’s learning topics and outcomes for:
    • informed groups of people
    • skilled groups of people
    • influencers.

The framework should make it easy for staff and other interested people to access learning and development activities easy. It should offer diverse learning opportunities that are based on listening to staff.


Gkioka et al (2020) found that giving staff easy access to effective and high-quality training and education in dementia is underpins the SPACE principles.

Royal College of Nursing (2019) guidance:

  • highlights the importance of planning and providing training that’s based on a robust training needs analysis and that’s been developed in partnership with people living with dementia and their families.
  • recommends that staff should have time and space to complete relevant training. To make sustainable changes to clinical practice, ‘whole system’ evaluations need to be in place across all organisations supporting people living with dementia.

Useful resources

  • Royal College of Nursing (2019) SPACE Principles. This conceptual model sets out the five principles for improving care for people living with dementia and their families. It’s designed to be used in a range of health and social care settings and includes the most recent evidence and best practice.
  • Cardiff and Vale University Health Board use a learning and development plan and training discussion form, which is supported by partners and has funded a learning and development team that works with partners. The team has put a learning and development framework in place that’s based on the three groups of people identified in the Good Work framework: informed, skilled and influencer.

  • Diverse Cymru's cultural competency toolkit can be used as part of any dementia learning and development planning process, so you can make sure you meet the diverse cultural needs of people with dementia and their families in your area.

  • GWENT Good Work Mapping Tool, quick fill form and guidance on how to use it is available for workforce development managers.

Next section: Delivery: providing learning and development in dementia care

First published: 15 June 2022
Last updated: 8 December 2022
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