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Pilot Scheme Aims to Improve Dementia Diagnosis Support

A £100,000 scheme aimed at speeding up dementia diagnoses and the support which then follows is to be trialled in Dumfries and Galloway.

Only three innovation sites in Scotland have been selected to pioneer approaches which are aimed at ensuring support is provided quickly to people who are diagnosed with dementia.

Dementia Improvement/Post-Diagnostic Support (PDS) Lead Gillian Coupland said: “It’s very exciting to have been given an opportunity to take forward this important work – with the bid submitted on behalf of Nithsdale GP cluster, backed by Dumfries and Galloway Health and Social Care Partnership.
”We’ll be looking to ensure that people who may be experiencing memory and cognitive problems receive an appropriate diagnosis and then support as soon as possible, and in a way which works best for them.”

According to local data, someone in Nithsdale approaching their GP with memory problems can face a wait of up to 18 weeks before receiving a diagnosis of dementia.

They can then face a further average wait of 21 weeks before the start of their guaranteed minimum 12-month post diagnostic support (PDS).

Gillian explains that the wait has grown due to the numbers being diagnosed.

She said: “The numbers of people who are being diagnosed with dementia is increasing exponentially, and so we’re really having to rethink how we deliver this if we’re to keep this guarantee.”

The Scottish Government want to increase the number of people diagnosed with dementia, as this provides a gateway to care. And it is funding methods which could improve post-diagnostic support.

Gillian said: “We’re going to do that by looking at things like Group Post-Diagnostic Support. But what we also want to do is look at accelerating the diagnostic part, so that people receive their diagnosis earlier.
“A quicker diagnosis reduces that period of uncertainty, and allows quicker access to the sort of support someone might need.“And the main aim is that by September 2019 people who receive their diagnosis of dementia in Primary Care will actually receive their support from within Primary Care, such as the familiar environment of their local GP practice, instead of it being delivered from under the Community Mental Health Team.”

Currently, post-diagnosis support is delivered by five Dementia Link workers provided by Alzheimer’s Scotland who are spread across Dumfries and Galloway.

Gillian said: “What we’re hoping to do is train and educate the existing Primary Care staff.
“Gillbrae Medical Practice in Dumfries is the test site, with all staff trained to the Informed Practice Level of Dementia Training for NHS staff, which helps them develop the skills and values needed to support someone with dementia, their families and carers. We’re hoping that we’ll then roll that out across all the practices across Nithsdale.”
With two nurses at Gillbrae already trained to this level, Gillian said: “The Assistant Practice Manager has told me it’s made a difference already.
“One of the receptionist said that someone came in who she recognised had memory problems and was struggling.
“She recognised that, took the person to the side, and asked for someone else to man the desk while she spent some time and helped the person – and this was as a result of the Informed Level training.”

A considerable amount of interest is focused on the work which will be carried out in Dumfries and Galloway, with monthly reports required by the Scottish Government which is providing annual funding of £50,000 for the next two years.

And with an ageing population in the region, Gillian said: “This work is hugely relevant.
“And we’re hopeful that the work we’ll be doing can help make a real difference to the way people receive a diagnosis of dementia in Dumfries and Galloway, and the support that’s quickly put in place.”

Outcomes from the Nithsdale project will be measured through a sample group of patients, and will be fed in to the International Consortium for Health Outcomes Measurement which is looking to transform healthcare systems across the world by applying standardised systems of measurement.

 

 

The new pilot scheme in Nithsdale will include:

 

  • A healthcare support worker based in Gillbrae Medical Practice one day a week, supporting staff and people who come in with memory concerns.

 

  • All GP practices across Nithsdale cluster becoming Dementia Friendly GP practices.

 

  • GPs and practice nurses supported with Cognitive Screen training.

 

  • Practice nurses, district nurses and healthcare support workers provided with training to use a version of the Montreal Cognitive Assessment (MoCA) with patients, which can then be provided to GPs as evidence of concern about memory and cognition.

 

  • Psychologists serving on the project to ensure everybody knows how to handle what can be a sensitive topic.

 

  • GPs able to prescribe cognitive-enhancing medications for the first time as part of the project.

 

  • Group care support developed as a means of providing support in a peer environment

 

  • People with Non-complex diagnoses where there are no contra-indications starting to quickly receiving dementia support.

 

  • Anybody with a complex diagnosis will still come through Secondary Care.

 

 

 

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