Memory Assessment Clinic

In the UK there are an estimated 850,000 people currently living with dementia and It is estimated that around 18,000 of these people are living in Hampshire alone. Due to the sharp rise in population numbers and the growing older population in Hampshire, these numbers will continue to rise.  This means the number of people accessing our memory assessment services will also increase.

Staff continue to work hard in ensuring we are providing the very best service, however, in order to meet the growing demand, we wanted to review our services to understand if and how we could make them better. Ultimately, we want to ensure the experience for those people accessing the service is a positive one.

We want to ensure that our services are equitable, regardless of geographic location. This means standardising our services to avoid unnecessary variation. You should receive the same service, assessment, treatment and access to post diagnostic support irrespective of where you live.

We want to ensure our services are of the highest quality. This means benchmarking them against agreed gold standards (the memory services national accreditation services standards - MSNAP). 

Due to the already unprecedented numbers (which are projected to double by 2040), dementia has unsurprisingly become a national focus over recent years. It is well known, that dementia has an impact, not only on the person with the diagnosis but also on family and carers who are significantly affected.

The national goal is to improve the overall dementia pathway for those accessing it. This is because, if we can diagnose dementia early, then we can provide access to treatment, support and start to plan for the future, to hopefully reduce crises later on.

The National ambition is that two thirds of the estimated number of people with dementia should receive a diagnosis and that diagnosis and treatment initiation should happen within 6 weeks of referral to memory services. Furthermore, the quality of care and support given to patients and their families post diagnosis has to be improved.

As part of the OPMH transformation project to improve our memory assessment services, we have reviewed processes within each team (process mapping), looked at individual patient journeys and carried out a baseline audit.

The audit used standards devised from the London Clinical Networks. 20 patients were reviewed from each of the 11 CMHTs (from within which our memory services operate) and the following data (amongst others) were reviewed:

• When they were first referred to the service
• How long it took until they were seen for the first assessment
• What the assessment looked like and if they were referred for other specialist assessments/ investigations such as an OT functional assessment or a psychological neuropsychiatric assessment or brain scanning
• How long it took for a diagnosis to be given
• What post diagnostic support was offered

The preliminary investigations and initial audit have highlighted that that there is significant variation across teams with the referral, assessment and post diagnostic support process and that we have some way to go with reaching the government target of diagnosing two thirds of people estimated to have dementia.

It is taking on average, 16 weeks for patients to receive a diagnosis following referral to the team. This is a long wait with little to no input or support for patients and families, at a time when they may feel particularly vulnerable. It is just not acceptable for patients and families to be waiting this long for treatment and support.

As a result of this, we have had preliminary meetings internally within the Trust to review the results and consider how we can move services forward. We have since held a workshop with internal, third sector and service user/ carer representation to look at ways of improving and standardising the service and reviewing potential models for a new memory assessment service.

We plan to continue these workshops, inviting input from primary care, patients/ carers, third sector organisations, Local authorities, Clinical commissioning groups and wider. The goal is to develop a service that is fit for purpose, meets the current and projected demands whilst maintaining the high quality we aspire to provide.

The anticipated benefits and outcomes of this project are that:

• People will experience a smoother and quicker diagnostic process and receive post diagnostic support from diagnosis to end of life
• People will experience the same diagnostic process, irrespective of geographical location
• People will be supported to live well with dementia and experience less crisis
• More efficient and cost effective services
• Greater compliance with NICE Standards