Early Intervention Memory Service Norfolk and Suffolk Foundation Trust (NSFT) has been commissioned by Ipswich and East Suffolk CCG to establish and run an Early Intervention Memory Service from April 2014 for a period of 3 years – 4 years. The service will address the under-diagnosis of dementia in the local population and intends to increase the number of people with dementia who receive a formal diagnosis to approximately 1500 per year. Service user numbers have been presented by IESCCG as part of the service specification. These numbers have been based on the national Dementia Prevalence Calculator when applied to population and demographics of the targeted area. Indicative numbers suggest 5746 people living with dementia in Ipswich and East Suffolk. A key element of the service will be the provision of the assessment and diagnosis for people with dementia in primary care settings, ie closer to patients and their families own homes. NSFT intends to achieve this by working with GP's to establish 10 new locality clinics (referred to as Lead GPs). Each of these clinics will offer appointments reference to assessment, diagnosis and post-diagnosis follow-up. NSFT now wishes to identify the 10 lead GP practices/surgeries with whom to formally develop and implement the service. NSFT will provide consultant led training in dementia assessment and diagnosis to those GPs who wish to work as part of this new and innovative service. Expand the diagnostic capabilities and capacity within Primary care. Minimise use of anti-psychotic medication and provide advice on alternative strategies. Role of the lead GP This is an exciting opportunity for GPs to work with specialist dementia clinicians in making a step change improvement in the earlier diagnosis of people with dementia. The key aspects of the Lead GP role are: The delivery of two half-day dementia clinics a month seeing at least 6 service users per month; The ability to undertake a customised training programme in dementia assessment and diagnosis, delivered by a consultant psychiatrist or associate specialist. In addition the lead GP practice is expected to: Make available for one day per month 2 rooms for clinical diagnosis. Support administratively the running of a dementia diagnosis clinic two days a month, including referrals from other surgeries NSFT will provide a Dementia Administration Support Team, whose role will include: arranging assessment and diagnosis appointments/clinic; diary management of clinical rooms; chasing pre-diagnosis test results; working with lead GP practice administration to support the smooth running of the assessment and diagnosis clinics. Memory Assessment Version V
In addition NSFT offers: An individually designed training programme for each Lead GP selected. Consultant Psychiatrists and Associate Specialist contactable by phone/ for advice. Nursing/Psychology staff accessible for advice/support/signposting. Availability of the Multi -Disciplinary Team [MDT] at diagnostic clinics to include support, sign-posting and advice regarding people with Behavioural Psychological Side Effects of Dementia. Remuneration will be in line with average clinical day rates, with the final rate being determined / fixed after consultation with interested GPs through the selection process. Selection process for lead GPs A detailed specification is available and GPs will be asked to confirm their interest. It is the intention of NSFT to negotiate a standard (generic) contract with selected GPs with the focus being a) long-term commitment; b) value for money; c) agreed business performance levels. Precise criteria for selection for lead GPs will be confirmed but will include: Geographic spread of practices to maximise accessibility for patients Appropriate environment in which to assess and diagnose people with dementia Ability and commitment to work with neighbouring practices and residential nursing home to maximise the number of referrals to the service. Work co-operatively with other services/agencies to meet identified service. Benefits for the potential service user More dementia patients managed in primary care for longer. People have a positive experience of care. Improved quality of life for patients and carers as a result of early diagnosis. People with dementia and their carers have appropriate information that allows them to manage their care more effectively along the pathway and understand how to access other assistance. Quicker turnaround time for treatment and diagnosis. Services will be provided at a more local level; will be readily accessible and will meet the range of needs of the local population including minority groups. Continuity of care across the pathway and integration with other care providers. Increase the skills, knowledge and understanding of clinicians working in primary care. A more holistic, multi-disciplinary approach, as other professionals, ie nurses and psychologists, would be involved in the assessment and diagnosis formulation. Memory Assessment V