This presentation about improving timely diagnosis and post diagnostic support by Professor Alistair Burns, National Clinical Director for Dementia, NHS England, was delivered at the launch of the Strategic Clinical Network for Mental Health, Dementia and Neurological Conditions Yorkshire and the Humber on 17 September 2013. Alistair encourages SCNs to work with Clinical Commissioning Groups, Area Team primary care commissioners, General Practices, deaneries and LETBs to design and implement a comprehensive improvement plan, which aims to: 1. improve access promote timely diagnosis 2. improve pathways to support people seeking help, and for post-diagnosis support 3. improve systems to capture diagnosis and to follow up after diagnosis

1. Improving timely diagnosis and
post diagnostic support

2. Some current issues in Dementia
• Awareness of dementia is at its highest
• Diagnosis rate
• Early vs timely diagnosis: benefits
• Support is the key
• Read codes
• Brain Imaging
• Population screening not appropriate
• Recast dementia as a Long term condition managed in primary care
• Primary care in charge
• Dementia rarely travels alone
• Primary care memory services
• Prevention

3. Improving the DES
Information
prescription
CCG support
Vascular dementia
Evidence base

4. Focus on post diagnostic support and the numbers will follow
Work with Clinical Commissioning Groups, Area Team primary
care commissioners, General Practices, deaneries and LETBs to
design and implement a comprehensive improvement plan,
which aims to:
1. improve access promote timely diagnosis
2. improve pathways to support people seeking help, and for postdiagnosis support
3. improve systems to capture diagnosis and to follow up after
diagnosis

5. Improve access: timely diagnosis
• Promote awareness via existing routes and community assets
• Communications strategy; utilise social marketing.
• Nurture ‘dementia champions’ and experts in General Practice,
including the GP business and admin team.
• Introduce new roles and new ways of working in primary care.
• Work with postgraduate deanery and LETB to invest in and
facilitate ‘action learning’ in general practice

6. Improve pathways, to support people seeking help, and for
post-diagnosis support
• Review standards of access; pathways; patient experience;
information.
• Monitor referrals, waiting times, eg MSNAP
• Incorporate protocols and standards for people presenting
with mild cognitive impairment.
• Commission pathways to support timely diagnosis, e.g.
- ‘in reach’ to primary care by memory services; primary care
access to specialist advice,
- rapid access to scans;
- post diagnosis support in community,

7. Improve systems: to capture diagnosis, and to follow up after
diagnosis
mentia
• Understand local prevalence and establish realistic trajectories
for improvement, using Dementia Prevalence Calculator.
• Use system levers (DES, LES, CQUIN). Are they having an
impact? What can be done to improve delivery, and improve
patient experience?
• Reconcile coding (ICD10, Read Codes) – ‘Coding Clean Up
Audit’
• Reconcile QOF with prescribing of antipsychotics for over 65s,
and prescribing of anti dementia drugs
• ‘Case find’; including patients in care homes.

8. Share knowledge, innovation and learning

9. dementiapartnerships.com

12. Clinician led and collaborative
• A portal for clinician led partnerships
to support, accelerate and improve
commissioning and service redesign
• Providing collaborative tools for networks,
organisations and individuals to improve
services and the health and wellbeing of
communities

13. Supported and supportive
Helping you to:
• promote and disseminate
• consult and engage
• find and share what works best
• recommend and comment
• network and learn from elsewhere
• identify and access expertise