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Improving timely diagnosis and post diagnostic support. 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
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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
Improving the DES Information prescription CCG support Vascular dementia Evidence base
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: • improve access promote timely diagnosis • improve pathways to support people seeking help, and for post-diagnosis support • improve systems to capture diagnosis and to follow up after diagnosis
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
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,
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.
