NHS Cornwall & Isles of Scilly PCT 1

Innovation/Service Improvement Synopsis

The Newquay dementia pathway

A model of primary care based dementia community service which enabled a GP-led Memory service to be set up. This introduced a primary care based dementia liaison practitioner role provide specialist in-reach into care homes and community hospitals; run a country wide ‘Worried about your memory?’ public information and awareness campaign; and introduce a standardised dementia health check for all people diagnosed with dementia

Long Term Condition

Dementia

Meets National Priority Area
Avoidable admissions

Benefits to Patient
Patients supported to stay at home. Early cognitive stimulation prescribed
Memory Care and meetings in groups for cognitive stimulation therapy

Benefits to Staff
Part of an effective MD team. Patient stays on the case load until the end of life-continuity of care

Cost Savings/Efficiencies
No cost data. Efficiencies in working as a patient focused team

Outcomes Measured
Outcomes within the integrated care pathway have been measured using the Quality Outcome Framework. Significant event audit monthly. DoH audit tool used - result positive feedback

Sustainability
Service has been running for 2 years. 2 of the 16 locality based DoH integrated care pilot sites in dementia care and mental health

Transferable
Suitable for other Trusts and GPs

Project Status
Current – ongoing

For more information e-mail info@nisw.co.uk

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