Second English National Memory Clinics Audit Report National Memory Clinics Audit Report... · ©...

Second English National Memory Clinics

Audit Report

December 2015

1 © 2015 Royal College of Psychiatrists

Funded by: Department of Health

Conducted by: Royal College of Psychiatrists

Authors: Sophie Hodge & Emma Hailey

Correspondence:

Sophie Hodge

Royal College of Psychiatrists’ Centre for Quality Improvement

21 Prescot Street

London

E1 8BB

[email protected]

An interactive map and copies of this report can be found on the website:

Publication number: CCQI193

www.rcpsych.ac.uk/memoryclinicsaudit

mailto:[email protected]

http://www.rcpsych.ac.uk/memoryclinicsaudit

© 2015 Royal College of Psychiatrists 2

Contents

Foreword 4

Recommendations 6

Executive summary 8

Interactive map and website address 9

Introduction 10

Definition of a memory clinic 10

Method 11

Questionnaire development 11

Participants 11

Data collection 11

Data cleaning and quality 11

Results 13

Response rate 13

Service type 13

Funding 13

Capacity 14

Waiting times 17

Timely diagnosis 19

Service provision 20

Involvement of people with dementia and carers in service development 22

Research 24

Membership of the Memory Services National Accreditation Programme 26

References 27


Foreword

It is a great pleasure to be asked to contribute to this important publication about the profile of memory services in the UK. Dementia is a national priority and memory clinics have a key part to play in the assessment, diagnosis and treatment of people suffering from symptoms which may be due to dementia. Previous work by the Royal College of Psychiatrists has expertly highlighted the current landscape of memory services in the UK and the Memory Services National Accreditation Programme has been instrumental in raising standards across the country. The inclusive nature of the process and transparent publication of findings is a template which similar audits could follow with benefit. We know there is variation in service provision across the country, in particular in waiting times, and MSNAP has been instrumental in bringing this issue to the fore and facilitating individual services to improve the care they provide for people, their families and carers. It is a privilege to be associated with the MSNAP process and I know the results contained in this report will benefit patients throughout the country. Alistair Burns National Clinical Director for Dementia NHS England


Recommendations

Capacity

Between 2013 and 2014, the number of patients seen by memory clinics increased by 31% on

average, although available capacity did not increase significantly. It is crucial that resources are

allocated appropriately to memory clinics to ensure that all those who need it receive timely

assessment, diagnosis and high quality follow-up care.

Waiting times

The average waiting time from referral to assessment increased from 5.2 weeks in 2013 to 5.4

weeks in 2014, and waiting time from assessment to diagnosis increased from 8.4 to 8.6 weeks.

Differences in average waiting times between services also increased, with the wait between

receipt of referral and first assessment being as little as one week and as long as 32 weeks.

Length of wait from referral to first assessment is too great in some areas and needs to be

addressed, with additional resources where necessary to reduce longer waits to acceptable

levels.

Psychosocial interventions

Cognitive Stimulation Therapy (CST) and life story work are available to people with dementia in

around two-thirds of memory clinics. Education and support for carers is available to almost all

clinics. These figures did not increase greatly between 2013 and 2014. CST is an intervention

recommended by NICE and all memory clinics should aim to provide or gain access to this

therapy.

Funding

In both 2013 and 2014, budgets ranged from tens of thousands to millions of pounds. For around

two-thirds of clinics that provided funding information in both 2013 and 2014, the budget stayed

the same or increased between the years, and the remainder had a reduction in their funding.

Consideration should be made as to why substantial variation occurs in funding for services.


Executive summary

An audit was conducted of memory clinics in England between 15 September and 31

October 2014.

182 out of 222 memory clinics in England responded, a response rate of 82%.

Key findings

Service model 36% clinics are stand-alone memory services

Funding Each clinic spent on average £557,000 in 2014 Working hours Average operating hours are 38 per week

Assessments Clinics offer on average 18 assessments per week

On average, clinics assessed 576 people over 12 months

Appointments Clinics saw on average 1579 patients in total (including assessment and follow-up) over 12 months

Waiting times

Average waiting time from referral to assessment was 5.42 weeks Average waiting time from assessment to diagnosis was 8.55 weeks

Timely diagnosis 52% patients received an early diagnosis

Service provision

95% clinics provide home based assessments 85% clinics have access to specialist post-diagnostic counselling 99% clinics are able to initiate anti-dementia medication

99% clinics are able to monitor anti-dementia medication

68% clinics have access to Cognitive Stimulation Therapy 98% clinics have access to education and support for carers

63% clinics have access to life story work Service user and carer involvement

People with dementia and carers are most likely to be involved in giving feedback on the service, and least likely to be involved in helping to deliver staff training

Research

85% clinics ask people with dementia if they would like to register their interest in participating in research

83% clinics recruited people with dementia to at least one research study in 2014

MSNAP Membership

47% clinics were members of the Memory Services National Accreditation Programme


Interactive map

Our interactive online map can be found on our website, displaying:

waiting times

research involvement

MSNAP membership

Additional copies of the report may also be downloaded from the website.

www.rcpsych.ac.uk/memoryclinicsaudit



Introduction

In 2011 the NHS Information Centre published their report Establishment of Memory Services - Results of a survey of Primary Care Trusts, final figures, 2011 which investigates memory clinics in England, following on from a recommendation in the English National Dementia Strategy in 2009 to commission these clinics. The audit collected data on spending, aspects of service provision, and accreditation by the Memory Services National Accreditation Programme (MSNAP). In 2012 David Cameron launched the Prime Minister’s Challenge on Dementia, which laid out a number of key recommendations for dementia diagnosis and care in England, including the recommendation to ‘Ensure that memory clinics are established in all parts of the country and drive up the proportion of memory services that are accredited [by MSNAP]’. The Royal College of Psychiatrists was then commissioned to conduct a further survey of memory clinics in England in order to report on the progress of these services against the ambitions in the Prime Minister’s Challenge on Dementia. This survey, conducted in 2013, found that many aspects of service, such as waiting times and funding, varied greatly across the country, and that patient numbers had increased fourfold between 2011 and 2013. In 2014 the Royal College of Psychiatrists was commissioned to repeat this survey to monitor progress against the 2013 audit, and against the Prime Minister’s Challenge. The results of this survey are included in this report, and comparison is drawn with the results from the previous audits.

Definition of a memory clinic ‘Memory clinics’ and ‘memory services’ were referred to interchangeably throughout the process in order to be as inclusive as possible. This was done deliberately because there is currently no agreement about what such services should be called and many would identify themselves as one but not the other. The following definition was used for the purpose of this survey:

“A memory clinic/service is defined as a multidisciplinary team (either NHS or private) that assesses and diagnoses dementia, and may provide psychosocial interventions for dementia. This can include Community Mental Health Teams for Older People.”


Method Questionnaire The same questionnaire was used as in the 2013 audit, with extra guidance added for clarification to some questions that were commonly misunderstood previously. In addition, in the 2013 audit many questions were ‘forced response’ which caused some confusion, so the majority of questions in the 2014 audit were optional to answer. This increased the number of non-respondents for each question but it was hoped this would mean only quality data were supplied.

Participants As in the previous audit, memory clinics were contacted directly as there were a number of questions to be included in the questionnaire for which it was felt that memory clinics themselves would have access to the most accurate data. A number of Trust audit leads were also included in the invitation in order to make them aware of the survey. The same database of contacts identified for the 2013 audit was used for the 2014 audit. During 2014, a mapping project was undertaken by the Royal College of Psychiatrists’ Centre for Quality Improvement to identify all memory clinics in the UK and this revealed a small number of additional services that had not been included in the last audit. This brought the total to an estimated 222 memory clinics in England.

Data collection

Data collection for the second national memory clinics audit began on 15 September 2014

and ended on 31 October 2014, via an online questionnaire.

Data cleaning and quality

After data collection any extreme outliers and null responses were identified and the

responder was contacted to ask for clarification. Where no answer was received, the data

were removed from the calculations.

As part of data collection, responders were asked to state what source of information they

mainly used in completing the questionnaire (shown in Table 1). In 2014, more services used


existing data or examining records to supply the information required than in 2013, and

fewer services estimated their response based on a clinical impression. It is possible that the

2013 audit prompted teams to begin collecting these data routinely, and this has remained

in practice.

Table 1: Main source of information used when completing the questionnaire

2013 2014

Data that service already compiles 99 (55.6%) 100 (60.6%)

Examination of records for the purpose of this audit 16 (9.0%) 23 (13.9%)

Clinical impression based on experience of working in the service

63 (35.4%) 42 (25.5%)


Results

Response rate

182 out of an estimated 222 memory clinics in England responded: a response rate of 82%.

Memory clinics from 60 NHS Trusts completed the survey.

Service type

Table 2: Types of memory clinic

2013 2014

Stand-alone memory clinic 54 (34.4%) 51 (36.17%)

Part of a wider service (such as a CMHT-OP) 103 (65.6%) 90 (63.83%)

Non-response 21 41

The proportion of memory services that are provided as stand-alone clinics remained similar

between 2013 and 2014. A greater number of clinics chose not to answer this in the 2014

audit; perhaps due to uncertainty about the structure, or changes in services.

Funding

Table 3: Average memory clinic funding per year

2013 2014

Average funding per year £622,621 £557,492

Range £25,000 - £5,000,000 £10,000 - £3,200,00

Median £445,685 £500,000

Mode £800,000 £300,000

Non-response 66 103

Table 4: Comparison of funding in clinics that provided funding information in both 2013 and

2014

Average change in funding 2013-14 +£1,646

Median change in funding 2013-14 +£21,706

Maximum increase +£2,950,000

Maximum reduction -£3,948,269

Excluded cases 123


As the non-response rate was so high in both years, these data should be treated with

caution. It appears that average funding reduced between 2013 and 2014 by £65,000 per

service. Comparing only those clinics that provided data in both 2013 and 2014 (n=59),

however, the average change in funding was an increase of £1,646. It is possible that clinics

were more likely to provide funding information in 2014 if their budget had increased rather

than if it had decreased. 64% of these clinics saw their funding increase or remain the same

between 2013 and 2014, whilst the remaining 36% had their budget reduced. The service

with the largest increase had almost £3million additional funds in 2014 compared to 2013,

whilst the service that faced the largest reduction lost almost £4million from its budget.

Whilst it is impossible to comment on the circumstances of individual clinics that vary in

terms of the population served and models of working, it appears that some services have

had substantial increases in funding whilst others have had significant cuts. In order to

provide high quality services that provide a universal standard of care, funding needs to be

examined and made more equitable.

Capacity

In this section the survey asked about the number of hours the clinic operates, the

maximum number of new patients that could be seen, and the actual number seen in each

clinic.

Table 5: Memory clinic operating hours per week

2013 2014

Average 37.6 38.4

Range 4 – 77 1 – 90

Median 38 38

Mode 38 38

Non-response 2 16

As with 2013, the average, median and mode working hours reflect a standard 9-5, Monday-

Friday working week. 9.0% of clinics open for more than 40 hours per week, which may

reflect working as part of a larger team (for example a community mental health team) that

operates extended hours or weekend opening. In addition, some memory clinics may offer

extended hours in order to increase the number of assessments they are able to undertake.

Table 6: Maximum number of new patients that can be assessed each week

2013 2014

Average 18.0 18.3

Range 2 – 102 1-70

Median 15 15

Mode 12 10

Non-response 1 17


Table 7: Total number of new patients that were assessed in the last 12 months

2013 2014

Average 543.8 576.3

Range 70 – 2,100 9 – 2,046

Median 445 456

Mode 400 400

Non-response 3 18

Table 8: Total number of patients who attended the clinic in the last 12 months (including

new assessments)

2013 2014

Average 1,206.2 1,579.2

Range 81 – 7,802 13 – 14,364

Median 887 992

Mode 500 600

Non-response 9 22

Figure 1: Total number of patients seen per year, including assessments and follow-up

appointments

On average, memory clinics each assessed 576 new patients and saw 1579 patients in total

in the 12 months prior to the audit. As seen in Figure 1, the most common number of

patients seen per clinic, per year was between 500 and 999 (32.2%). A small minority saw

more than 4000 patients per year (4.6%).

Examining Figure 2, it can be seen that there was a dramatic increase in patient numbers

between 2011 and 2013 and the average number of patients attending each clinic or

0%

5%

10%

15%

20%

25%

30%

35%

Pe

rce

nta

ge o

f m

em

ory

clin

ics

Number of patients seen per year


organisation continued to rise, albeit at a slower rate, between 2013 and 2014. Clinics in

2014 saw on average 30.9% more patients than in 2013 and conducted 6.0% more

assessments.

Figure 2: Average number of patients accessing memory clinics per organisation (Trust) and

memory clinic between 2008 and 2014

However, capacity in memory services did not increase significantly between 2013 and

2014, with clinics able to assess on average 18.3 new patients per week in 2014, as

compared with 18.0 in 2013. This equates to memory clinics offering an average of only 16

additional assessments each per year.

As with 2013, the figures varied greatly between clinics. Some of the variance may be

explained by differences in population size but there is also likely to be variance in resources

or referral patterns. One clinic saw over 14,000 patients in total, while another saw only 13,

which suggests differences perhaps in service configuration and specificity.

0

500

1000

1500

2000

2500

3000

3500

4000

4500

2008/9 2009/10 2010/11 2013 2014

Patients perclinic

Patients perorganisation


Waiting times

Table 9: Waiting time between memory clinic receipt of referral, and assessment

2013 2014

Average 5.20 weeks 5.42 weeks

Range 1 – 25 weeks 1 – 32 weeks

Median 4 weeks 5 weeks

Mode 4 weeks 4 weeks

Non-response 1 0

The average waiting time for an assessment increased from 5.2 weeks in 2013 to 5.4 weeks

in 2014. Whilst this may not be a significant increase, the longest waiting time recorded in

2014 was 32 weeks as compared with 25 weeks in 2013. In some areas, patients waited only

one week for an appointment and inequality remains across all areas. Visit our interactive

map at www.rcpsych.ac.uk/memoryclinicsaudit to find out what the waiting time was in

your area.

The standard set by the Memory Services National Accreditation Programme states that

people should wait no more than 6 weeks between referral and their first assessment.

73.6% services are currently within this target, a slight reduction on 2013 (75.7%). Figure 3

demonstrates that the vast majority of services have waiting times less than 12 weeks.

Figure 3: Number of weeks’ wait between memory clinic receipt of referral and first

assessment

0

5

10

15

20

25

30

35

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32

Nu

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linic

s

Number of weeks



Table 10: Waiting time between assessment and receipt of diagnosis

The average waiting time between the first appointment and receiving a diagnosis also

increased slightly between 2013 and 2014. Again, this varies greatly from zero weeks

(delivering a ‘one-stop shop’ where the diagnosis is given the same day as the assessment)

to 40 weeks’ wait, with the average at 8.6 weeks. The wait between assessment and

diagnosis can depend on factors such as waiting for test results from other departments or

for a diagnostic appointment with a specific person (often a consultant psychiatrist) who

may have limited sessional time in the clinic. As with waiting time for assessment, Figure 4

reveals that most memory clinics are able to deliver diagnosis within 12 weeks of

assessment.

Figure 4: Number of weeks’ wait between the person’s first assessment and receiving a

diagnosis

As seen in Table 11, the average total wait between referral and diagnosis is 13.9 weeks, a

slight increase from 13.48 weeks in 2013, with the wait for diagnosis accounting for

approximately two-thirds of that time. However, the total time varies from 2 to 56 weeks.

Figure 5 demonstrates the spread of waiting times and shows that the vast majority of

clinics fall between 2-24 weeks’ wait from referral to diagnosis. Furthermore, 80.2% clinics

deliver a diagnosis within 18 weeks of referral.

0

5

10

15

20

25

30

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39

Nu

mb

er o

f m

emo

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s

Number of weeks

2013 2014





Non-response 1 1


Table 11: Number of weeks’ wait between memory clinic receipt of referral and the person

receiving their diagnosis

Figure 5: Number of weeks’ wait between memory clinic receipt of referral and the person

receiving their diagnosis

Timely diagnosis

Table 12: Percentage of people diagnosed in the last 12 months who were diagnosed in the early stages of dementia (according to thresholds defined by the assessment tool used)

2013 2014

Average 49.3% 51.7%

Range 4 – 100% 1-100%

Median 50% 50%

Mode 80% 60%

Non-response 19 53

The percentage of people diagnosed whilst in the early stages of dementia increased

modestly from 49% in 2013 to 52% in 2014. It is encouraging that several clinics gave very

high estimates as to their rate of timely diagnosis, however some clinics are still seeing the

majority of people presenting with moderate to severe dementia and there is room for

improvement in this area which could be aided by education of referrers and the public.

0

2

4

6

8

10

12

14

16

18

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 55

Nu

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ics

Number of weeks

2013 2014






Service provision

Figure 6: Percentage of memory clinics that provide various features of service provision

Figure 6 demonstrates that clinics overall were able to offer more aspects of service in 2014

than in 2013. Almost all clinics prescribed and monitored anti-dementia medication in 2013

so these figures did not rise notably in 2014. However, access to specialist post-diagnostic

counselling was available in 85% clinics in 2014 as compared with only 74% clinics in 2013.

Access to Cognitive Stimulation Therapy (CST) and life story work did not change

significantly between 2013 and 2014; these activities remained available in around two-

thirds of clinics. Given that CST is a NICE-recommended psychosocial therapy, it would be

expected that this intervention would be available in a greater proportion of clinics.

Table 13: Number of people who used specialist post-diagnostic counselling, per clinic, in the

last 12 months

2013 2014

Average 259.7 207.4

Range 1 – 1451 0 – 2000

Median 155 60

Mode 20 0

Non-response 77 79

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Home basedassessment

Access tospecialist post-

diagnosticcounselling

Initiation ofanti-dementia

medication

Review of anti-dementia

medication

Access tocognitive

stimulationtherapy

Access toeducation and

support forcarers

Access to LifeStory work

2013 2014


It appears that the number of people using specialist post-diagnostic counselling reduced by

around 20% between 2013 and 2014, however interpretation of these data should be done

with caution as there is disagreement over what constitutes specialist post-diagnostic

counselling. This intervention should be delivered by a qualified counsellor for people with

rarer diagnoses or particularly adverse reactions to the diagnosis. However many clinics

interpreted this as routine advice and support delivered by the memory clinic team

following diagnosis, so the numbers may be somewhat distorted.

Table 14: Number of people who used Cognitive Stimulation Therapy, per clinic, in the last 12

months

2013 2014

Average 53.7 63.7

Range 0 – 500 0 – 637

Median 27.5 47

Mode 0 0

Non-response 60 90

Although the proportion of clinics offering CST courses has not increased, it appears that the

number of people attending them has. Within the clinics offering this intervention, in 2014

an average of 64 people used CST, compared with 54 people in 2013, an increase of 19%.

However there was also a high rate of non-responders to this question, suggesting that not

all clinics keep figures of people that attended the course. If delivered by a third party, it

may be difficult for the clinic to access these data.

Table 15: Number of people who used education and support for carers, per clinic, in the last

12 months

2013 2014

Average 251.9 271.9

Range 0 – 1977 0 – 2000

Median 100 150

Mode 0 50

Non-response 8 57

The number of carers accessing education and support rose by 8% between 2013 and 2014,

which is in line with the fact that the number of clinics offering this service rose from 94% in

2013 to 98% in 2014. It is essential that carers receive adequate support both to maintain

their own health and support their caring abilities.


Involvement of people with dementia and carers in service development

As seen in Figures 7-11, the proportion of clinics in 2014 that do not involve people with

dementia and carers in service development has decreased compared to 2013. However, it

also appears that more clinics in 2014 opted to involve either people with dementia or

carers only, but not both. The proportion of clinics that involved both parties in service

development decreased between 2013 and 2014 across all aspects surveyed.

As with 2013, in 2014 the area in which both people with dementia and carers were most

likely to be involved was giving feedback on service quality, and the aspect they were least

likely to be involved in was helping to deliver staff training. It is encouraging to see that a

greater proportion of people with dementia or carers were involved in peer support work in

memory clinics in 2014 (Figure 11).

0%10%20%30%40%50%60%70%80%90%

100%

Both peoplewith

dementiaand carersinvolved

People withdementia

onlyinvolved

Carers onlyinvolved

Neitherpeople with

dementianor carersinvolved

Appointment of new staff

2013

2014

0%10%20%30%40%50%60%70%80%90%

100%

Both peoplewith


People withdementia

onlyinvolved

Carers onlyinvolved

Neitherpeople with


Feedback on service quality

2013

2014

Figure 7: Percentage of memory

clinics which involve people with

dementia and carers in the

appointment of new staff


clinics which involve people with

dementia and carers in delivering

feedback on service quality


Figure 11: Percentage of

memory clinics which involve

people with dementia and

carers in helping support

other people with dementia

and carers

0%10%20%30%40%50%60%70%80%90%

100%

Both peoplewith


People withdementia

onlyinvolved

Carers onlyinvolved

Neitherpeople with


Planning changes to service organisation and delivery

2013

2014

0%10%20%30%40%50%60%70%80%90%

100%

Both peoplewith


People withdementia

onlyinvolved

Carers onlyinvolved

Neitherpeople with


Staff training

2013

2014

0%10%20%30%40%50%60%70%80%90%

100%

Bothpeople with


People withdementia

onlyinvolved

Carers onlyinvolved

Neitherpeople with


Helping support other people with dementia or carers

2013

2014


clinics which involve people

with dementia and carers in

planning changes to service

organisation and delivery

Figure 10: Percentage of

memory clinics which involve

people with dementia and

carers in staff training


Research

Table 16: Number of memory clinics which ask people with dementia to register their

interest in participating in research studies

2013 2014

Asks people with dementia to register interest 130 (73.0%) 140 (85.4%)

Does not ask people with dementia to register interest 48 (27.0%) 24 (14.6%)

The data in table 14 demonstrate that a greater proportion of clinics in 2014 ask people with

dementia to register their interest in taking part in dementia research than in 2013 (85%

compared with 73% respectively). Involvement in research was a key commitment in the

Prime Minister’s Challenge on Dementia and is also included in the Memory Services

National Accreditation Programme standards, so it is encouraging to see that a greater

proportion of clinics are involved in 2014. However, as seen from table 15, the proportion of

clinics that actually recruited people to at least one study has decreased slightly. The

average number of studies each clinic recruited to also decreased from 3.55 in 2013 to 2.98

in 2014.

It is hoped that services such as Join Dementia Research run by the National Institute for

Health Research will help memory clinics to effectively recruit people with dementia to

relevant research studies, and that this will boost the number of people recruited through

memory clinics in the future.

Table 17: Number of research studies each memory clinic recruited patients to in the past 12

months

2013 2014

Average 3.55 2.98

Memory clinics that recruited people to at least one study

118 (84.3%) 153 (82.5%)

Range 0 – 44 0 – 20

Median 2 2

Mode 1 2

Non-response 38 15

In Figure 12 the spread of recruitment to research can be seen; 66% of clinics recruited to

between 1 and 4 studies while a handful recruited to more than 10.

https://www.joindementiaresearch.nihr.ac.uk/


Figure 12: Number of different research studies that recruited patients through memory

clinics in the last 12 months

0

5

10

15

20

25

30

35

40

45

50

0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Nu

mb

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Number of research studies


Membership of the Memory Services National Accreditation Programme

Details of membership of MSNAP were taken from the membership list on the MSNAP

website and it was noted which of the responders were members of the programme, and

their accreditation status.

MSNAP is a quality improvement programme which reviews memory clinics against a set of

evidence-based standards, and supports clinics to achieve accreditation.

Table 18: Percentage of memory clinics that are members of the Memory Services National

Accreditation Programme

2013 2014

Members 60 (33.7%) 88 (47.2%)

Non-members 118 (66.3%) 94 (52.8%)

Breakdown of memory clinics by accreditation status

Accredited as excellent 15 (8.4%) 35 (19.7%)

Accredited 12 (6.7%) 19 (10.7%)

In review stage (not yet accredited) 27 (15.2%) 20 (11.2%)

Affiliate member (part of network but not reviewed) 6 (3.4%) 10 (5.6%)

MSNAP membership increased from around a third of English memory clinics in 2013 to

almost half in 2014, and there has also been an increase in accredited services between

2013 and 2014. Since membership of, and accreditation by, MSNAP, is a recommendation in

the Prime Minister’s Challenge on Dementia, it is good to see that both domains have

increased. However there still remains over half of memory clinics that are not members of

the programme and may benefit from joining.

http://www.rcpsych.ac.uk/memory-network



References

Establishment of Memory Services, Final results of a Survey of PCTs (2011). NHS Information

Centre

https://catalogue.ic.nhs.uk/publications/mental-health/surveys/est-mem-serv-res-surv-pct-

fin-2011/est-mem-serv-res-surv-pct-fin-2011-rep.pdf

Join Dementia Research


Living well with dementia: A National Dementia Strategy (2009). Department of Health

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/168220/d

h_094051.pdf

Memory Services National Accreditation Programme (MSNAP)

www.rcpsych.ac.uk/memory-network

Memory Services Register

www.rcpsych.ac.uk/memory-services-register

NICE Clinical Guideline CG42: Dementia: Supporting people with dementia and their carers

in health and social care (2011). National Institute for Health and Care Excellence

http://publications.nice.org.uk/dementia-cg42

Prime Minister’s Challenge on Dementia (2012). Department of Health

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/215101/d

h_133176.pdf

https://catalogue.ic.nhs.uk/publications/mental-health/surveys/est-mem-serv-res-surv-pct-fin-2011/est-mem-serv-res-surv-pct-fin-2011-rep.pdf

https://catalogue.ic.nhs.uk/publications/mental-health/surveys/est-mem-serv-res-surv-pct-fin-2011/est-mem-serv-res-surv-pct-fin-2011-rep.pdf


https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/168220/dh_094051.pdf



http://www.rcpsych.ac.uk/memory-services-register

http://publications.nice.org.uk/dementia-cg42




Royal College of Psychiatrists’ Centre for Quality Improvement

21 Prescot Street

London

E1 8BB

© 2015 Royal College of Psychiatrists

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