National Audit of Dementia: Spotlight Audit in Memory Assessment Services 2023/24 (8 August 2024)

Summary

This report examines waiting times, access to assessments, treatment, and post-diagnostic support for people with dementia in memory assessment services. This is drawn from data collection carried out in Memory Assessment services at the end of 2023, relating to patients who had appointments for assessment from the beginning of the year, plus information about how the service is provided. The results indicate that there is still a great deal of variation between services in key results such as average waiting time for patients, the proportion of patients diagnosed with dementia, and the provision of post diagnostic support and therapy.

Content

Key findings

Report recommendations

• Memory Assessment Services should ensure provision and consistent recording of high-quality memory assessment, including brief assessment of: eyesight and hearing, alcohol consumption and falls. They should offer post-diagnostic follow up and support through provision or facilitated access to a dementia advisor, Cognitive Stimulation Therapy, carer psychoeducation courses, and medication review as required.
• Trusts should ensure monitoring at an appropriate senior level of the recommendations set out in the Dementia Care Pathway Implementation Guidance and work together within regions, involving people with lived experience and their carers, to identify barriers to access, including demographic factors and deprivation.
• Integrated Care Boards should review results of their services with reference to responsibilities to meet the recommendations set out in the Dementia Care Pathway Implementation Guidance, including:
  • Commissioning to meet current and anticipated need.
  • Recommended waiting times in line with the Guidance.
  • Criteria to ensure equitable access to services.
  • Diagnostic criteria and components of routine in-clinic assessment, as set out in the Guidance.
  • Equitable access to post diagnostic support, including standard provision of Cognitive Stimulation Therapy to people diagnosed as living with mild to moderate dementia.
  • NHS England/ Dementia Evidence Toolkit.
• NHS England, at national and regional levels, should support Integrated Care Boards and Trusts to work jointly to address variations highlighted by the audit data in access to and provision within memory assessment services, with the expectation that in all parts of the country people using services receive equitable provision, including:
  • appropriate referral and assessment, including appropriate use of neuroimaging,
  • timely diagnosis within recommended timeframes,
  • access to evidence-based treatment (e.g. Cognitive Stimulation Therapy),
  • post-diagnostic support and follow up,
  • as recommended in the NICE guideline. This work should be informed by the Dementia Care Pathway Implementation Guidance and the Memory Services National Accreditation Programme Standards for Accreditation.