Diagnosing Well

Click on the links below to access a range of tools and resources that could be used to improve dememtia diagnosis rates in your area: 

 

 

Primary care resources

Dementia Quality ToolKit (DQT) 

Yorkshire and Humber Strategic Clinical Network, in conjunction with Airedale NHS Foundation Trust, have been working together to provide a set of primary care resources to support clinicians who are identifying, diagnosing and providing ongoing care to patients diagnosed with dementia.  This work package has been created with clinical input and is designed to support the review process to achieve the various national targets for Dementia.

The Dementia Quaity ToolKit is one of the key elements and is available for practices who use SystmOne or EMIS Web systems.

Follow the links below for instructions on how to access the DQT:

SystmOne (Technical guidance)

EMIS Web (Technical Guidance)

EMIS Web XML documents for download

Please see the EMIS Web technical guidance for how to import these files to your GP practice system

Care Plan templates

Dementia quality toolkit

A Helpful Frequently Asked Questions document can be found  HERE

 

Primary Care resources User Guide

We have now introduced this PDF User Guide which has links embedded within it to all of the resources described above. Feel free to download the PDF HERE and share across your organisational networks and contacts.

Dementia diagnosis rates

The estimated diagnosis rate for people with dementia in Yorkshire and Humber was 71.9% at the end of October 2018 this is lower than the North of England regional average (72.7%) but higher than the national average of 67.9%. 

Monthly rates at CCG level, STP level and numbers on GP practice dementia registers are now made available at: https://digital.nhs.uk/data-and-information/publications/statistical/recorded-dementia-diagnoses

! NEW RESOURCES!

We are now providing links to 2 NEW resources which you may find useful on a Monthly basis

The current months data is highlighted with will keep previous months in case you wish to look at retrospective data

Dementia Diagnosis Report - October 2018

*Dementia Diagnosis Report November 2018

Anti-Psychotic Drug Treatments in Dementia Patients - October 2018

*Anti-Psychotic Drug Treatments in Dementia Patients - November 2018

Changes to diagnosis rates methodology

The methodology used to calculate dementia prevalence estimates will change from 1st April 2017 and this will impact on CCG dementia diagnosis rates with implications for CCG planning trajectories.  The new method will use the registered population from GP lists instead of ONS population estimates.  In Yorks & Humber, 12 CCG rates will increase as a result of the change (range from 0.7-9.5% increase) and 11 CCG rates will decrease (range -0.9% to -14.0%).  To see the impact on rates for your CCG (based on numbers on GP practice dementia registers as at end of February) click here.  For more information click here. 

 

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Why is a diagnosis of dementia important?

 

Does dementia matter?

Dr Sara Humphrey, GP Clinical Advisor for the Clinical explains why a dianosis of dementia is important. Click on the webinar and slides below for more information:

 

Understanding the benefits of a dementia diagnosis

Tackling the challenges of dementia. A new fact sheet developed by East Riding of Yorkshire CCG and Alzheimer's Society details the benefits of an early dementia diagnosis. 

 

Financial case for primary care

An important feature of QOF is the establishment and maintenance of disease registers. There are 5 QOF points available for establishing and maintaining a dementia register. It is the responsibility of the practice to demonstrate the systems that are in place to maintain a high quality register. Running the dementia quality toolkit every 6 months will give demonstrable help. The worked example here demonstrates the financial benefit of ensuring that anyone with adementia diagnosis is added to the register and that patients who present with symptoms are investigated and referred on as appropriate.

 

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DeAR GP tool

 

The tool is used by care workers in care homes to identify residents who may be showing signs of dementia. Care workers are asked to identify signs such as confusion or memory problems which have lasted over 3 months, and if they have concerns to report these to the GP or another clinician by completing the DeAR-GP tool. 


To read the briefing report click here.
You can download the tool here.

 

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DiADeM Tool – Diagnosing Advanced Dementia Mandate (for care home settings)

This protocol aims to support GPs to diagnose dementia for people living with advanced dementia in a care home setting. DiADeM is designed to be used only with those patients living with advanced dementia within a care home setting for whom a trip to memory services is unlikely to be feasible and/or make a difference to ongoing management.

THERE ARE 2 VERSIONS 

1) DiADeM with 6CIT

2) DiADeM with GP COG

Click on the relevant link to download the PDF

  © Yorkshire and Humber Strategic Clinical Network and Code4HealthAll content is licensed under the Open Government Licence v3.0 except where otherwise stated

 

DiADeM App

For some time now it was felt that an electronic version of the application would be really useful and the Yorkshire & Humber Clinical Network teamed up with Code4Health to develop the paper form into an 'App' that can be used on a variety of hand held and portable devices.  A small steering group which includes the Dementia Clinical Networks GP Dementia Adviser, representatives from Code4Health, Application Insight - and Network Quality Improvement Lead, has been working towards getting a Public Beta version ready and this is being launched on the 6th September 2017

You can find out more about DiADeM here  To use the DiADeM App you can sign up for an account here

User guides for the App can be found here

1) Full DiADeM User Guide

2) Quick Guide for Clinicians Using the App

3) Quick guide for report recipients

 

Developing DiADeM the APP Version – Blog by Colin Sloane Quality Improvement Lead YH Clinical Network, Dementia and Older Peoples Mental Health

DiADeM is a tool that is used to help to diagnose advanced dementia particularly designed for use by clinicians in care home settings.  DiADeM has been around for a while in paper format, approx. 2 years.  During which time it has been used with some degree of success and has been steadily promoted and picked up in varying degrees, by others up and down the Country.  So when the Yorkshire and Humber Clinical Network came across an opportunity to work with Code4Health and the Apperta foundation we jumped at the chance to take DiADeM to another level and create the APP.

The journey began approx. 12 months ago now and it seems like it has been a lengthy journey to get to where we are today.  The Public Beta Version launched on 6th Sept 2017, which coincides very nicely with the NHS Expo 2017.

As the service improvement lead responsible for the overall management of the project, it has been a really interesting project to work on and if you have an interest in Apps, and IT generally then I recommend doing something like this.  The initial stages of the project involved participating in ‘App in a Day’ training.  Which I thought was great however, on reflection this is where we first came across some difficulties with communications across different organisations and individuals that you will all need to think about with projects like this.  With my interest in IT I took the memory stick copy of LiveCode and put it on my home laptop and off I went to put my prototype of DiADeM together.

From there we quickly and thankfully got the full support from Apperta and Code4Health and we were assigned to a developer – Dave Kilroy @application insight.  From this point the real ‘hard work’ began.  Thankfully for me we now had an ‘expert’ coder on the team which was great.

There are a few things I’ve learned about working across very different organisations.  Health professionals and Information Technology specialists both do incredible things but they take very different routes to get to their respective ‘end point’

The language difference alone is something I’m now very aware of.  A ‘composition ID’ to a coder is standard everyday terminology, however, it’s not a term used at all by most health professionals.  They might assume they are being given license to write a concerto! Perhaps?  Equally there are terms in the health service that mean nothing to coders - ICD 10 codes, CTv3, READ codes for instance, might raise the eyebrows amongst coders? They refer to codes that most IT ‘coders’ will never have come across. 

The most important thing I’ve learned is to recognise and respect ‘difference’ and not to try to change the way people do things.  It is so important to find a compromise, working out between you a way to do things to get the best out of all people and their specialities.  Build time in to the work to allow this to happen, otherwise you may fail to get the best out of everyone and that’s a missed opportunity.

‘Persevere and be patient’ – it’s worth it in the end – when I reflect on all of the above, the journey we’ve all been on with DiADeM I know it has all been worth it when I look at the product that we now have, knowing that the use of DiADeM will help people with dementia and their carers, families to get the help and support they may not have had access to if the tool hadn’t been around.

More info about DiADeM HERE

Happy to be contacted for further info please email:  colinsloane@nhs.net

 

Widening the use of DiADeM

View the National Webinar here 

Download the DRAFT DiADeM Guidance Paper Here

 

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DiADeM App Case Study

Code4Health have produced a case study about the development of the DiADeM App

Download it HERE

 

Dementia coding

The Clinical Network has been collaborating with GPs to improve dementia diagnosis rates. This guidance document is prepared for use across the North region to provide a consistent way of coding dementia in GP practices and can be downloaded here. An example diagnosis letter template can be downloaded here. 

 

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Dementia quality toolkit

The Dementia Quality toolkit is a set of system searches (and supporting documentation) for general practice to help practices identify patients who have Read/CTv3 codes in their notes that may suggest dementia but who have NO corresponding dementia diagnosis. This webinar, relevant to GP practices within Yorkshire & Humber, explains how the toolkit works and answers some frequently asked questions.

 


  

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ECG Guidance: The Assessment of Cardiac Status Before Prescribing Acetyl Cholinesterase Inhibitors for Dementia

The Yorkshire and Humber Dementia Clinical Network launced the final guidance in April 2016. You can access it here

A Summary Sheet is also available HERE

You can also view our webinar relating to how the guidance was developed below.

Once you have viewed the webinar a CPD certificate can be downloaded here

 

Patient/Carer Stories

 

 

 

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