Memory Clinic North Derbyshire

Category:          Scheme best addressing Choice for Patients

Name:               Carole Barker

Job Title:           Advanced Nurse Practitioner

Organisation:    Derbyshire Mental Health Services NHS Trust

Email:                carole.barker@chesterfieldpct.nhs.uk

Telephone:        01246 513076

Key team:          Carole Barker, Jayne Bowns - Clinic Nurse, Jill Smith - Admin Assistant

Title:                  Memory clinic north Derbyshire; involving people with dementia and their carers in future development needs

• Pressure on waiting times for access to the clinic.
• The need for more staff.
• Discussion around extending the role of the nurses instead of the clinic having to be medic led.
• Problems highlighted by users and carers during their appointments.
• Discussions with commissioners about the funding needs.
• More 'expert' users of the service and their obvious need for information and latest innovations in the care of early dementia sufferers.
• All these were issues that I felt should have the views of users and carers of the service rather than just staff within the trust.
• In order to decide on future needs of the clinic and the best way to develop it seemed common sense to gain the views of those who use it and listen to them.

• Both users and carers would benefit by informing how the service could be improved.
• The roles of the clinical staff would develop in line with real needs rather than perceived ones.
• The trust would benefit by gaining an insight into what the current problems and positives were leading to an improved service.
• We devised a patient satisfaction survey in a user friendly way covering many issues e.g. staff, appointments, experience overall and asking for comments. We also asked if they would like to attend a conference to discuss the findings. The response to this was so great that we had to hold two conferences.
• The conference programme was structured to allow for interaction and participation, with proactive prioritising of people with dementia and their carers. The speakers included a user with dementia and relevant professionals. People in lead positions within the PCT's and NHS Trust attended to listen to the users views.

The Alzheimer's Society, Changing Workforce Programme, and the Community Health Council jointly helped to organise and fund the conference.  The Community Health Council helped in the analysis of the qualitative data and produced a report of the conferences afterwards.

The conferences were both excellent and feedback from users carers and others who attended was tremendous.  We have been regularly asked about the possibility of arranging another event for users of our service.

The response to the survey and the conferences helped to persuade commissioners that the service was a good one and this resulted in the funding being made available to appoint another nurse and in turn extend the nursing roles to help address some of the highlighted problems of the service.

It also raised the issue of how as a trust we need to address real issues concerning the needs of people with early dementia.

Originally there was some resistance from key members of the trust and the PCT's but this was overcome by sensitive explanation of the need to involve users even if the comments are not positive.

The large numbers of people wanting to attend the conference raised a challenge. One idea being that tickets would be allocated randomly. I felt very strongly that all who wanted to attend should, this was finally addressed by having two.

Concerns about the safety of users were solved by involving social services who sent staff to help with accompanying people to the toilet etc.

Unexpected benefits were seeing how quite unconfident individuals who initially were hesitant about letting people know their diagnosis began to share experiences with others around their tables.

The users and their carers were very vocal about their needs and due to the organisation of the day had no qualms about expressing these to those in powerful positions within the organisations.

Many who had been nervous of asking for other support options asked for carer assessments and information about services.

Some wrote to the trusts and the PCT's and their MP's about the usefulness of our service and their needs in relation to its further development.

The PCT's in the North were so impressed that within weeks extra funding had been made available to ensure the service continued and developed.

The word has spread through users, carers, others who attended, and clinic staff.  The Derbyshire Times put a 2-page spread on early dementia highlighting the memory clinic.

A presentation for Derbyshire Mental Health Services NHS Quality Awards Exhibition in Derby and Chesterfield lead to a runner up award.

I have discussed the survey with other nurses working in different areas and have been asked if they could use our survey design for use in their clinical environment.