The Bevan Exemplar at Swansea Bay University Health Board team has experience of implementing this tool as part of a community dementia triage service (over five years).
The story began in 2015/16 with it was clear that the multidisciplinary community resources teams had no health professionals with dementia expertise. As the vast majority of their service users are older adults with greater risk of dementia/cognitive impairments potentially with multiple conditions, the specialist support was considered as important.
Two community Nurse Practitioners with a background in dementia support and expertise were appointed and together with a team of Dementia Support Workers (funded by the Welsh Government), a service was developed to quickly respond to people who may be living with undiagnosed dementia.
The service was set up to provide early information, signpost and support services according to need. The identified ‘gap’ was the provision of a robust triage service where clinically significant cognitive changes could be detected.
The team used the CANTAB tool as part of the technology-enabled dementia triage process in the community and this showed reductions in Consultant led outpatient appointments and freed up valuable resources in the community. Furthermore, it helped establish newer and more prudent pathways to diagnosis that acknowledges the need to engage with the Primary Care sector in order to deliver this.
The Bevan Exemplar project was presented as part of a showcase (click here to read more).
This prudent way of delivering a diagnosis of dementia came at a time when more and more people are becoming affected by the disease. The ‘size of the prize’ for our service has been in terms of gaining a reputation very early on as being able to augment the current pathways and to save unnecessary referrals to Secondary Mental Health Services thus allowing them to concentrate their resources on those patients needing their input. As at March 2020, a total of 396 patients had been referred to or came through self-referral for the Swansea Community Dementia Support team*. Three out of five (around 60%) of the referrals came from General Practice, housing teams, police, and Third sector organisations. One in five referrals came from self-referral and family-based referrals.
The Swansea Community Dementia Support team was funded by the Integrated Care Fund led to enhanced primary care support across the health board at the start of the project. The Dementia Support Workers aligned to each of the 8 GP Cluster networks, and the model was endorsed by the West Glamorgan Partnership.
* This service has been disbanded and is no longer in operation.