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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
An interactive map and copies of this report can be found on the website:
Publication number: CCQI193
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
3 © 2015 Royal College of Psychiatrists
© 2015 Royal College of Psychiatrists 4
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
5 © 2015 Royal College of Psychiatrists
© 2015 Royal College of Psychiatrists 6
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.
7 © 2015 Royal College of Psychiatrists
© 2015 Royal College of Psychiatrists 8
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
9 © 2015 Royal College of Psychiatrists
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
© 2015 Royal College of Psychiatrists 10
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.”
11 © 2015 Royal College of Psychiatrists
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
© 2015 Royal College of Psychiatrists 12
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%)
13 © 2015 Royal College of Psychiatrists
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
© 2015 Royal College of Psychiatrists 14
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
15 © 2015 Royal College of Psychiatrists
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
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em
ory
clin
ics
Number of patients seen per year
© 2015 Royal College of Psychiatrists 16
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
17 © 2015 Royal College of Psychiatrists
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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Number of weeks
© 2015 Royal College of Psychiatrists 18
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
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f m
emo
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linic
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Number of weeks
2013 2014
Average 8.36 weeks 8.55 weeks
Range 0 – 21 weeks 0 – 40 weeks
Median 8 weeks 8 weeks
Mode 8 weeks 10 weeks
Non-response 1 1
19 © 2015 Royal College of Psychiatrists
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
mb
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emo
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lin
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Number of weeks
2013 2014
Average 13.48 weeks 13.92 weeks
Range 0 – 36 weeks 2 – 56 weeks
Median 13 weeks 13 weeks
Mode 8 weeks 12 weeks
© 2015 Royal College of Psychiatrists 20
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
21 © 2015 Royal College of Psychiatrists
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.
© 2015 Royal College of Psychiatrists 22
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
dementiaand carersinvolved
People withdementia
onlyinvolved
Carers onlyinvolved
Neitherpeople with
dementianor carersinvolved
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
Figure 8: Percentage of memory
clinics which involve people with
dementia and carers in delivering
feedback on service quality
23 © 2015 Royal College of Psychiatrists
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
dementiaand carersinvolved
People withdementia
onlyinvolved
Carers onlyinvolved
Neitherpeople with
dementianor carersinvolved
Planning changes to service organisation and delivery
2013
2014
0%10%20%30%40%50%60%70%80%90%
100%
Both peoplewith
dementiaand carersinvolved
People withdementia
onlyinvolved
Carers onlyinvolved
Neitherpeople with
dementianor carersinvolved
Staff training
2013
2014
0%10%20%30%40%50%60%70%80%90%
100%
Bothpeople with
dementiaand carersinvolved
People withdementia
onlyinvolved
Carers onlyinvolved
Neitherpeople with
dementianor carersinvolved
Helping support other people with dementia or carers
2013
2014
Figure 9: Percentage of memory
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
© 2015 Royal College of Psychiatrists 24
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.
25 © 2015 Royal College of Psychiatrists
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
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mo
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linic
s
Number of research studies
© 2015 Royal College of Psychiatrists 26
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.
27 © 2015 Royal College of Psychiatrists
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
https://www.joindementiaresearch.nihr.ac.uk/
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
© 2015 Royal College of Psychiatrists 28
29 © 2015 Royal College of Psychiatrists
Royal College of Psychiatrists’ Centre for Quality Improvement
21 Prescot Street
London
E1 8BB
© 2015 Royal College of Psychiatrists