The Fife Dementia Strategy: 2010 – 2020 - The Knowledge Network

Following a diagnosis of dementia, individuals continue to receive high quality
care and services guided by the development of a dementia patient pathway
(see Section 4.2.1).
I remember [my GP] being very very compassionate. He was very good
that way, you know. And he explained the dementia, what effects it would
have on me, you know. And he did say, “If ever you want to come and talk
to me” you know, he was very good, “we’ll have a chat anytime you want
to come.” (Person recently diagnosed with dementia)
4.1.2 Develop the role of generalist and non-dementia specialist
clinicians by ensuring clinical staff in primary and secondary care
settings are able to recognise a potential case of dementia, rule out
alternate explanations, and make an appropriate referral to specialist
services for further assessment.
Local consultations completed within Fife show that it is generally the case
that primary care and non-specialist 14 physicians do not make a diagnosis of
dementia; rather if they recognise potential cases of dementia they will refer
their patient on to the appropriate specialist service. This practice is
concordant with the rest of the UK 15 . Non-specialist clinicians in secondary
and acute care services play a similar role in this regard and face similar
challenges in accessing specialist services and equipment necessary to make
a dementia diagnosis.
There is a local concern that general awareness and recognition of dementia,
as well as understanding of what to do if a patient is suspected of having a
dementia in non-dementia/older person specialists, is limited. And, despite
improvements being made in recognition, referral and diagnosis, the culture
continues to be one of under diagnosis. Thus, as highlighted in Sections 3
and detailed in the Implementation Plan, an educational and awareness
raising programme targeted at generalist/non-specialist clinicians will be
developed. The targeted programme will be in line with SIGN guidelines 16 to
reinforce the importance in recognising dementia, making and effectively
communicating an early diagnosis of dementia, developing skills in history
taking for suspected dementia, and also ensuring awareness of follow-on
services available for diagnosis and post-diagnosis support. This work will be
completed in conjunction with the development of a clear referral pathway for
assessment and investigation (4.1.1), and a continuing patient pathway
(4.2.1).
The education programmes highlighted in Section 3 will lead to increases in
the number of people with suspected dementia being referred to specialist
services for assessments. As the SIGN dementia guidelines should be
14 The term ‘non-specialist physicians’ refers to all physicians who would not normally make a
differential diagnosis of dementia.
15 DOH (2009) National Dementia Strategy: Living Well with Dementia. Pp 36.
16 SIGN (2006).
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