What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?

Many people delay seeking a diagnosis of dementia and, once they do, can face uncertainty and lengthy waits to be seen and assessed (1). The impact of COVID-19 has exacerbated this issue, with a 25% drop in the number of people receiving a dementia diagnosis in Scotland in 2020/21 compared to 2019/20.

We have already carried out a survey of dementia diagnosis models across Scotland (from 33 responses from 28 of the 31 Health and Social Care Partnerships across Scotland) and are undertaking an evidence review. Following initial analysis of this survey, we have identified variation in how people receive a diagnosis of dementia and the timeframe in which this diagnosis is delivered.

What does your project aim to achieve?

·       in-depth analysis of how a dementia diagnosis is delivered in Scotland

·       carry out a deep dive into health and social care areas who are delivering innovative models of improving dementia diagnosis

·       evaluate a service model of dementia diagnosis access innovation for scalability

·       develop a test case for building a methodology for building a model of scalability

How will the project be delivered?

1.       We will utilise the survey results already generated, as well as undertaking interviews with service users (patient and caregivers) and clinicians delivering these services, to understand experiential data.  We will use the Consolidated Framework for Implementation Research (2) as an analytical framework.

2.       We will evaluate an innovative model of service delivery derived from the findings of the first phase of this programme of work.  We will utilise the Medica Research Council’s complex intervention development and evaluation (3).  Service level data, alongside experiential and process data will be collected to understand the safety, effectiveness and person centeredness of this model of delivery in relation to its potential for widespread scale and spread.

3.       In parallel with phases one and two, we will provide a detailed summary of our methodology.  This will help future evaluation of service developments within health and social care systems in relation to readiness for spread.

How is your project going to share learning?

·       Develop and publish a case study for sharing widely through Q network and other networks across UK

·       Webinar to share learning through Healthcare Improvement Scotland dementia learning system sessions

·       An in-depth report that describes our methodology for undertaking service model evaluation.

(1)    (Alzheimer’s disease International, World Alzheimer Report, 2021).

(2)    The updated Consolidated Framework for Implementation Research based on user feedback – PubMed (nih.gov)

(3)    A new framework for developing and evaluating complex interventions: update of Medical Research Council guidance – PubMed (nih.gov)