1. Joanne Wombwell

2.  Joanne Wombwell (Independent Non-Medical Prescriber)  Maxine Woodbine (Senior Memory Clinic Nurse)  Jill Smith (Team Admin)  Amanda Clarke (Admin Assistant)

3.  Dr Whittingham: Clay Cross and Peak and Dales  Dr Sykes: Chesterfield  Dr Saxena: North Eastern Derbyshire

4.  MAS (pre diagnosis assessment by nurse)  Treatment 3 month AcHI or Memantine Trial (Independent Nurse Prescriber)  Routine follow ups  Referral to other agencies (Social Services, Alzheimer’s society, Derbyshire Carers, Day hospitals, CMHT OA)  Staveley Q and A events, held 4 x year

5.  Diagnosis explained  Treatment explained  Refer to external agencies if needed  Leaflets given  Contact number for memory clinic given  Rx given  Review in 8 week  Then 4 weeks later  Evaluate if continue or not.  Continue-6 or 12month f/u-GP prescribes  Stop-8wk post dis review in clinic or via telephone-discharge or reinstate AcHI

6.  On AcHI or Memantine  As part of shared care agreement patients are seen every 6 or 12 months for formal memory testing and assessment.  Referred to other agencies if required  AcHI or Memantine stopped if of nil benefit  Patients and carers contact if any problems and need to be seen sooner.

7.  Previously done by Doctor  Nurse undertakes MCIA, ACR-R, and other tests if required  Refer to consultant for diagnosis  Request routine dementia screen and ECG and CT scan if not done

8.  Service provided to review patients on a 6 monthly basis who do not have a diagnosis.  If decline then appt with Consultant for diagnosis  Less patients seen now for EM since NICE Guidelines changed and prescribing in mild AD as well as moderate and severe

9.  Staveley clinic  A social worker and carer support worker from Alzheimer’s society present in Bistro to see patients following their appointments  Streamline service/one stop shop  Reduces patient waiting time to access other services

10.  Started early 2012 in Chesterfield  Panel of Dr, Nurse, OT, Psychology, Social Worker, HCA  Displays from charitable organisations  Open event  Opportunity for carers and patients and those interested in dementia to ask professionals questions  Runs 4 x year