HNY Policy and Pathway Repository - Humber

Hull Memory Clinic provides a specialist memory assessment service for people over the age of 18 (however those aged between 18 and 65 require referral to working age CMHT in the first instance), aiming to provide a memory assessment, diagnosis and treatment where appropriate within an integrated pathway. The Team also work with the person’s supporter to ensure a quality assessment and treatment process, that takes everyone’s needs into account. 12 weeks following diagnosis a review is held to ensure all patient needs are met and a care plan is agreed. The patient is usually discharged at this point.

When the GP has completed 6CIT and physical screening to eliminate other causal factors.

A reported CT Scan is required to accompany the referral form.

1. Rapid onset not related to confirmed stroke
2. Rapid progression
3. Short duration (less than 6 month history)
4. Marked confusion
5. Early visuospatial symptoms (within 6 months of onset)
6. Neurological symptoms including headaches (esp if worse on leaning forwards, coughing, sneezing), poor coordination, gait disturbance, weakness, seizures
7. History of head injury in the preceding weeks associated with new onset of cognitive symptoms, nausea, vomiting or reduced consciousness.
8. Atypical history or features not otherwise listed (clinician experience)

Exclude Red Flag Symptoms

If there are any concerns regarding the Red Flag symptoms appropriate screening should be carried out. This should include brain imagery if there are neurological concerns other than that of a neuro-degenerative condition due to a suspected dementia.

Prior to referral the GP must exclude all treatable causes of cognitive problems.

Screening bloods must be included as per the referral form along with the outcome 6CIT and a brief history of the memory problems and social circumstance.

Where there is evidence of acute mental illness the patient is to be referred to Mental Health services.

Where the patient is under the age of 65 the referral must be referred to working age CMHT in order to rule out any other causal factors.

Where there has been presence of delirium referral should be suspended for 6 months.

Where treatment has been initiated for low vitamin B12 referral should be suspended until treatment is complete.

Below are support agencies

Butterflies Memory Loss Support Group  http://www.butterflies.org.uk/

Carer's Information & Support Service https://portal.yhcs.org.uk/group/hull-ccg/carers-information

Alzheimer's Society  https://www.alzheimers.org.uk/

East Riding Adult Carers  https://www.yourlifeyourway.uk/carers-uk-digital-resource/

If the GP identifies social care needs the GP must refer onwards to the relevant agencies.

If the GP has concerns regarding the patient’s ability to drive safely, the GP must inform the DVLA also for assessment the regional driving assessment centre maybe appropriate https://www.rdac.co.uk

People over the age of 18, however those aged between 18 and 65 require referral to working age CMHT in the first instance.

People presenting with memory problems or declining cognitive function who haven’t received a diagnosis of dementia and for whom other physical causes have been excluded.

Those with a recent diagnosis of dementia related to Parkinson’s disease can be referred for 12 week review only, this should be indicated clearly on the referral form.

The patient must consent to the referral and this must be indicated on the referral form, where possible Next of Kin/Supporter details should be included.

Referrals

Referral form on ARDENS

Routine Referrals via eRS (Service Name - Hull and East Riding Memory Assessment Service - Humber Teaching NHS Foundation Trust - RV9).

GP’s must complete and attach Hull Memory Referral Template (templates now available via CCG Ardens process) and recent bloods with reported CT Scan.

Referrals are screened on the next working day following receipt, where referrals are rejected the patient and the GP are informed. Where a referral is accepted the patient is informed.

Urgent Referrals are not accepted by this service.

Contact Telephone Number (01482) 336617 for queries only.

Do Not Refer

Under 65 presenting with cognitive problems to be referred initially to the eRS Mental Health Triage and Assessment Service - Humber Teaching NHS Foundation Trust - RV9.

Patients must be registered in a Hull GP except Pocklington.

Patients from other localities will be rejected.

Acute functional Mental Health Problems require to be referred to the eRS Older Peoples Triage Service - Humber Teaching NHS Foundation Trust - RV9.

People who have a learning disability and are open to a learning disability service.

People who have experienced a delirium in the past six months.

People who have an open referral to Neurology.

People who have a diagnosis of Dementia.

Patients requiring to be reported to DVLA must be completed by the GP if the GP has concerns.

Patients requiring to be referred to Social Services must be completed by the GP if the GP has concerns.

Patients not referred for CT Scan where clinically indicated.

Patients without a fully completed Hull Memory Referral Template (templates now available via CCG Ardens process).

Alzheimer's Society

Butterflies Memory Loss Support Group

Distress in Dementia

Information To Include

Hull Memory Referral Template (templates now available via CCG Ardens process) with recent bloods, reported CT Scan and 6CIT.

Referrals should include patients current and historical physical health and also social circumstances.

Referrals should include any previous contact with Mental Health Services.

Include current medication with a full medication history.