Clinical Lead: Harsha Wijeratne
Tel: 020 8708 2386
(Please ensure patient identifiable information is password protected)
Referrals are accepted by email. All new referrals need to be made via the GP to exclude/treat physical causes for presenting problems.
Criteria: Any person aged 18 or over with dementia or suspected of having dementia Resident in Redbridge.
Exclusions: None but patients will be triaged for suitability.
Test results required at referral: If suspected dementia, please complete dementia blood screening and midstream urine (MSU).
Information for referrers
What is the Memory Assessment Service?
When to refer for a memory assessment?
- If your patient and/or their family member report memory and/or cognitive problems that have been apparent and physical health causes have been ruled out.
- If a family member reports behavioural and/or personality changes.
- If you notice your patient has memory and/or cognitive problems; this may be because of a recent decline in illness, self-management skills, because they have forgotten to attend appointments or because they have failed a cognitive screening test.
What should you include on the referral form?
- Persons personal details.
- Information about the memory/cognitive problems.
- Any mini mental test scores such as AMTS, GPCOG, 6 CIT or MoCA
- Any risks.
- Medical history and current medications.
- Results from dementia screening blood tests, which should not be more than three months old.
- Next of kin contact details.
- If an interpreter is needed and if so, for which language.
How do you explain to your patients why you are referring them?
Patients need to know that they are being referred for an assessment of their memory/cognitive functioning, which involves finding out about their current difficulties and how these affect them in everyday life.
They need to be aware that while there are lots of causes of memory problems (including depression or anxiety, side effects of medication, physical health causes), the assessment might find that they have a type of dementia.
If they do get a diagnosis of dementia, we will work with them to develop a plan to support them to live well with their illness.
Whilst other people, including you as their GP, might think it is important for them to be assessed, your patient needs to agree to the referral being made, unless s/he lacks capacity to consent, in which case an assessment must be judged in the patient’s best interest.
The assessment process
There are four components to the standard assessment process:
- Pre-assessment counselling to ensure the person understands the reason for the assessment, the possible outcomes and most importantly gives their informed consent
- The assessment, which includes clinical history taking, cognitive testing and neuroimaging, if appropriate
- Feedback of the assessment outcome in accordance with the person’s wishes
- Support planning, which outlines support systems and interventions for the person with dementia and their family.
The benefits of referring to the Memory Assessment Service:
- Your patient gets an accurate and timely diagnosis.
- Useful information on prognosis.
- Identification of reversible causes of dementia/cognitive impairment.
- Treatment with anti-dementia drugs, if appropriate.
- Access to evidence-based non-pharmacological interventions such as Cognitive Behavioural Therapy.
- Access to post diagnostic support, including educational patient and carer groups, Admiral Nursing Service and Voluntary Sector Organisations.
- Participation in relevant research studies.
- Information on managing affairs e.g. power of attorney, driving, planning for the future.
- Access to support services and benefits.
Please remember it is always worthwhile referring your patient. Psychological interventions, medications and social support for both the patient and their family can ensure the person with dementia lives well with their illness.
How long will the process take?
The time from referral to diagnosis should not usually exceed 15 weeks, but it is dependent upon the complexity of the patient and timescales for structural imaging which is undertaken by BHRUT.
In rarer complex presentations, the patient may require more specialist tomography and/or other expert tests, which the Memory Assessment Service will arrange with another provider. In these circumstances, it is not possible to indicate the timescales from referral to diagnosis, but the patient/family will be kept informed.
Access to the Memory Assessment Service
Patients are expected to make their own way to the Memory Assessment Service or the GP should arrange transport for them. In exceptional circumstances where the person is housebound, the Memory Service will offer a domiciliary visit.