Service Mapping Exercise - Mapping Pathways and Data Flow in Dementia Diagnostic Services

Why carry out a Service Mapping Exercise?

When someone seeks a diagnosis of dementia, a range of different services can be involved. Typically, the GP will be the first point of call, who will then make a referral to a Memory Assessment Service in the community for diagnosis and follow up. See this page on how to get a dementia diagnosis from the Alzheimer's Society for more information.

However, this pathway can vary.  For some types of dementia, the GP or memory service may refer the person to a neurology or other hospital department for specialist investigations, such as different types of brain scans.  And in different parts of England and Wales, NHS services might be organised slightly differently so that a diagnosis can be made by a specialist GP, a psychiatric service, learning disability service or other service.

Community-based Memory Assessment Services can also vary in what they can provide, with some offering follow-up support in-house and others referring people on to separate organisations such as charities after the point of diagnosis.  If medication is suitable, Memory Assessment Services usually make the initial prescription and this is then continued by the GP, but sometimes prescriptions and treatment are carried out and monitored by other services.

These variations can make it difficult to see whether patients are receiving equitable provision. We know from carrying out audits in community-based Memory Assessment Services that there are differences in the length of time it takes to get a diagnosis, in the types of dementia diagnosed by services, and in follow-up treatment provided. Memory Services Spotlight Audit 2023 National Report

Mapping the patient journey through services will help us to discern whether there are service models better adapted to the needs of patients, and understand more about relative performance.

What does it involve?

We are asking all NHS-funded dementia diagnostic services of any type to register with information about their service type and Trust or Health Board plus contact information.  We will then ask each service to give information about how they receive referrals, how they are staffed, and the investigations, diagnoses, treatments and support they are commissioned to deliver.

Results will be published in a report at the end of 2025

Future audit

During this exercise, we will evaluate what patient level data is routinely collected by the different types of diagnostic services, which can be used to compare patient experience and outcomes, for example, on waiting times. If sufficiently robust, this data will become the basis of future audits, for which the aim is to provide services with results on an ongoing basis while minimising any burden of data collection work locally.