Dementia Identification Protocol
It is important to identify whether a patient is developing dementia as early as possible in their disease, so that they can be provided with the support that they need, and disease modifying agents can be started as early as possible. CCGs have recently installed and activated a protocol on practice systems which can encourage clinicians to identify patients with dementia, and to offer support to those patients with dementia. This tool may help improve the identification and support for patients with cognitive problems, however there are a number of issues which the protocol also can cause.
The protocol asks clinicians to screen patients for dementia or offer advice, the clinician can either click “yes”, “no”, or “cancel”. If the clinician does not want to ask these questions they should click “cancel” to stop the protocol. If the clinician clicks “no” rather than “cancel” this incorrectly records that the patient does not have cognitive impairment. The protocol can thus add inaccurate codes to the patients record.
The protocol also slows clinical systems down so that records cannot be opened. Being unable to access a patients record in a timely fashion is both frustrating and dangerous.
The protocol also appears at the start of a consultation irrespective of why the patient is attending, and thus could act as a distraction for the clinician. This could lead to clinicians forgetting the reason for opening the patient record. This again is a safety risk.
The LMC was not consulted about this protocol being added to clinical systems. Whilst we encourage the early identification of cognitive impairment, we have asked that practices have the ability to turn off this protocol if they do not feel that it is helping patients. If your practice wishes to turn this protocol off this can be done by going to Set up/Workflow Support/Protocols/NHS Lincolnshire and unclick the relevant dementia protocol.