Ian Greaves

National Dementia Strategy: well intentioned--but how well founded and how well directed?

The National Dementia Strategy was published in February 2009. It was eagerly anticipated and has generated a good deal of sustained media interest, widened awareness, and heightened expectation of better help for people with dementia. The three ambitions of the strategy--to raise awareness, facilitate assessment, and improve services--are unquestionably correct; but the assumptions, emphases, and economic predictions are questionable. Encouraging reliance on referral to secondary care centres, and exaggerated claims for the effectiveness of interventions to achieve clinical improvement and cost savings, may lead to disappointment and frustration. The infrastructure of care and treatment of people throughout the course of dementia will be better informed and delivered by a collaborative model which respects the knowledge and commitment contained within families and primary care. Better services will require substantial redirection of resources.

Putting personalisation and integration into practice in primary care

Purpose – The purpose of this article is to discuss the policy developments of integration and personalisation within the context of Primary Care, specifically an innovative Memory Service provided within a General Practice. It examines how these policies work together in this context to deliver a high quality service that is responsive to individual needs in an area of care: memory disorder or dementia, which has often relied heavily on secondary care services.Design/methodology/approach – The article is a case study analysis of integration and personalisation in Primary Care, allowing for examination and elaboration of both concepts as applied in this setting; and their contribution to a better quality care Memory Service. The analysis is produced by independent researchers (MC and NM), background and facts by service personnel (IG, NG and DJ).Findings – The innovative Memory Service operates as a person‐centred facility, integrating into the surgery, expertise that would traditionally be locked into se...

Gnosall Primary Care Memory Clinic: Eldercare facilitator role description and development.

The Gnosall Primary Care Memory Clinic has been operating since 2006 and adds the skills of a specialist old age psychiatrist to the extensive skills and knowledge available in primary care. Key to the organisation and function of the clinic is the eldercare facilitator, a new role situated in primary care and linking with the specialist and a wide range of other agencies and people. In order to facilitate replication of the model elsewhere, the function, role and competencies of existing and previous eldercare facilitators in the clinic have been reviewed, clarified and related to a competency framework and to similar initiatives in the literature. The selection and training of people with the attributes and skills required to become an eldercare facilitator will determine whether extension of the model is successful elsewhere.

The Gnosall project: Setting new benchmarks for dementia care

A pioneering project in Staffordshire is expected to play a pivotal role in shaping the treatment of dementia in the UK. The GP who developed the scheme has already won national recognition for his work. Dr Ian Greaves received the 2010 GP Enterprise Award from the Royal College of Practitioners. He introduced a service at the Gnosall Health Centre that helped to reduce the diagnosis period for dementia from the national average of 3 years to just 4 weeks. Since its launch, the project has saved the NHS about £400,000. The National Dementia Strategy recognises the importance of early diagnosis and improved patient care. This paper describes how specialist services, families, and primary care providers have worked together to make the project a success — particularly through the screening of primary care vascular databases for patients with cognitive decline. There is considerable evidence associating vascular disease and dementia.

Memory clinics and primary care: not a question of either/or

Meeuwsen and colleagues’ finding that the usual care provided within Dutch general practice for people with dementia is at least as effective as that provided by secondary care memory clinics is encouraging.1 The Gnosall model takes specialist skills that are usually tied into a secondary care clinic out to the …

All people with dementia need accurate assessment and ongoing support

Le Couteur and colleagues warn that effort and money may be wasted if we lose our focus.1 Activity that might be appropriate for research is sometimes wrongly translated into routine clinical work, where it adds nothing useful, but can cause harm. Memory clinics are said to be of unproved worth, to generate stress as well as expectations, to risk excess …

Diagnosing dementia: piecing the jigsaw together: Comment

Our commentaries from the Primary Care Neurology Society (P-CNS) provide a primary care perspective on the neurology articles in Progress. Here, Drs Benbow, Greaves and Jolley consider ‘Neuroimaging in dementia: an update for the general clinician’ (see p16).Our commentaries from the Primary Care Neurology Society (P‐CNS) provide a primary care perspective on the neurology articles in Progress. Here, Drs Benbow, Greaves and Jolley consider ‘Neuroimaging in dementia: an update for the general clinician’ (see p16).

Diagnosing dementia: piecing the jigsaw together

Our commentaries from the Primary Care Neurology Society (P-CNS) provide a primary care perspective on the neurology articles in Progress. Here, Drs Benbow, Greaves and Jolley consider ‘Neuroimaging in dementia: an update for the general clinician’ (see p16).Our commentaries from the Primary Care Neurology Society (P‐CNS) provide a primary care perspective on the neurology articles in Progress. Here, Drs Benbow, Greaves and Jolley consider ‘Neuroimaging in dementia: an update for the general clinician’ (see p16).

Improving diagnosis of dementia in primary care

Our commentaries from the Primary Care Neurology Society (P-CNS) provide a primary care perspective on neurology articles featured in Progress. Here, Drs Susan Mary Benbow, David Jolley and Ian Greaves consider ‘Speed versus accuracy in cognitive assessment’ (see page 21).

Improving diagnosis of dementia in primary care: Improving diagnosis of dementia in primary care

Our commentaries from the Primary Care Neurology Society (P-CNS) provide a primary care perspective on neurology articles featured in Progress. Here, Drs Susan Mary Benbow, David Jolley and Ian Greaves consider ‘Speed versus accuracy in cognitive assessment’ (see page 21).