Developing the advanced nurse practitioner role in a memory service

This article describes how one NHS trust in northern England developed the advanced nurse practitioner (ANP) role within its memory services. It discusses how ANP roles were developed and implemented across four localities of a large NHS trust that provides a number of locally based memory services to improve the diagnostic pathway for people referred to the service and their carers. Advanced practice is considered more broadly followed by a review of the literature related to the role of the ANP and non-medical prescriber in mental health and, more specifically, memory assessment and diagnostic services. Challenges to gaining the requisite competency to work as an ANP are discussed. The need for a clear agreed strategy to ensure practitioner competence and effective governance for the introduction of these roles is described. It is argued that using this model allowed for mental health nurses within memory services to make a major contribution to the transformation of such services and receive recognition for the expansion of their role and appropriate remuneration linked to national NHS employment role profiles. The potential benefit of the ANP role more broadly in mental health services is discussed, together with factors that may have previously hindered their contribution to the transformation of services. The strategic development and planning process that led to implementing the ANP role within memory services is presented, together with a description of how the relevant higher level clinical skills required for the roles were achieved and formally accredited.

Developing the advanced nurse practitioner role in a memory service

This article describes how one NHS trust in northern England developed the advanced nurse practitioner (ANP) role within its memory services. It discusses how ANP roles were developed and implemented across four localities of a large NHS trust that provides a number of locally based memory services to improve the diagnostic pathway for people referred to the service and their carers. Advanced practice is considered more broadly followed by a review of the literature related to the role of the ANP and non-medical prescriber in mental health and, more specifically, memory assessment and diagnostic services. Challenges to gaining the requisite competency to work as an ANP are discussed. The need for a clear agreed strategy to ensure practitioner competence and effective governance for the introduction of these roles is described. It is argued that using this model allowed for mental health nurses within memory services to make a major contribution to the transformation of such services and receive recognition for the expansion of their role and appropriate remuneration linked to national NHS employment role profiles. The potential benefit of the ANP role more broadly in mental health services is discussed, together with factors that may have previously hindered their contribution to the transformation of services. The strategic development and planning process that led to implementing the ANP role within memory services is presented, together with a description of how the relevant higher level clinical skills required for the roles were achieved and formally accredited.

What Do General Practitioners Tell People with Dementia and their Families about the Condition?

There has been growing discussion in the literature about the merits and demerits of disclosing a diagnosis to a person with dementia. There is growing empirical evidence that general practitioners (GPs) are reluctant to share the diagnosis with people with dementia. To date little research has examined what GPs tell their patients and their families. The purpose of the reported study was to examine what GPs tell people with dementia and their families about the condition. The study relied on data gathered from an opportunistic sample of 114 GPs who were attending a training course in care of people with dementia. Findings reveal a disparity between what GPs tell the family and the person. People with dementia tend to be given information about the symptoms and the cause is described predominantly as part of ageing. Family members are given information about symptoms, cause, prognosis and available supports. Best practice regarding diagnosis disclosure to people with dementia needs to be established. This includes what people with dementia are told, how they are told and what supports are made available to those who have been told.

Eating, ethics and Alzheimer's

This article describes a situation in practice where the patient's difficulties in swallowing became an ethical dilemma for her family and the author. The incident caused the author to reflect on practice and look for ways to improve, by reviewing the relevant literature.