Bernie McInally describes how collaborative working between a community psychiatric nurse and staff in general practice resulted in the delivery of an improved clinical service

Dedicated memory services have been recommended as a single point of referral for people with cognitive impairment for many years. This may, however, discourage them from visiting a GP or specialist services to seek early diagnosis, through fear of what might happen, or of stigma.

GPs have limited skills in dementia diagnosis, in particular at the early stages of the illness, which is where the current need exists. One model that is known to be effective in healthcare delivery is that of the nurse-led mental health clinics for older adults. This concept was investigated using the specialist skills of a community psychiatric nurse in older adult mental health and trialled in three GP practices in the Scottish Borders. After one year the project was evaluated. This showed it to be cost-effective, to equal medical-led clinics in sensitivity and accuracy of diagnosis, and often to be preferred by service users. Non-medical prescribing by the nurse is central to its success.