Shaping better health
REMEDY : BNSSG referral pathways & Joint Formulary

Dementia referral & support during COVID-19

Checked: 02-07-2020 by vicky.ryan Next Review: 06-05-2021


Please see below the current Covid-19 response from Bristol, South Gloucester and North Somerset dementia service providers.

Alzheimers' Society

The Alzheimer’s Society across BNSSG, have adapted their face to face services to phone, and (developing) virtual support. Calls to their national dementia connect helpline have increased by 40% nationally as people reach out for more support during this time.

Specifically this is a list of what we they doing for carers & people with dementia in the community: 

  • Welfare calls either weekly fortnightly or monthly to every service user on our caseload, including those that attended groups and have our befriending service by the dementia support worker or dementia adviser
  • Companion calls by our Volunteers (this is on top on the welfare calls) – this is a new service that we have developed using our exiting volunteers that did support us at groups and new volunteers
  • Sending out work books weekly to people who attend our activity groups
  • Setting up Virtual singing for the brain groups weekly, we are looking to also do our carers information and support course as well as memory cafes and activity groups virtually
  • Emailing Carers information on how to source online activities
  • Researching what is available locally that we can sign post to for practical support such as shopping etc

Please continue to refer into our service as we can do assessments over the phone, and continue to support people, or contact us individually for support in each of the areas.

Bristol – Sharon Cooper 07540920973

North Somerset – Sally Cavill 07771633068

South Gloucestershire – Lynn Cross – 07484054050

People normally have to have had a diagnosis (or be a carer or loved one of somebody) to receive our dementia support service but we are currently able to provide this to any one concerned about memory loss.

Bristol Dementia Wellbeing Service

The core/clinical service will change, moving from face-to-face delivery to primarily telephone contact. The following is a summary of the contact that we will have with our service users and carers:

Welfare Checks

  • Welfare Checks to everyone on the community caseload (either direct to service user, or to carer as appropriate).
  • The content of these checks should be to provide reassurance, information and advice and to explore current risks, vulnerabilities, etc., particularly in regards to Coronavirus and general welfare (e.g. medicine, food, supplies)
  • If this check yields information that requires further action, we will consider what support might be able to be put in place.
  • If no other options are available as a service, we may need to provide practical support (e.g. picking up medication, supplies).
  • During this time, these Welfare Checks will be in place of our regular schedule review process and therefore Wellbeing Plans, Risks Assessments, etc. should be updated on the back of these.  

Crisis Management

  • Current clinical work or future requests for input to manage crisis should be made via telephone input wherever possible, this will include liaising widely with others (e.g. family, carers, GP, etc.) and providing support and guidance as required
  • Our priority clinical areas will be:
    • BPSD
    • Risk to Self
    • Risk to Others
    • Risk of Self Neglect
    • MHA Assessments/Admission
  • If telephone support and problem solving is not sufficient to manage/reduce risk, face-to-face input maybe required.

 Routine Referrals

  • Referrals will be thoroughly triaged to establish risks, as detailed above, and appropriate response. However, any routine work will not be actioned via face-to-face contact but should be followed-up by telephone.
  • Diagnostic assessments are considered to be routine and will therefore not be undertaken at this time.

North Somerset Memory Service

Where possible and appropriate we are providing telephone diagnostic feedback. We are routinely providing medication reviews, dementia wellbeing reviews and occupational therapy advice and if required aids.

All patients referred to the service and either open to an HCP (as in having had an initial assessment and awaiting further provision of care) or awaiting allocation (assessment) have been contacted (some continuation of this as we are now addressing medics caseloads) to provide a welfare check, general support and advice. A number of patients / family / carer are now on a list held by the nurses and these will be receiving follow up calls to ensure they stay emotionally well and any need for practical support reviewed. We are referring to Care Connect / Winter Wellness and independent / voluntary agencies as indicated at an individual level. This includes a range of services from telephone support, shopping and more general support to maintain their independence in the community i.e. free Carelink for a period.

We continue to provide a duty system Monday to Friday 9am – 5pm which is managed by the team who have access to medics if required to address more complex queries. During this time we are happy to receive telephone queries, as we have already, from patients discharged from our service to support any concerns and give advice or signpost to appropriate services. It is also a service that can be accessed for advice by other health and social care practitioners and GP’s.​

South Glos Memory Service

Update 02/07/20: SG MS is opening for Routine referrals to MS on 20th July.

In response to the COVID-19 pandemic and the need to bolster acute and inpatient services, the AWP South Gloucestershire Memory Service closed temporarily on the 17th March 2020 to new referrals. Most staff in the Memory Service have been redeployed, leaving a skeleton service to continue essential work. 

At present the Memory service is completing medication reviews for services users with a diagnosis and reviewing outstanding cases (where assessments are incomplete) and offering supervision to South Gloucestershire Dementia Advisors based with Sirona. Service users with incomplete assessments have been informed/advised to make contact if they have any concerns/issues.

If there are concerns about people with dementia or suspected dementia in the community the Later Life services are happy to offer telephone advice.  We are operating as a Later Life hub with a central telephone number of:  0117 378 4640 should advice be needed, the number is staffed during normal working hours Monday- Friday (excluding bank holidays.)

NBT Cognitive Disorders Clinic

We have a nurse led helpline for all patients currently under the cognitive disorders clinic (we are contacting all our patients to let them know).

Neurology now offers an advice and guidance line to all GPs, we should be able to help with questions regarding neurological complications of dementia – Epilepsy/Movement disorders.  We also give advice on rapid onset, young onset cognitive disorders through this line.

Delirium and COVID-19

Managing Delirium in confirmed and suspected cases:

Atypical COVID 19 presentations in Older People

Please see the attached information on Atypical COVID 19 presentations in Older People produced by Sussex Partnership NHS Foundation Trust