Brain Health Scotland; Alzheimer Scotland

Description

The Scotland Flagship site has a strong partnership with the National Health Service (NHS) in Scotland. Brain Health Services are being created in partnership by Alzheimer Scotland and NHS colleagues as part of the Scottish Government’s program for brain health. The Scotland Flagship program involved engagement with several NHS areas, and was established across clinical settings (nurse-led assessment team, psychology and primary care) in one NHS board as well as at a new employer-led Brain Health Clinic at Scottish Rugby, which commissioned brain health services for its former elite athletes. Depending on the setting, the digital cognitive assessment was conducted by a nurse, healthcare support worker, psychologist, assistant psychologist, general practitioner, or healthcare assistant. The blood test was facilitated on a case-by-case basis between nurse and consultant psychiatrist as part of the assessment pathway.

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Universal healthcare is provided by Scotland’s public health service, NHS Scotland.

What are the key lesson learned for the site?

Gaining buy-in at the policy level

Recognizing the importance of brain health, the Scottish Government provided funding and Brain Health Scotland was established in partnership with Alzheimer Scotland in 2020, prior to implementing the Early Detection Program. This meant that the flagship program was well aligned with the existing policy and movement and was able to gain buy-in from the government stakeholder, NHS Scotland.

Goal 1: Evaluate your healthcare system context.

Aligning on policy and sustainability of the Quality Improvement project

The Scotland site ran the DAC-SP Early Detection Program as a Quality Improvement (QI) project. As a QI project, they did not need research ethics approval to implement newer tools such as the Digital Cognitive Assessment (DCA) and blood-based biomarkers (BBMs). All necessary healthcare system approvals were gained. These tools were implemented in clinical practice in one NHS Board Area in Scotland with transferable learning to other NHS Areas in Scotland.

Goal 5: Select your cognitive assessment tools

Co-designing the workflow

The site leads focused on a relational approach from the outset, working together with all the key stakeholders including the clinicians, the Information Governance team, local Alzheimer Scotland Consultants and Senior Managers. The approach taken was to work with the early adopters who were invested in early detection, to co-design the program workflow and spread within the system. This allowed the workflow to incorporate different perspectives and accommodate existing practices.

Goal 9: Develop protocols and workflows.