The Impact of Integrating a Parkinson's Specialist Psychiatrist Into the Multidisciplinary Team on Patients With Parkinson's and Cognitive Impairment.

Cognitive impairment in Parkinson's disease (PD) is common, but there is scarce evidence as to how this group of patients can be most effectively assessed and managed. Our quality improvement project evaluated the impact of integrating a PD specialist psychiatrist (PDSP) into an existing multidisciplinary team (MDT) to allow direct referral of patients with cognitive impairment rather than to a separate service. We collected data over 1 year to map the referral trajectories of patients through the new pathway and estimated cost savings by comparison with the previous pathway. Eighty-five patients were referred to our PDSP, 47 with cognitive impairment. Estimated cost savings attributed to the new pathway were more than £1000, with the greatest savings associated with patients diagnosed with mild cognitive impairment (MCI). Integration of a PDSP into our MDT led to a more streamlined service, rapid access to diagnosis and management and likely cost savings.