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Independents' Day

NHS chief calls for ‘step-change’ in GP dementia diagnosis

The head of the NHS in England has backed calls for GPs to raise dementia diagnosis rates, urging GPs not to delay diagnosis because of a false perception ‘nothing can be done’.

NHS England chief executive Simon Stevens said there needs to be a ‘step change’ in diagnosis in order to meet the Government’s objective of ensuring two-thirds of people with dementia have a formal diagnosis by next year.

Mr Stevens’ comments were timed to coincide with publication of a new ‘dementia toolkit’ aimed at ‘demystifying’ the condition for GPs.

He said: ‘We are looking at making a step change in improving the proportion of people who get a diagnosis. We are looking at going from under half of people currently to two thirds of people with dementia getting a diagnosis by 2015.

‘Today we have published a Dementia Toolkit for GPs in which we say that there are compelling arguments against delaying diagnosis. It is increasingly important that we diagnose people with dementia.’

The toolkit claims ‘most’ GPs have patients ‘dying of “undiagnosed” dementia’, which it says makes it harder to plan their care. It says GPs concerned about overwhelming assessment services and the uncertain benefits to patients of making the diagnosis are ‘out of the loop with regard to dementia care’.

GPs are advised prescribing drugs for dementia is ‘straightforward’ and ‘well within their capabilities’, and that they have an important role in managing delirium and minimising the use of anticholinergics.

The announcement was made at a conference held by the Alzheimer’s Society, which earlier this week called on the Government to raise the target diagnosis rate even further, from two-thirds to three-quarters of people having a formal diagnosis.

The Society’s work on dementia prevalence and diagnosis was influential in Government policy leading to the current dementia case-finding DES, widely opposed by leading GPs.

However, GP experts this week questioned the rationale for the continued emphasis on raising diagnosis rates, while the Society itself acknowledged some patients are facing waits as long as nine months for memory clinic appointments.

A Department of Health spokesperson told Pulse the Government was concentrating on the commitments already made through the Prime Minister’s dementia challenge.

Speaking at the conference, health secretary Jeremy Hunt said: ‘We are now doing more to improve dementia care than ever before by doubling research spending in recent years and giving thousands of NHS and social care staff specialist training to support people with dementia. We are also working with the Alzheimer’s Society and Public Health England to tackle stigma through the Dementia Friends programme. 

‘I am absolutely committed to improving care and support now and in the years to come.’

>>>> Clinical Newswire

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Readers' comments (8)

  • Er does anyone read these toolkits?
    The last one I read told me the shocking information that viruses can't be cured with antibiotics.
    What amazing revelations will the dementia toolkit reveal to a half wit GP like myself?

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  • One more comment - has anyone studied the diminishing returns in telling GPs each week how poor their diagnosis rates are in sponsored condition X.

    I used to feel mildly concerned that I was missing something, now it just reminds me that NHS chiefs have no idea what to do with themselves!

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  • Please, just back off and leave patient care to clinicians. Are these "toolkits" as patronising as they sound?

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  • Why not try reducing the stigma of being diagnosed with dementia and ask patients to attend practices for memory tests.
    Patients and carers unfortunately are not asking for memory tests and to be referred.

    this is a failure of the charities to get the message across , public health, and the government health policies.
    I doubt gps actually would refuse to assess patients for dementia and refer on if patient/ carers asked.

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  • The call for step change in dementia diagnosis is irrelevant. Most Gps are well aware of how to diagnose dementia. However there needs to be an understanding that this cannot be done quickly as there are no clear diagnostic tests. Yes, tools such as the GPCOG help. Symptoms develop over time and other conditions such as depression cause similar symptoms or often coexist. In addition GPs need to assess the individual circumstances and decide if the problem is simply mild cognitive impairment (which is common) or dementia where the patients ADL are being affected. If every patient with a hint of memory problems is referred to specialist services, the services would be overwhelmed and would be unable to cope with those in real need. I'm sure CCG pressure to decrease referral and spend also has some impact in GP decision making. You can't have both increased dementia detection and screening and reduce specialist service referral rates. NHS England needs to decide what are its priorities. There needs to be an understanding that making a diagnosis is not easy and there is an art to it. But the art of medicine has become an archaic principle with the current EBM drive and is gradually disappearing with sound bites like these. Yes, there is evidence that current drugs have some use in dementia but picking the right patients who would benefit is not easy, not even for elderly care specialist. Would NHS England like GPS to prescribe these drugs which often have significant side effects and monitoring needs to every patient with MCI?

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  • He 'calls for' an awful lot - but what does he actually deliver? Is anyone actually listening, even in his own organisation?

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  • ‘Today we have published a Dementia Toolkit for GPs in which we say that there are compelling arguments against delaying diagnosis. It is increasingly important that we diagnose people with dementia.’

    Errr - you could just tell us even 1 in this article - as I'm afraid there aren't any really, that are not Completely contradicted or undercut by CCG referral reduction targets, Lack of funding for social care, complete lack of provision of care home places just as a tip of the negatives iceberg.

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  • Leaving increasingly large amounts of elderly and demented people in their own homes, with a few 10 minute carer visits for the lucky few, while the vast amount of the rest are unable to afford to pay for any care without having to sell their houses.

    Dohh! Just got it:

    1. Diagnose dementia, declare no capacity, force them to sell their house to pay for care.

    2. Solve housing crisis.

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