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The waiting game

GPs record 25% hike in dementia cases since introduction of 'cash for diagnosis' scheme

The Prime Minister has almost achieved his target to radically increase the number of people diagnosed with dementia, after the controversial £55 payment to GP practices for new cases prompted a 24% hike in recorded diagnoses.

The figures, released by the Health and Social Care Information Centre and clarified by NHS England today, show the number of patients with a record of dementia on the QOF register went up from 336,445 at the end of September - when the scheme was introduced - to a total of at least 415,964 at the end of March this year.

GPs have come under pressure since 2013 to identify more people with dementia since the Prime Minister’s Challenge on dementia pledged to get two-thirds of the population thought to have the condition formally diagnosed by 2015.

NHS England has now told Pulse that its new estimate for people living in England with dementia was 659,000, having changed the way it calculates new dementia prevalence from this month.

This means that, according to NHS England, 63% of people with dementia have been diagnosed - just shy of the Prime Minister’s target of getting 67% of patients formally diagnosed by 2015.

The diagnosis drive saw the introduction of a dementia case-finding DES, encouraging GPs to screen certain high-risk groups of patients for the condition.

But a sudden rise in diagnoses comes after a controversial enhanced service offering GP practices £55 for every additional patient on their list diagnosed with dementia was introduced last year.

This has led to a 24% increase in diagnoses, with a colossal increase of 23,000 patients - a 6% hike - in March alone, the final month of the incentive scheme.

That scheme has now been dropped for good, but GPs are still being pushed on diagnoses, with the case-finding DES further expanded this year to include more patients in the target groups for screening.

GP experts have questioned whether the Government should be pushing for the so many more diagnoses, warning that it could lead to misdiagnoses. Dr Martin Brunet, GP trainer in Guildford who campaigned against both dementia DESs, said the big jump in diagnosis rates ‘raised questions’ about why NHS England was continuing to push for more diagnoses by expanding the dementia case-finding DES.

Dr Brunet said: ‘The higher you aim the more danger there is of misdiagnosing, or just spending a lot of effort, time and resource on people who don’t have dementia when you should be spending it on people who clearly do.’

NB This was updated at 17:45 on 16 April 2015, to reflect new figures provided by NHS England

Readers' comments (15)

  • I thought everyone was too busy, the money too little, everyone emmigrating etc

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  • Wave a few quid at them and our supposedly overworked GPs will drop their pants.

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  • This comment has been removed by the moderator.

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  • Well done UK, money for a target - no clouded judgrment there. GPs have lost their marbles too it seems.
    Puppets of Cameron playing with a condition that cannot be diagnosed or treated in frank reality.
    Lobbying drug companies are happy (more to come surely!) and the work of social services carried by GPs - well done.

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  • Lies, damned lies and statistics!

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  • this is disturbing & unethical and how can GPs not be ashamed of this statistic!!
    poor patients most importantly, this is GPs playing into the hands of the government and desperate times means selling their ethics/soul to the devil/government for money...wait until the daily mail gets a hold of this......-embarrassing really

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  • This is obscene

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  • All we did was conducted a search by medications all dementia patients are on and then coded any missing patients correctly. If the PM wants to pay us to code patients correctly I'm not going to argue about that. Took us a couple of hours to do and it was a very simple admin task.

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  • Re partner 0.22 am- I agree, much missed 'prevalence' comes down to consistent & correct coding etc... even with a robust coding policy in-house there can be slippage, especially if there are lots of locum clinical staff (ie: it's not necessarily a reflection of poor clinical practice) . Optimising QOF targets involves 'cleaning' data entry & coding in a similar way... but someone has to do the work, and it takes time and money !

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  • If all the patients coded have actually got the diagnosis, then this is merely an administrative exercise.

    If there is fake or incorrect diagnosis, that is serious.

    Either pointless or dangerous.

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