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Six in 10 practices sign up for 'cash for dementia diagnoses' scheme

Exclusive Six in 10 practices have signed up to the ‘cash for dementia diagnoses’ scheme, which will pay GPs £55 for every additional patient on their list diagnosed with dementia, Pulse can reveal.

NHS England confirmed that 60% of practices have signed up to the ‘important’ enhanced service, which will run until April but will not be extended beyond then.

It follows widespread criticism of the scheme from the profession, with critics saying it amounted to ‘cash for diagnoses’ and could damage the doctor-patient relationship.

GP leaders said that uptake figures were relatively low for an enhanced service, adding that practices would be professional and not let the payments affect their clinical judgement.

Under the terms of the scheme, practice who sign up will be given £55 for every each additional diagnosis of dementia if they show a net increase in cases recorded on their practice register between October 2014 and March 2015.

A Pulse survey before the original deadline for sign-up of 17 November found that at least 40% had signed up or intended to sign up.

However, the vast majority of other practices said they were still deciding, with NHS England extending the deadline to allow greater sign-up.

But the two-thirds of GPs expressed serious doubts about the ethics of the scheme and one Kent practice pledged last month to donate any cash it receive to a dementia care day centre.

However, an NHS England spokesperson told Pulse that the majority of practices had signed up.

The spokesperson said: ‘Sixty per cent of practices have signed up to deliver this important service to their patients but we hope all will make early diagnosis of dementia a priority.

‘For most patients with dementia, their carers and families, timely identification and referral will enable them to plan their lives better, to provide treatment as appropriate, to enable access to other forms of support, and to enhance their quality of life.’

Deputy chair Dr Richard Vautrey said that the take-up was relatively low.

He said: ‘Take-up figures for other enhanced services tend to be much more than 60%, so this low figure shows the number of practices that don’t think it’s worthwhile.

‘Our concern is that patients may feel that GPs are asking them questions about memory loss for financial gain. We have to be careful not to do anything that would undermine the doctor-patient relationship.’

Dr Vautrey said his own practice had signed up to scheme, however. Asked how he would avoid patient concerns, he said: ‘By being professional and ensuring that you don’t change your clinical practice as a result of the scheme.’

Dr Martin Brunet, a GP in Godalming, Surrey, has refused to sign up. He said: ‘You can look at this two ways: either 60% per are signing up or 40% are refusing. I know that plenty of GPs disagree with it, but they are also trying to balance their books and I can understand why they might sign up.

‘I’ve no objection with GPs diagnosing people with dementia, but problem is about introducing money into the equation. If you pay someone for a diagnosis you don’t know automatically that it’s a worthwhile diagnosis or whether it was properly explained to patient or whether they are getting good follow-up support. No one’s looking at those aspects.’

Last month, a group of leading GPs, consultants and health campaigners called for the scheme to be scrapped.

In an exclusive interview with Pulse, NHS England chief executive Simon Stevens said that they will not renew the DES after April.

Readers' comments (13)

  • HAHAHAHA....can the public be given a list of all other enhanced payments

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  • It is sad that practices are so strapped for cash that they feel compelled to sign up for this appalling DES to earn extra to offset their rising expenses

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  • Are there really GPs out there who will misdiagnose dementia for a couple of quid? If so this would be a useful mechanism to name and shame if overdiagnosis could be detected.

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  • It would be useful for a Pulse survey to determine how many practices like mine find the prospect morally repugnant, will continue to practice as we always have with regard to dementia diagnosis behaviours, and yet are so financially pressed they cannot turn down the money on point of principle in case it makes the difference between being able to trade or insolvent.
    For the record a hard winter onset currently looks like the grim reaper is clearing out more sufferers than we are diagnosing new.
    The April round up of net gain will be the final nail that this is an immoral and inappropriate method to fund primary care.

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  • Vinci Ho

    Yes, reality bites under circumstances but it does not stop you to carry on with your everyday ethos with resilience to changes AND still sign the 'treaty'. Forget about what the other bas****s say.
    Perhaps to treat a hypocrisy , we have to be 'hypocritic' as well.

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  • It's not just the morally wrong cash incentive for making a diagnosis with no known effective intervention.

    It's the amount of resources that's redirected to earn this cash. How many patients would be happy knowing their surgery will prolong their wait in favour of giving appointments to earn this cash? This is introduced at the worst possible time with winter pressures building.

    As a result, more attendances in AED then. Well done Mr hunt, you really have scored an own goal here.

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  • We have signed up to the DES, but the partnership agreed to donate any money earnt to local services for dementia. I'm not convinced it will earn very much anyway based on a high prevalence already and it certainly won't affect how we diagnose or treat dementia. I know we aren't the only practice locally having the same policy

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  • not sure what all the fuss is about. this is just an extension of qof. but many of u have got so used to qof that you have forgotten what we became GPs for in the first place

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  • It's nothing like QOF. QOF is payment for achieving certain quality care standards. This is payment to divert time and resources towards pursuing and making a particular diagnosis, one which carries major implications, for political ends.

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  • @12:28 err no actually QOF every year always has some strange thing added or axed - remember this

    another pointless exercise which everyone complied with for payment - a bit like this DES don't u think
    Get rid of QOF and this dES! People do general practice for helping patients. One aspires for quality NATURALLY. treat the patient not QOF.

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