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Dementia clinics refuse to accept GP referrals

By Lilian Anekwe

GPs are being forced to deal with growing numbers of patients with early-stage dementia who are being bounced back from secondary care.

Secondary care services were so overwhelmed they had little choice but to send patients back to GPs. But with a lack of resources or expertise GPs often had simply to wait until symptoms worsened before re-referring patients, delegates heard at the Primary Care Neurology Society meeting in Birmingham last week.

Dr Louise Robinson, a senior lecturer in primary care at the University of Newcastle and a GP in the city, warned of the problems GPs commonly faced when referring patients with memory difficulties and mild cognitive impairment to secondary care.

'People with memory difficulties who are not appropriate for secondary care or old age psychiatric services are often being fed back to primary care, but we have no formal mechanism or quality framework points for following these people up. They just have to come back to us if they get worse,' she said.

Dr Robinson said although services were good in her area, there was wide variability in access and what services were able to offer. 'We need consistency of approach in how people with memory problems are assessed,' she said. 'In Newcastle things are advanced, we have memory clinics and very specialist services that can assess people with early memory problems. But in some parts of England these services are just not available.'

Other experts agreed with Dr Robinson's analysis.

Dr Chris Manning, a member of the Primary Care Neurology Society executive council, asked: 'It's a concern – what happens to these people? If someone who works in the catchment area of the best secondary care memory clinic in the country still finds they are fed back into primary care, God only knows what services are like elsewhere.'

The warnings came in the wake of a report from the Alzheimer's Society predicting the number of people with dementia was set to rise from 700,000 to 1.7 million by 2051.

The society also estimated that dementia currently costs the NHS £17bn a year.

The report warned that fewer than a quarter of people with dementia came into contact with old age psychiatry services at any time in their illness, and that 'services are not available for a large majority of the population to deliver memory assessment and care services'.

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