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The waiting game

GPs to screen all at-risk patients for dementia

GPs will be expected to screen large proportions of their practice list for the signs of dementia, under the details of a new DES published today.

Under the draft terms of the DES, GPs will have to assess all patients over 75 years and those aged over 60 years with CVD, stroke, peripheral vascular disease and diabetes.

All patients with learning disabilities and long term neurological conditions such as Parkinson’s disease should also be assessed for the early signs of dementia, the Department of Health said today.

At the initial assessment GPs will have to question patients to see if there are any concerns about their memory and follow up if necessary with a more specific test to detect early signs of dementia, such as GP Cog.

Patients who are suspected of having dementia should be referred to a memory assessment service or memory clinic for a further assessment and GPs should also offer support to their carers, says the draft terms of the DES.

The DES will be funded by the cash released from the abolition of the organisational domain of QOF.

Readers' comments (11)

  • It seems to me GP's are rapidly losing thier clinical freedom and judgement? My Mother says if any GP tries this on her the date is 1.1.1066!

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  • This is crazy. When are we expected to see the patients with ACTUAL REAL PROBLEMS?

    I predict a mass exodus of GPs retiring and a great reduction in young doctors choosing it as a career if they have any sense!

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  • we already screen everyone over 75 using MMSE, and we have been surprised at how many fail assessment

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  • This is an important and necessary step. Too few patients with dementia receive a diagnosis before being admitted as emergencies through A&E departments. Focusing on this patient group may help reduce admissions by mobilising support before a crisis. I'm not sure why two of the responses above are negative. Surely screening people for a condition that can be missed but leads to both personal misery and vast cost to the NHS is a good thing.

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  • More, more , more, - screen for dementia, exercise, diabetes, IHD, CVD, renal disease,abuse,depression, smoking, alcohol, obesity, hypertension - on and on for less and less. What dopes we are!!

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  • There is only so much work we can do in a day... perhaps the DH has hidden agenda to save money because they know we won't have the time to earn back the money they are taking away by scrapping the organistional domain

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  • Because the issue is social support, and having a diagnosis of dementia should not be linked to increased package of care , it should not make any difference. This is the nhs spending money because there is not enough social service care budget, and it's very political,

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  • Let common sense prevail

    Let's apply Wilson's criteria for screening tests to dementia:

    The condition should be an important health problem

    The natural history of the condition should be understood

    There should be a recognisable latent or early symptomatic stage

    There should be a test that is easy to perform and interpret, acceptable, accurate, reliable, sensitive and specific
    Check - MMSE

    There should be an accepted treatment recognised for the disease
    Mmmm - not really

    Treatment should be more effective if started early
    A bit doubtful

    There should be a policy on who should be treated
    At a stretch

    Diagnosis and treatment should be cost-effective
    I can't buy that

    Case-finding should be a continuous process

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  • Dr Bush had hit the nail on the head. What is NICE up to..are they independant or have they too become corporate members of the Goverment?

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  • blimey.......are all GPs over 60 going to be screened...better get the pensions sorted out guys

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