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Patients wanting dementia test to be allowed to sidestep GPs

By Lilian Anekwe

Ministers are planning a dramatic expansion in memory clinics across the UK as part of proposals to allow patients to side-step GPs and refer themselves for examination.

But the proposals for self-referral for dementia testing have split GPs and professional groups, with concerns that even an expanded service would be overwhelmed.

The Department of Health is seeking views on the plan for an open system of referral as part of its National Dementia Strategy, due to be published later this month.

The proposal is likely to be given the go ahead, despite the consultation document openly recognising that ‘these only exist in a very few areas and even then do not have the capacity to see the large number of cases that are in the community'.

To address the lack of memory clinics, the DH is set to provide new money to fund the establishment of a new memory clinic in each area, Pulse has learned.

Professor Steve Iliffe, professor of primary care for older people and a member of the strategy's core consultation group, told Pulse: ‘When the strategy is published there's likely to be substantial pressure to construct memory clinics in every PCT, and to make them large enough and well-enough staffed for them to work.'

But opinion is divided over whether self-referral to memory clinics would improve diagnosis of the condition, or merely clog up the system with inappropriate cases.

The British Psychological Society warned that its trials had showed open referrals led to many inappropriate referrals being bounced back to GPs.

‘A contributor to this response who is working in a memory clinic service which had a trial of open referrals found there was a large increase in referrals and that many of these were inappropriate.

Instead, the BPS recommended that referrals should continues to be through a GP, but that there should be a ‘significant increase in screening services'.

The Royal College of Psychiatrists also argued that ‘GPs need to be involved in each case, ideally having done some initial screening'.

Other organisations, including the Royal Pharmaceutical Society of Great Britain, backed self-referral to memory clinics.

Dr Louise Robinson, clinical senior lecturer in dementia at the University of Newcastle and a GP in the city, said: ‘We should look at ways that we can improve access to memory clinics. But I think self-referral would just open the floodgates.'

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