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Revealed: GPs denied access to antipsychotic alternatives in dementia

Exclusive The Government's dementia drive has had little effect on antipsychotic prescribing, with GPs continuing to lack access to treatment alternatives, a Pulse investigation has found.

One in 10 PCTs does not commission any alternative dementia treatments for GPs to refer to, while in other areas waits can be up to six months.

Figures obtained by Pulse reveal that since the Government issued a call to reduce NHS prescribing of antipsychotics in dementia patients by two-thirds, there has been only a 16% reduction in GP prescribing of the drugs.

Prescribing figures extrapolated by healthcare market research agency Cegedim Strategic Data from 150 practices show an estimated 43,584 patients with a dementia diagnosis received a GP prescription for an antipsychotic in May.

This is a reduction from a peak of 55,616 patients taking the drugs in March 2009. But since November 2010, when the Government set its target of reducing prescribing by two-thirds, the fall has been just 16% in primary care.

As part of the ‘Prime Minister's challenge on dementia', launched last year, GPs were asked to review all patients on antipsychotics and explore NICE-approved alternatives, such as aromatherapy, multisensory stimulation or massage.

But a Pulse survey of 82 PCTs in England shows 11% do not commission any alternative therapies.

Of those who do, only 13% allow GP referrals and waiting times ranged from three weeks to six months.

Responding to Pulse's investigation, RCGP chair Dr Clare Gerada said although GPs should be cutting down on antipsychotic use, it was essential the provision of memory clinics and community psychiatric services was expanded.

She said: ‘We are going to end up with patients, families and carers without support, and that's the worst possible scenario.'

Professor Steve Iliffe, a GP in north-west London and professor of primary care for older people at University College London, said GPs were often faced with an urgent situation as the ability of care home staff and carers at home to deal with behavioural problems was ‘limited', and added: ‘It makes no sense to say "stop using this treatment" if alternatives are not available.'

Dr Simon Ruffle, a GP in Twyford, Berkshire, said: ‘Some [patients] are terrified, see things and smear faeces on the wall – we are supposed to stand back and allow this?'

A spokesperson for the DH said it remained committed to reducing inappropriate prescribing.

Read acting deputy editor Nigel Praities' analysis here.


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