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DH asks GPs to design alternative to dementia DES

Exclusive The Government’s dementia tsar has met with a group of leading GPs who expressed concerns over the plans to offer practices a dementia case-finding directed enhanced service, and invited them to propose alternatives.

Pulse can reveal that the national clinical director for dementia Professor Alistair Burns met the group this month after receiving their open letter of concern about the dementia DES due to be introduced in April.

The group is now considering whether there would be a workable alternative to the DES that it could suggest.

The group has launched a petition against the controversial DES, that would see GPs assess all over-75s, and all over-60s in risk groups, for dementia, as they say it will cause unnecessary concern for patients and overload memory clinics. The DES is funded by the retirement of organisational QOF points and will be worth £3,600 to the average practice.

The GPs taking part in the campaign include Dr Martin Brunet, a GP in Surrey, Dr Deborah Colvin, chair of City and Hackney LMC, and former RCGP president Dr Iona Heath.

Dr Brunet said there were some ‘issues of common ground’ with Professor Burns, but that it would be difficult to design something that was workable.

He said: ‘We agreed to disagree whether the DES represents screening or not, but he did say could we come up with some alternatives that might work.

‘What we need to contemplate now is whether there is a DES that would be useful. It is difficult, to be honest. The need in dementia care is in secondary and social care access and support.

‘It is also not very much money, £3,600 for the average practice, so there is only so much the DES can do. If the DES could be used to care for those who have a diagnosis then that may be something we would be very keen on.’

He added: ‘The Government is concerned that diagnosis rates are far too low but I think that assumption needs challenging. I think it is about improving access to a diagnosis for those where there is a concern for their memory.

‘We are concerned about the potential harm of the DES, of overloading memory clinics with patients who were not worried but are now worried because we caused it by having them do a test that they seemed to fail.’

The GPC has already said GPs will not have time to take on all the new DESs proposed by the DH for April, while a Pulse survey suggested that a third of GPs may refuse all DESs.

A DH spokesperson said: ‘The consultation on our proposed changes to the GP contract is ongoing and we remain happy to return to negotiations. So far the GPC have refused to negotiate.’