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Embattled £42m dementia DES to end from April



The Government’s ‘deeply unpopular’ dementia DES will be scrapped from April, with the £42m price tag to be reinvested into core general practice.

The news, which formed part of today’s 2016/17 GP contract announcement, puts an end to the scheme which increased the number of patients with a dementia diagnosis on practice lists by a quarter.

NHS England said the decision to end the scheme was ‘in recognition of the fact that GPs are more routinely diagnosis dementia’.

A statement on changes said: ’The dementia enhanced service will cease as at 31 March 2016 and the £42 million resource will be transferred into global sum, in recognition of the fact that GPs are more routinely diagnosing dementia. All other enhanced services will continue unchanged.’

GPC chair Chaand Nagpaul said: ‘The deeply unpopular and imposed dementia DES will be removed with resources moving into core funding.’

But dementia groups have warned it could be seen as ‘taking the foot off the gas’ on diagnosis, with overall increases in diagnosis masking regional variation.

Jeremy Hughes, chief executive of the Alzheimer’s Society charity said: ’While it’s good news that GPs are more routinely identifying people with dementia, the job is clearly not done.’

’The removal of the DES, which has been proven effective in starting to tackle unacceptably low diagnosis rates, could be seen very much as taking the foot off the gas on diagnosis.’

The controversial DES, with which the GPC did not agree, has seen GPs routinely making ’an opportunistic offer of assessment for dementia to “at-risk” patients on the practices registered list, where the attending practitioner considers it clinically appropriate to make such an offer’.

This has included patients aged 60 and over with vascular disease or diabetes, those over 40 with Down’s Syndrome, other patients over 50 with learning disabilities and patients with neurodegenerative disease.

But it came under criticism from GPs who said it may do more harm than good to patients, especially amid a lack of appropriate referral services.

The negative voices grew even louder with the introduction of the temporary £55-per-diagnosis incentive added to the scheme last year, which was branded an ‘ethical travesty’ by some GPs.

It formed part of Prime Minister David Cameron’s drive to ensure 67% of patients with dementia received a formal diagnosis by 2015.