Exclusive Estimated GP practice dementia rates will automatically rise from April after NHS managers accepted their previous projections for the prevalence of the disease were out of date.
NHS England has confirmed to Pulse that it plans to change the official estimated prevalence to recognise the latest research that shows the spread of dementia has slowed, partly due to better treatment of CV risk factors and improved levels of education.
The change will lower current Government figures on the expected number of patients with dementia in England from approximately 670,000 to less than 620,000 and bring the Department of Health much closer to its target dementia diagnosis rate of 67% in 2015.
A Pulse analysis of the latest QOF data reveals this would result in an estimate of roughly 60% of the predicted number of people with dementia diagnosed from April – a rise of five percentage points from the current estimated prevalence of 55%.
The Prime Ministers ‘challenge’ on dementia kickstarted a major case-finding drive that has seen GPs offered various incentives to case-find – including a controversial scheme to pay practices £55 for each patient newly added to the QOF dementia register – despite concerns that it could harm patients.
The PM’s project was underpinned by figures that showed less than half of people with the condition were diagnosed, based on a prevalence of 7.1%.
But more recent CFASII data from the Medical Research Council found that dementia prevalence rates were only 6.5% of the elderly population – almost one quarter lower.
The MRC researchers said they suspected the prevalence drop was largely due to ‘sustained improvements in primary prevention’ and more systematic care, such as through the QOF.
In a statement, NHS England said: ‘We are holding CCGs intensively to account for their activities towards the national ambition that two thirds of people with dementia have a diagnosis and care planning. Until now NHS England used the Alzheimer’s Society 2007 Delphi consensus, which is an estimate determined through a consensus agreement by experts based on a review of international studies.
‘The updated Delphi consensus was published in November 2014, so for the CCG planning guidance round for 2015/16 we had the opportunity to decide what prevalence estimates to use, using all the information to hand. Instead of using the updated Delphi Consensus, we decided to use CFASII, as it represents best science.’
The statement added: ‘The figures we will be using are solely for use by NHS England in holding CCGs to account for the planning guidance in 2015/6.’
Professor Alistair Burns, NHS England’s clinical director for dementia, said: ‘Our most important aim is that every person with dementia gets the best treatment and they, their families and carers get the best high quality support following the diagnosis.
‘We are always looking to refine and improve our methods of estimating the number of people with dementia and to make sure we use the most accurate information available so we can diagnose the people who need the care most.
Dr Martin Brunet, a GP in Surrey who was one of the most prominent critics of the DH’s dementia diagnosis policy, told Pulse: ‘I think this is great news. There are still problems with using prevalence data to set targets – that is still a fundamental problem – but if they are going to do that, at least they are using the most up-to-date and relevant data, it’s been a time coming and it’s very welcome.’
He added that as NHS England asserted the figures were for use ‘solely’ to hold CCGs to account, individual practice data should no longer be published ‘because once it is there people will hold you to account for it even if it is not accurate.’
How dementia figures are changing
Current estimated dementia prevalence – 7.1%
Estimated dementia prevalence from April – 6.5%
Number of people estimated to have dementia across England under the current estimated prevalence – 670,000
Number of people estimated to have dementia across England under the estimated prevalence from April – 620,000
Number of people diagnosed with dementia according to QOF data from end of January – 371,244
Average estimated diagnosis rate – 55%
Average estimated diagnosis rate from April – 60%