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GPs record 25% hike in dementia cases since introduction of ‘cash for diagnosis’ scheme



The Prime Minister has almost achieved his target to radically increase the number of people diagnosed with dementia, after the controversial £55 payment to GP practices for new cases prompted a 24% hike in recorded diagnoses.

The figures, released by the Health and Social Care Information Centre and clarified by NHS England today, show the number of patients with a record of dementia on the QOF register went up from 336,445 at the end of September – when the scheme was introduced – to a total of at least 415,964 at the end of March this year.

GPs have come under pressure since 2013 to identify more people with dementia since the Prime Minister’s Challenge on dementia pledged to get two-thirds of the population thought to have the condition formally diagnosed by 2015.

NHS England has now told Pulse that its new estimate for people living in England with dementia was 659,000, having changed the way it calculates new dementia prevalence from this month.

This means that, according to NHS England, 63% of people with dementia have been diagnosed – just shy of the Prime Minister’s target of getting 67% of patients formally diagnosed by 2015.

The diagnosis drive saw the introduction of a dementia case-finding DES, encouraging GPs to screen certain high-risk groups of patients for the condition.

But a sudden rise in diagnoses comes after a controversial enhanced service offering GP practices £55 for every additional patient on their list diagnosed with dementia was introduced last year.

This has led to a 24% increase in diagnoses, with a colossal increase of 23,000 patients – a 6% hike – in March alone, the final month of the incentive scheme.

That scheme has now been dropped for good, but GPs are still being pushed on diagnoses, with the case-finding DES further expanded this year to include more patients in the target groups for screening.

GP experts have questioned whether the Government should be pushing for the so many more diagnoses, warning that it could lead to misdiagnoses. Dr Martin Brunet, GP trainer in Guildford who campaigned against both dementia DESs, said the big jump in diagnosis rates ‘raised questions’ about why NHS England was continuing to push for more diagnoses by expanding the dementia case-finding DES.

Dr Brunet said: ‘The higher you aim the more danger there is of misdiagnosing, or just spending a lot of effort, time and resource on people who don’t have dementia when you should be spending it on people who clearly do.’

NB This was updated at 17:45 on 16 April 2015, to reflect new figures provided by NHS England