MPs have blamed GPs for delays of up to a year in diagnosing dementia, and called for the planned extension to general practice training to focus specifically on dementia to address current barriers to diagnosis.
A new report from the All Party Parliamentary Group on dementia found that carers and people with dementia viewed primary care, and ‘particularly GPs’, as ‘barriers to a diagnosis rather than gatekeepers’.
The report has made recommendations to the Government, the Royal Colleges and commissioners on how to increase the number of people with dementia with a diagnosis in the UK, including a call for greater training on dementia in primary care, with particular attention to spotting the symptoms.
MPs said they supported proposals to extend mandatory GP training to at least four years, and suggest there should be ‘a focus on dementia in the additional year’.
A questionnaire carried out for the report found fewer than 15% of carers, family members or friends saw a GP within three months of noticing symptoms, while 36% waited more than a year before going to the GP, and 10% never went to the GP.
The report also advised the RCGP and members of the Dementia Action Alliance action group to ‘compile and promote a list of available and effective training in dementia care for health and social care professionals’.
Some 40% of GPs who responded to the questionnaire said that they had ‘some but not enough’ or ‘none beyond basic training in medical school’ when asked about training in dementia diagnosis
The report also raises concerns about the role of the QOF as a ‘potential barrier’ to dementia diagnosis, with GPs questioned by the group highlighting problems with the assessment tools available to them.
The report says the Dementia Action Alliance action group on diagnosis should explore the issues with assessment tools and suggest solutions to improve national practice, while GP training on dementia diagnosis ‘should contain information on known problems with assessment tools and encourage GPs to use their clinical judgement’.
MPs later recommend that diagnosis be ‘more embedded in the community’, with GPs taking a lead and working alongside secondary care to improve diagnosis.
The report urged the English Government to adopt ‘quantified targets’ for improving early diagnosis and management of patients with dementia, based on evidence from Scotland, where targets had helped increase diagnosis by encouraging practice level changes, ranging from ‘simple administrative changes, such as putting the diagnosis on the top of the referral letter, to exploring different service models that might suit the population better’.
Other recommendations include Government investment in a ‘sustained public dementia awareness campaign’, and for commissioners to invest in ‘appropriate memory service resources to cater to the needs of their population’.
Baroness Sally Greengross, chair of the All-Party Parliamentary Group on Dementia, said: ‘It is shocking that today fewer than half of people with dementia have a formal diagnosis.
‘I am confident that if the recommendations in this report are implemented there will be a significant increase in rates of diagnosis.’