Practices to earn £55 per extra patient diagnosed with dementia

Practices signed up to an enhanced service are to be offered £55 per extra patient diagnosed with dementia as part of NHS England's plans to significantly boost numbers diagnosed with the condition.

The Dementia Identification Scheme enhanced service, designed to ‘reward GP practices for undertaking a proactive approach’ to identifying patients with dementia, will run until the end of March 2015. Practices wishing to participate must sign up by 17 November 2014.

NHS England chief executive Simon Stevens announced at the annual RCGP conference in Liverpool that an extra £5m would be set aside to incentivise GPs to diagnose more dementia patients, which will form part of the enhanced service.

NHS England documents on the scheme show practices will be allocated a £55 slice of this £5m per additional patient they diagnose with dementia as a result – which they will be expected to invest in plans to further improve dementia services.

Current estimates suggest that around 50% of people living with the condition remain undiagnosed. The enhanced service forms part of NHS England’s drive to boost diagnosis rates up to 66% by 2015.

NHS England said GPs were ‘critical’ to increasing the numbers diagnosed and ‘we [NHS England] need to ensure they have the resources and support to get the job done’.

Offer to assess at-risk patients

Wessex LMCs chief exective Dr Nigel Watson said the scheme was ‘politically driven’ rather than to the benefit of patient care.

He said: ‘I'm not sure it’s going to have the impact the government hopes it will. I think there's an element of list cleaning, and many practices have already done this in the last few years. Personally, I'd have rather seen them put the money somewhere else.’

He warned that many patients will only be seen by memory clinics six to nine months after GP referral, meaning the six-month limit of the enhanced service could work against GPs and leave their hard work ineffective.

GPC deputy chairman Dr Richard Vautrey warned that the enhanced service was ignoring what patients really needed.

‘The enhanced service is clearly directed at identification of patients with dementia and making this consistent with the prevalence in an area. But I think the key focus for NHS England should be providing and ensuring better services for patients that actually have dementia.

‘That’s the area GPs are most concerned about: ensuring that patients and carers get the right amount of support and that’s something that often lacking. That’s where there's a real need for improvement.’

Assessing at-risk patients

As part of the enhanced service, practices are expected to offer ‘at-risk’ patients on their list a dementia assessment; ensure all dementia patients have up-to-date records; and work with their CCG to improve local services and care packages for patients on their dementia register.

Patients identified as being at-risk include those over 60 living with chronic conditions such as cardiovascular disease, COPD, obesity or diabetes; patients over 40 with Down’s syndrome; and patients over 50 with learning disabilities.

In order to calculate payments, practices that sign up for the enhanced service will report to their NHS England area team how many patients with dementia are on their register as of 30 September 2014.

The practice will do this again on 31 March 2015. The number of additional patients signed up as a result of the enhanced service - and associated payments - will be calculated based on the differential between these two registers.

A spokesman for NHS England said: ‘Dementia can be devastating both for individuals and their families. We know that more needs to be done across the health service to ensure that people living with dementia are identified so that they can get the tailored care and support they need. This additional investment is part of a drive to ensure this.’

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