Dementia diagnosis drive ignores need for support

The 'target-driven' focus on diagnosing huge numbers of people with dementia risks sidelining resources for services that support patients with established disease, a GP has warned.

Dementia: support needed
Dementia: support needed

Surrey GP Dr Martin Brunet warned the directed enhanced service (DES) to case-find dementia had ignored diagnostic and support services such as memory clinics, leaving patients without the care they need.

But in a debate at the RCGP conference yesterday, England’s dementia tsar Professor Alistair Burns, said earlier diagnosis gave vulnerable patients access to more support services and avoids hospital admissions.

NHS England introduced the controversial dementia DES to case-find for dementia among at-risk groups in the 2013/14 GP contract.

Dr Brunet, an outspoken critic of the DES, said the drive to raise diagnosis rates to 65% amounted to a ‘target’ to diagnose a certain number of people with the condition in general practice, something that was not pursued in other disease areas.

He said the drive benefitted the political agenda, the pharmaceutical industry and companies providing diagnostic tools, rather than patients.

The session’s chairman, Surrey GP Dr Pete Deveson, said there were concerns that resources for patients with diagnosed disease could even be taken away if memory clinics were flooded with people who may only have cognitive impairment. 

‘Local to us, our GP commissioners are concentrating on the dementia DES, and setting up that. That’s where the attention and money is going, it’s not going to memory clinics, or respite care.’

Dr Jill Rasmussen, RCGP clinical champion for dementia, backed case-finding for long term conditions and said patient surveys showed most patients want to know if they had dementia.

‘It’s only through diagnosis that patients can often access all the benefits, all the interventions, both health benefits and the social care benefits.’

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