Expand depression quality indicators

The quality framework indicators for depression need to be expanded to target patients from a wider range of disease areas, according to a report by leading mental health charities.

Currently, the quality framework awards eight points to GPs who screen for depression in patients with diabetes and CHD.

But the report by the charities Depression Alliance and Sane has criticised the framework for not doing enough for patients with depression, a condition that can affect between 8 and 12 per cent of the population.

The report reveals findings from a survey of 450 people living with depression in the UK. The survey showed that 14 per cent of people with depression are likely to have hypertension, 12 per cent chronic painful conditions and 11 per cent arthritis.

The report states that there should ‘be the development of a quality framework indicator that encourages GPs to look for depression in a wider range of disease areas, in addition to diabetes and CHD.’

Dr Chris Manning, chief executive of Primary Care Mental Health and Education who also worked on the report, said: ‘The survey highlights that the current quality framework needs to be expanded to encourage the recognition and acknowledgement of depression, in its own right and as being often co-existent with other key major illnesses and conditions, such as stroke, cancer and pain.’

But North Shields GP Dr Dave Tomson said that he was not convinced that extending screening for depression to more disease areas was necessary.

Dr Alan Cohen, South London GP and director of primary care at the Sainsbury Centre for mental health, said that there was some evidence to suggest screening for depression in people with strokes but not enough for other conditions.

‘The difficulty is to ensure that any changes to the quality framework are evidence based and are able to be converted into clinical indicators that are precise and measurable,’ he said.

The report also suggests that quality indicators be developed to support the increased involvement of patients in their treatment decisions and to support GPs in the identification, management and ongoing care of those with depression.

Emer O’Neill, chief executive of Depression Alliance, said that changes to the quality framework would improve patient care.

Dealing with depression
The Depression Alliance report calls for:

  • Look for depression in a wider range of disease areas.
  • Take into account the psychological and somatic symptoms associated with depression in an initial diagnosis.
  • Involve patients when making treatment decisions.
  • Identify, manage and provide ongoing care for those with depression.

What do you think? Email your comments to GPletters@haymarket.com

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