Practices could boycott £5m dementia diagnosis scheme

Practices should consider boycotting a scheme that would pay them £55 per patient diagnosed with dementia, the GPC has suggested.

Dr Richard Vautrey: practices should think carefully about taking part (Photo: JH Lancy)

NHS England announced this month that £5m would be used to incentivise GPs to diagnose more dementia patients, under the dementia identification scheme enhanced service.

The scheme runs until the end of March 2015 and practices wishing to participate must sign up by 
17 November 2014.

NHS England documents show practices will be allocated a £55 slice of this £5m for each additional patient they diagnose with dementia, which they will be expected to invest in plans to further improve dementia services.

Poll: should GPs boycott dementia payments?

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

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

But GPC deputy chairman Dr Richard Vautrey said: ‘Diagnosis of dementia is important, but chasing government targets is not, particularly if this undermines the doctor/patient relationship, which this proposal could do.

‘Diagnosing dementia and making sure patients and their carers get the right support and treatment is something all GPs try to do every day. They do not need financial incentives to do this. Practices should think very carefully about whether they should engage with this scheme.’

He called for proper investment in GP services that would benefit all patients, and funding for ‘timely appointments at memory clinics and real support in the community’.

Politically driven scheme

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

He warned that many patients will only be seen by memory clinics six to nine months after GP referral, and that the six-month limit of the enhanced service could mean a higher diagnosis rate was ineffective.

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 the CCG to improve local services and care packages for patients on their dementia register.

To calculate payments, NHS England will count the difference in size between practices’ dementia registers on 30 September 2014 and 31 March 2015. A spokesman for NHS England said: ‘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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