More quality targets for dementia

Stronger targets are needed in the quality framework to boost early diagnosis of dementia, an expert report has recommended.

The Dementia UK report released by the Alzheimer’s Society this week said that as part of making dementia a national priority, GPs should be encouraged to identify, diagnose and manage dementia.

It is estimated that up to 700,000 people in the UK have dementia. This figure is expected to reach almost one million by 2021 and 1.75 million by 2051.

Andrew Chidgey, head of policy and campaigns at the Alzheimer’s Society, said: ‘The development of the GMS quality framework needs to reflect that fact that there will be more people with dementia in the future.

‘Making sure GPs have access to all the right screening tools could be part of the quality framework.’

GPs are currently awarded up to 20 quality framework points for producing a register of patients with a dementia diagnosis and for reviewing the care of 15–60 per cent of patients within 15 months.

Dr Stephen Iliffe, north London GP and member of the NICE dementia guideline development group, said more dementia indicators were likely to be added to the latest reviews of the quality framework.

‘The evolution of the quality framework will go along the lines of NICE guidelines,’ he said.

Blood tests to exclude hypothyroidism or vitamin B12 deficiency are likely to be included, added Dr Iliffe, as is introduction of cognitive function tests such as the mini-mental state examination. GPs should also be rewarded points for documenting an informant history.

‘That’s quite crucial in dementia diagnosis because the person with the problem might not see the problem,’ he said.

‘Then there’s going to be something around shared care, medication use, providing support to carers and possibly demonstrating some systematic follow-up for psychological or behavioural changes.’

But Dr Andrew Dearden, chairman of the GPC’s community care committee, was uncertain about adding further dementia indicators.

‘I don’t know of any good evidence that the sooner you diagnose dementia the better the final outcome,’ he said.

DoH older people’s czar Professor Ian Philp said: ‘I was pleased to see dementia included in the last review of the quality framework and would welcome more indicators.’

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