Paying GPs to spot dementia won’t tackle dismal diagnosis rates, warns health boss

Paying GPs to detect dementia in patients is ‘politically motivated and raises ethical considerations’, says a senior Manchester health official.

The comments come following news of plans to pay practitioners £55 for each diagnosis of the disease, which currently has a diagnosis rate of 48%.

Dr JS Bamrah, Medical Director at the Manchester Mental Health and Social Care Trust, said that the idea has best interests at heart but fails to tackle what he calls ‘dismal’ dementia diagnosis rates.

Speaking to MM, he said: “I can understand why there needs to be an incentive in order to try and get patients to have a diagnosis.

“It seems to me that there are ethical considerations in paying people to make a diagnosis. It’s a political target. It could have been clinically more meaningful if clinicians were involved.”

The plan was announced in October as a means of improving meagre rates of dementia detection, but many GPs have since expressed anger at the scheme.

In an open letter last month to the head of NHS England Simon Stevens more than 50 medical professionals voiced ‘serious concern’ at the idea and urged that it be scrapped.

Dr Bamrah said: “I think that it does rather change the relationship of the GP and the patient because the patient will feel a little weary of the fact that a GP is earning from what is a potentially serious condition.

“Incentivising individual GPs is not the right thing to do which is why I understand GPs haven’t really been happy with it.

“[The diagnosis rate] is really quite dismal nationally. In Manchester the diagnosis rate is 48%. I think it certainly needs to be much better than that.”

Rob Stewart, a spokesman for Alzheimer’s Society – a charity which works to improve the quality of life of sufferers of dementia – told MM there a many reasons why the condition goes untreated.

He said: “Some people delay seeking advice from their GP. Memory loss is often seen to be a natural part of ageing and people aren’t aware that treatments and support are available.

“Some health professionals have not received sufficient training to recognise and diagnose dementia, or do not see the value of a diagnosis.”

The number of dementia suffers in Greater Manchester is estimated to be in the region of 30,000 and the need for more training in spotting the condition is a view shared by Dr Bamrah.

“I think training needs to be better, training needs to involve primary care, not just GPs, primary care nurses as well, and [we need to equip GPs to be able to make the diagnosis],” he said.

“It’s an increasing problem so it’s about managing demand.

“I can appreciate why the government… wants to improve the rates of diagnosis. There might be a better way to do it.”

Image courtesy of katiecurrid with thanks.

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