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Plans to boost dementia diagnosis met with criticism

Plans to pay GPs' practices extra money for diagnosing more patients with dementia have met with a strong response.

Some doctors' groups say the move creates perverse incentives for GPs, but the NHS claims the move will give them more time to make the correct diagnosis.

ITV News Correspondent Nina Nannar reports.

Your experiences with loved ones' dementia diagnosis

The NHS is trying to improve identification of dementia cases by paying GPs to increase diagnosis rates.

We asked our Facebook readers to share their experiences of dementia diagnosis.

It took them three years to diagnose my poor mum. They just kept saying was old age , but as a family we knew it was more.

– Loza Tingley

I was raising concerns back in 2008 to mum's GP. He said it was all in my head. I kept going back but it all fell on deaf ears...Mum was diagnosed in July 2011 with Alzheimer's and Vascular Dementia

– Lisa Evans

I'm a carer and have been for 13 odd years. I recognise dementia when I see it and as carers we have been trained to recognise the possible signs of this awful condition...maybe carers should get the pay rise!

– Rachel Hennessy

The doctor kept saying my dad had dementia [although] we argued it wasn't. Finally he collapsed on a Friday, on the Monday it was confirmed he had a brain tumour and three months to live

– Kim Chappell

We had to practically beg to get a doctor to come out and see my gran who has bad dementia and had taken to her bed

– Amanda Todd

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What are the common symptoms of dementia?

Concerns over identifying dementia have prompted NHS England to propose paying GPs extra to increase their diagnosis rates.

The Alzheimer's Society provides a list of some of the common symptoms of the condition.

• Day-to-day memory – difficulty recalling recent events

• Concentrating, planning or organising – difficulties making decisions, solving problems or carrying out a sequence of tasks (eg cooking a meal)

• Language – difficulties following a conversation or finding the right word for something

• Visuospatial skills – problems judging distances (eg on stairs) and seeing objects in three dimensions

• Orientation – losing track of the day or date, or becoming confused about where they are.

British Medical Association opposed to dementia plans

The British Medical Association, which represents doctors and medical students, says it is opposed to proposals to pay GPs for increasing dementia diagnoses.

Many elderly patients are diagnosed with dementia. Credit: Daniel Karmann

Dr Richard Vautrey, deputy chair of the BMA’s GPs committee, told the Daily Telegraph: “This is not a jointly negotiated enhanced service, it’s something NHS England wanted to do."

"Practices will have to make their minds up as to how they will approach it and I’m sure they will have lots of issues with it.

Cash-for-diagnosis dementia plan 'an ethical travesty'

The former head of the Royal College of GPs has said proposals to pay doctors to diagnose dementia are "an intellectual and ethical travesty".

Dr Iona Spence's comments were echoed by Surrey GP Dr Martin Brunet, who told healthcare magazine Pulse the idea "creates a major conflict of interest that is frankly unethical".

According to the Daily Telegraph, GPs in some parts of the country could be paid as much as £200 per diagnosis under the plan.

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Anger over 'dementia diagnosis cash' for GP plans

GPs are to be paid a bonus for diagnosing dementia patients. Credit: PA Wire

Plans to pay GPs a £55 bonus to diagnose dementia have been criticised by the Patients' Association.

Family doctors are expected to receive the money under an NHS scheme which is thought to be the first national initiative to reward doctors for diagnosing patients with a condition.

Katherine Murphy, chief executive of the Patients Association, said it was "a distortion of good medical practice".

She said: "We know GPs receive incentive payments to find all sorts of conditions, such as high cholesterol, raised blood pressure and diabetes - but this seems a step too far. It is putting a bounty on the head of certain patients.

"Good GPs will be diagnosing their dementia patients already. This seems to be rewarding poor GPs.

"There is an issue of people presenting late with dementia to doctors, but this is not the right way to go about tackling that. If people were given hope that something could be done, that would be the greatest incentive for coming early."

A spokeswoman for NHS England said: "Dementia can be devastating both for individuals and their families.

"We know that 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."

Serious concerns raised over dementia care in England

Serious concerns were raised today about the standard of care given to dementia patients in England.

A scathing report from the Care Quality Commission said nine out of ten hospitals and care homes are failing on some aspects of their service.

ITV News correspondent Rupert Evelyn reports from Bristol:

Ninety per cent of dementia units have 'poor care'

Nine out of 10 dementia units have been assessed as having aspects of poor care, the Care Quality Commission (CQC) has found.

Ninety per cent of dementia care was assessed as poor. Credit: PA

The watchdog criticised hospitals and care home staff for having "a lack of understanding and knowledge of dementia care" as well as poor information sharing.

It also found that known risks to patients like falling over, urinary tract infections and malnutrition were not being managed properly.

Andrea Sutcliffe, the CQC's chief inspector of adult social care, said: "People living with dementia, their families and carers have every right to be treated with respect, dignity and compassion.

"Our review found some great care, delivered by committed, skilled and dedicated staff.

"But this is not the case everywhere or even within the same service meaning too many people are at risk of poor care. This has got to change."

The CQC plans to appoint a new national specialist adviser for dementia care and more training for inspectors to "understand what good dementia care looks like".

Health Secretary Jeremy Hunt said: "There can be no excuse, and no hiding place, for poor care within our NHS - we are focusing on improving the lives of dementia patients and their families as never before."

Report: Smoking, obesity and early-life education may affect dementia

A new report has made the case for raising awareness about the way lifestyle choices can affect your risk of dementia later in life.

It points out "there is no evidence strong enough at this time to claim that lifestyle changes will prevent dementia on an individual basis". However, evidence suggests the following could result in a lower risk:

  • Stopping smoking
  • Improved detection and treatment of diabetes and hypertension
  • Increased physical activity and reduction in levels of obesity
  • Education in early life
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