GPs to be paid £55 a patient to diagnose dementia

GPs are to be paid £55 per patient for each additional dementia diagnosis they make in the next six months in plans announced by NHS England to meet diagnosis targets.

Launched as part of a new ‘Dementia Identification Scheme’ unveiled by NHS England, which follows the contract agreement announced this month, the new scheme sees GP practices paid for the net increase in dementia diagnoses they record from now until next April.

The aim is to get the rate of diagnosis of dementia up from 50% to two-thirds of those with the condition.

But GP experts are say the scheme amounts to “cash for diagnoses”. Dr Iona Heath, former RCGP president and a GP in north London told Pulse: “I think the proposal is an intellectual and ethical travesty.”

The experts claim the fees risk undermining the bond of trust between doctors and patients by giving GPs for the first time a financial incentive to diagnose a specific condition.

GPC negotiators said they had again opposed the incentivisation of dementia diagnoses during recent negotiations for the 2015-16 GP contract, while the RCGP said practices already diagnosing cases in a timely way will be penalised.

Dr Maureen Baker, chair of the RCGP, said: "More resources to support GPs and primary care professionals to identify dementia in patients as early as possible is welcome, but we must ensure that this does not lead to the over-medicalisation of our patients.

"It is also important to ensure that GP practices do not become a victim of their own success at diagnosing patients with dementia in a timely fashion. Whilst the 66% target might sound ambitious, many GP practices around the country are already achieving this and it is important that practices exceeding this target do not lose out on more money and resources.

"We must also ensure that with any increase in diagnose of dementia, there are also enough resources to provide appropriate post-diagnostic care in the community.”

NHS England has introduced the new scheme as part of a £5m funding boost for general practice, announced by Simon Stevens at the RCGP conference, to “spearhead the NHS drive to identify people with dementia”.  

The service is optional for GPs and pays for diagnoses only, with payment based on the net increase in the dementia register at the end of March 2015, compared with the end of September 2014.

The Patients Association oppose the payments. Chief executive Katherine Murphy said: “This 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. It is a distortion of good medical practice.”

Jeremy Hunt, the health secretary, has condemned diagnosis rates of dementia, which were just 37% as recently as 2010, as shockingly low and “a national shame”. There are thought to be up to 400,000 people in England with dementia who have not been diagnosed.

A spokesperson 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.”

Tell us what you think – have your say below or email [email protected]


Andie   22/10/2014 at 12:54

In my opinion I think it is an enormous waste of money paying doctors for something they are already well paid to do - that is, diagnose patients! What next? £20 for an appendicitis diagnosis? Absolutely ridiculous!

Sarah   22/10/2014 at 14:46

This isn't just picking up dementia diagnoses on an ad hoc basis when people attend the surgery for other reasons. The activity required to complete each diagnosis is estimated to take 2 - 3 hours. Even if it were sufficient to use nursing staff alone to do the extra work, the cost is greater than £55. And then the patients will need additional support, either from their GP or from other services which may or may not be available in their neighbourhood. Is it fair to label people with dementia if there is no provision to help them cope with the condition - for which there is no effective treatment.

Rae   22/10/2014 at 15:32

Of course GPs are already paid well enough. Are they going to charge for everything they do in a consultation? There was a time when GPs were not in it for the money- only... This refers to Jeremy Hunt as NH Sec. He is not the health sec for Scotland-fortunately-and I sincerely hope that the Scottish Health Service-and Doctors-do not adopt this money grabbing attitude. (£5 for a sore toe anyone?!)

Keith   22/10/2014 at 16:19

So well paid GP's will get paid £55 for a dementia diagnosis, which will then require treatment from Health and Social Care with no extra for CCG's or Local Authorities. Meanwhile low paid NHS staff can't have a 1% pay rise because it can't be afforded. Something's wrong somewhere!!

Jimbotech   22/10/2014 at 17:18

My wife has a Scitzio Affective Disorder(SAD+?) and can have a bladder infection which affects her speach and behaviour. Antibiotics, her psychiatric medication and cateracts in both eyes compound the possibility of a misdiagnosis. Is it possible that the respective GP will be correct and therefore earn his extra five bob?

David   22/10/2014 at 20:23

This is a very worrying trend.In my experience it is not GP's who are best placed to diagnose Dementia and in the case of my father - now deceased - it was a Psychiatrist who diagnosed him with Alzheimers. The role of the GP was to refer him for diagnosis only and thus the GP is doing the job for which he more that adequately paid already. This is just more tick box medicine and sets a dangerous precedent.

Peter   25/10/2014 at 01:24

Giving GPs an incentive to diagnose is rubbish! Make sure they have the training and resources to do their job - and then make sure adequate provision is made for people who are suffering with dementia, and support for those who care for them!

Anon   05/11/2014 at 14:29


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