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BMA meeting: Early dementia diagnosis is pointless without support services

BMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i3505 (Published 27 June 2016) Cite this as: BMJ 2016;353:i3505
  1. Abi Rimmer
  1. BMJ Careers

An early diagnosis of dementia is pointless if there is no relevant support available for patients and their families, the BMA has said.

Doctors at the BMA’s annual representatives meeting in Belfast on Wednesday 22 June voted in favour of a motion that said that the “government’s drive for early diagnosis of dementia without the corresponding support for those who receive such a diagnosis is pointless.”

The motion said that making a diagnosis without support being available “only serves to increase distress for patients and families.”

Proposing the motion, GP Alex Freeman said that dementia was a terminal disease, but patients did not have the same access to high quality palliative care as others with terminal diseases.

She said that families often struggled to get help for their relative after diagnosis. “Why do we put families through this and why do we think that an early diagnosis of dementia and the promise of this in your future is a good thing?” Freeman asked.

“We must do better—all people with any terminal illness deserve equal care and respect,” she added.

Speaking in favour of the motion, Tim Yates, a junior doctor, highlighted the impact that the national dementia campaign—which asked “Do you worry about your memory?”—had had on dementia clinics.

“Well established dementia clinics weren’t that busy before the campaign and nine out of 10 patients seen did actually have cognitive impairment, with the remainder having varying degrees of memory related anxiety or psychopathology,” Yates said.

“Since the campaign this ratio reversed. Patients without memory problems, but with other significant problems, are waiting months and months to see the wrong specialist typically far away from the help that they need.”

He said that doctors owed it to their patients to press the government to look at the dementia campaign again.

The government launched the Dementia Identification Scheme in October 2014. It paid GPs £55 for each additional patient on their list with a new diagnosis of dementia. The scheme ran until March 2015 but was heavily criticised by many, including GPs, as unethical.1 2

Speaking to journalists ahead of the debate, Richard Vautrey, deputy chair of the BMA’s general practitioners committee, said that patients with suspected dementia should be seen in a memory clinic within one or two weeks of being referred, but that in some parts of the country they wait six months or more for an appointment.

“To live with the uncertainty of a dementia diagnosis is unacceptable,” he said. Getting a diagnosis “should be the gateway to a whole range of support.”

He added, “We cannot see it as a success to achieve a certain number of diagnoses unless there are the services to back it up. The focus should be on service provision not just on numbers.

“In many ways there has been a focus on the cheap thing, which is the drug [treatment], but not the support, which is expensive. It is very frustrating.”

Gary Wannan, chair of the BMA’s committee on community care, said, “Local authorities simply don’t have the money to provide the level of care that is needed. The best care is when different professionals and different agencies come together and can plan care. But when budgets are tight that doesn’t happen.”

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