GPs to be paid £55 for diagnosing Dementia

Why is this a revelation? Ever heard of QoF?

Not sure why all the GP bashing. Most GPs are hardworking and knowledgeable. Of course, as with most things you will only hear about the bad cases/high earners as it is headline grabbing.

You honestly think hospital is any different?
 
it's utter complete junk what is being offered. I think a huge proportion of GP's are quite uncomfortable with the ethics alone of being paid on diagnosis. It's another area where we as a profession are being hounded for being either incompetent or money grabbing or both. I don't know anyone who thinks it's a good idea after it was announced yesterday. If you think it will incentivise anyone you are very much mistaken also.

In my practice we have above average prevalence of dementia (nearly 1.5%) with currently 112 people on our register. how many new cases do you think is likely to happen in the slightly under 6 months this will be run as an experiment for? A dementia diagnosis doesn't happen overnight either. I would see someone and assess them, arrange for some screening bloods to make sure other simple modifiable causes are not the reason for their memory problems, review them with the results and then refer them to a memory clinic. It will take a couple of months before they are seen in a memory clinic, and they will then perform more tests on their memory, arrange MRI/CT scans of their brain, assess them in day centres and their side generally takes several months to complete before a diagnosis is made. It's quite clearly important you need a robust diagnosis of dementia you don't just want to give it to anyone who has very mild memory problems, as it will have very marked affect on their lives. The whole process in general takes slightly more than 6m for a robust diagnosis. So in reality the new diagnoses of dementia are for people we have referred in the last few months and there is no incentive as it is for work you have already completed

It also is not £55 per patient diagnosed it is £55 for each extra case on your register compared to 30th september, by end of March 2015. so the fact that some of our frail patients with dementia will die in this timeframe would mean that 112 may become 108, so we would actually need to have 5 new diagnoses for the headline grabbing £55, so actually £10 per diagnosis.

I have absolutely no idea what the purpose of this whole scheme is as it will be meaningless, and will only undermine our profession, my practice will not be signing up for it as it only appears divisive. It's another politically driven headline grabbing stunt from NHSE and I'm fed up to the teeth of this rubbish, and if you saw me face to face my ranting over this carp would be significantly worse
 
LordSplodge said:
For those who love the person suffering it, yes. For the person suffering it, not so much as you don't get to see the hurt it causes those who love you.
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Meh. I would disagree. You're right. But people with dementia have lucid moments too, where they then realise they are forgetting things and become frustrated.

The thing that is bad for them is when they forget how to do basic body functions, like swallow.

You either have to force feed them up until they die, or let them starve for however long it takes.
 
estebanrey said:
A bloke on the radio this morning made a good point which was that given that dementia is a disease with no cure and cathcing it early does nothing to stop it happening, isn't it better (for many people) that they are left in ignorant bliss for longer rather than knowing at the earliest possible stage?

Diagnosing it years before any serious affects happen can lead to depression and in some cases suicide.
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there is a drug that if given years before dementia gets a hold can increase the time before it hits by 10+ years
 
balky12 said:
Meh. I would disagree. You're right. But people with dementia have lucid moments too, where they then realise they are forgetting things and become frustrated.

You either have to force feed them up until they die, or let them starve for however long it takes.
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Lucid moments for a dementia sufferer are going to be horrible. However their loved ones feel the effects of dementia 24/7.

As for end stage dementia, like many terminal conditions we treat animals better. However that's a completely different topic.
 
Nix said:
1. GPs should be paid well. They serve a very important role, and considering that some half-wit in the private sector can get paid handsomely for doing absolutely nothing of note, it only seems fair.

2. What is the actual purpose of an incentive? It implies that some GPs aren't doing their job properly when it comes to diagnosing if that is the problem, in which case, how is throwing money at it in the most literal way going to fix anything? It reeks of stupid carrot-and-stick upper-management policy.

3. Dementia is ****ing terrifying.

4. The money would be better thrown at the support services.

5. What happens with the overzealous GPs who actively try and diagnose something that isn't there? Will that not cost the NHS more in the long run? I guess they're banking on an offset. Financial incentives and healthcare provisions seem like very awkward bed-fellows.
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I wholeheartedly agree with point number 4. In my employment I meet people with dementia on a regular basis. Dementia is an evil disease, it takes no prisoners. In my view its worse than cancer, yet is talked about far less. We need to start investing in supporting people with this disease until a cure/treatment is found. The Dutch are miles ahead of us in this respect.
 
LordSplodge said:
For those who love the person suffering it, yes. For the person suffering it, not so much as you don't get to see the hurt it causes those who love you.
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I've met many a person who know that they have dementia and know that they simply cannot remember things. Its an awful disease for everybody involved.
 
The need for payment infers that GPs are not currently doing their job properly and dementia patients are slipping through the net. I am not sure that this is a sensible message to send to the public.

Mind you, no mention of "ash cash" which is possibly worse.
 
holymonk said:
I wholeheartedly agree with point number 4. In my employment I meet people with dementia on a regular basis. Dementia is an evil disease, it takes no prisoners. In my view its worse than cancer, yet is talked about far less. We need to start investing in supporting people with this disease until a cure/treatment is found. The Dutch are miles ahead of us in this respect.
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What is it that you do, if you don't mind me asking?
 
I think there is a bit of a spin here from certain quarters. This payment whilst being more explicit is not that different from the different incentives already given to GPs in other areas. GPs are given money on what they actually treat already rather than a flat salary. This money is not going directly on the GPs pay cheque but as a payment to facilitate services. Eg if a GP earning 60k has 1000 patients he diagnoses with dementia then they will still be on 60k but would then employ maybe 2 x Band 5 nurses who had a remit in dementia services. I am sure one will abuse the system but they will be up in front of the GMC for their actions and out of the game in short order.
 
Of course GPs should not be paid for it.
They are paid a salary to do their job properly, with training and disciplinary measures required if they do not.
If I suddenly got £55 for doing a certain part of my job properly I would be inclined to purposefully do it wrong if I was declined the bonus.
 
So there we have it public sector workers should not have financial incentives (even though this is not really what this is) whereas if someone dare say that about private sector workers on these forums (eg bankers) you get half the forums on your head saying we want the best you have to reward success etc.
 
Some very surprising anti-GP comments in here. The amount of knowledge they know and training / exams to get there is absurd! Throw money at them I say, and throw more money at nurses too.

Not entirely sure of the reason behind the incentive. It's an incredibly nominal sum for a GP.
 
This is really no different to the way GP's are already paid, ie by maintaining registers of patients with certain conditions and being paid for performance and hitting QOF and QIF targets. The number of people in this thread that clearly haven't got clue is pretty surprising!

Gammawolf said:
The notion of a GP needs to be overhauled into the information era. We're no longer reliant on someone who needs on the spot encyclopaedic knowledge with the vast amount of instant information available. But what about the other side of the coin? No one cares about underpaid researchers who ultimately feed everything to the medical industry just for a GP to simply prescribe to a patient. All the public sees is they turn up, see a doctor and get drugs. It's the end of the world if they turn up and there's no doctor, but if there's no researcher then no one cares - because they don't see it.

The role is now increasingly just a middle man role between the end user and the developer - so the pay and training required should match.
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Lol. What a load of nonsense.
 
holymonk said:
Utter rubbish.
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Any first hand experience there?

What I've witnessed through a family friend and what has been explained to us by doctors and people at the home...

One article on the interwebs.

Difficulty swallowing. Part of the decline of dementia often involves forgetting how to swallow correctly. Food, and especially liquids, can go down the wrong way, into the lungs. There are products you can buy that will thicken liquids to stimulate the natural swallowing reflex. This enhances the likelihood the fluid will go into the stomach rather than the lungs.
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Learn to use google before spouting your insensitive ****, especially when you are clueless.
 
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Mr Jones said:
Stupid incentive is stupid. Just so they can jack the number of Dementia?
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The more patients that are diagnosed, the more money glaxosmithkline (and others) make from their drugs.
The more patients that are diagnosed, the more money the government makes by stealing their house to pay for care.

That's pretty much all there is too it.
 
My crude understanding of how general practice works is that practices are paid 'bonuses' (their salary) for completing X amount of blood pressure checks, or seeing so many % of their asthma patients in a year (see http://www.qof.hscic.gov.uk/).

Given that they are already awarded money in this fashion for carrying out their work I have little problem with them being paid for making dementia diagnoses. I think the media is portraying this in quite an unforgiving light.
 
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