GPs criticised over lack of dementia diagnosis

A MAJOR conference staged to examine the treatment of dementia in the Borders heard criticism of some local GPs who are being accused of dragging their feet when it comes to diagnosing the disease.

Staged at the Ednam House Hotel last Thursday, the conference was organised jointly by Alzheimer Scotland, NHS Borders and Scottish Borders Council social work staff.

There has been recent concern from those in the frontline of dementia care across this region that, despite having a large ageing population, only 40 per cent of those estimated to be suffering from dementia in the Borders have actually had it confirmed by a medical diagnosis.

Such is its concern over the situation in the Borders, that Alzheimer Scotland has launched a localised campaign targeting this region to try to raise public awareness of the disease.

The national organisation also says the Borders is now trailing behind almost everyone else in Scotland when it comes to diagnosis rates for the illness and says out of 1,800 dementia sufferers in the Borders, only a little over 700 have had the disease officially confirmed by a doctor.

Faltering rates of diagnosis are, therefore, making it difficult for those arguing the case for increased resources in tackling the disease.

Although the three bodies behind the conference have agreed a joint Scottish Borders Dementia Strategy, with widespread praise for work already being done, it looks like some in the region may soon get their knuckles rapped by Scottish Government ministers over the failure to meet national so-called HEAT (Heath improvement, Efficiency, Access & Treatment) targets – set for three-year periods by the government to promote high-impact changes in specific health conditions.

From April 2008, each NHS Board had to deliver agreed improvements in the early diagnosis and management of patients with a dementia by March this year.

Alzheimer Scotland’s resource worker in the Borders, Stephen Fox, was delighted with the large turnout for the conference and the varied mix of delegates.

“The important thing was the mix of people who attended. We were overscribed. We also had a lot of people who were at the personal carer-end of dealing with dementia, and it was good to hear their experiences,” he told TheSouthern.

“There were some consultants present, but only one GP.

“What was clear is that the Borders is pushing at best practice, which is good, as the Scottish Government is expecting us to deliver that.

“But it’s clear we are still struggling when it comes to getting GPs to engage fully in terms of the role needed to get this moving forwards.

“There is enthusiasm and we are delivering success across the board, but a problem persists in getting the diagnostic rate up.”

NHS Borders Clinical Service Manager Trudy Gane was one of the invited speakers who addressed the conference and told delegates of the raft of excellent work being done in the Borders across a whole range of areas.

However, she too sounded a warning about the low rates of diagnosis.

She said: “We have heard from a lot of speakers about the importance of early diagnosis. We are absolutely certain that it is the right way to go. But we’ve still not met that HEAT target.

“It is not an easy one to crack and there is a lot of good practice going on by GPs, but there’s going to be flak from the Scottish Government because we have not met the target and are not going to.”

Consultant psychiatrist with NHS Borders, Dr Paul Norris, was clearly frustrated with the situation, telling delegates: “There is clearly a lot of good stuff going on in the Borders, but it appears we’re going to get a really big black mark against our names.”

Asked for a response to the comments made at the conference, Dr Ross Cameron, medical director at NHS Borders, said the organisation recognised the challenging issues around the early diagnosis and management of people with a dementia that it faced in achieving the national target.

“We are currently undertaking a range of activities to ensure that dementia is responded to as a priority across the organisation and as a result our performance in meeting the target is gradually improving,” he added.

“A Dementia Services Programme has been set up to establish a whole-system person-centred service for people with dementia and their carers. This includes designing and implementing a diagnosis-specific Dementia Integrated Care Pathway; focusing on service redesign work to establish robust and active systems for identification and early diagnosis and on key areas where performance appears to be low.

“This increased focus highlights our commitment to improving our services and performance in relation to dementia care.”