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Dementia diagnosis delayed by complex referral criteria

Complex and time-consuming reminiscence clinic referral criteria are contributing to delays within the diagnosis of dementia, in response to a paper revealed by the Journal of the Royal Society of Medicine. Around 850,000 individuals are dwelling with dementia within the UK however the quantity thought to have dementia considerably exceeds these with a proper diagnosis. Early diagnosis is a precedence for the federal government and the NHS.

Currently GPs are liable for referring sufferers for evaluation and diagnosis by specialists, often in devoted reminiscence clinics which set referral criteria. There is appreciable variation in referral criteria, with necessities set by some reminiscence clinics that exceed nationwide tips. Requirements can embrace totally different mixtures of cognitive exams, laboratory blood checks, urine checks and bodily examination that fluctuate between clinics.

Lead writer Dr Benedict Hayhoe, of the School of Public Health at Imperial College London, says: “GPs have difficulty assessing patients with memory problems in strict accordance with guidance within a 10-minute consultation; in our experience a significant proportion of available consultation time can be taken up by carrying out just one of the brief cognitive tests.” He went on to recommend that, with present workload pressures on main care, complex criteria involving a number of investigations are probably to offer a big disincentive for referral.

The authors set out various approaches to hurry up diagnosis. Dr Hayhoe stated: “A primary care led process, perhaps staffed by practice nurses carrying out assessments according to protocols, may speed up diagnosis while reducing pressure on GPs and specialists.” He added that it might even be applicable to permit individuals with reminiscence considerations direct entry to reminiscence clinics.

Dr Hayhoe concludes: “A system that discourages or delays referral for dementia is highly counterproductive; an urgent review of this area is necessary to establish a system that effectively supports patients and clinicians in early diagnosis, treatment and prevention.”

Article: General practitioner referrals to memory clinics: are referral criteria delaying the diagnosis of dementia? Benedict Hayhoe, Azeem Majeed and Robert Perneczky, Journal of the Royal Society of Medicine, doi: 10.1177/0141076816671939, revealed 9 November 2016.

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