Quality in Primary Care Open Access

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Understanding the dementia diagnosis gap in Norfolk and Suffolk: a survey of general practitioners

Nicholas Steel, Margaret Fox, Chris Fox, Willie Cruickshank, Bridget Penhale, Fiona Poland

Background The National Health Service (NHS) has announced its new target to increase the ‘shockingly low dementia diagnosis rate’ in England from the current level of 45% to 66% by end of March 2015. Clinical commissioning groups (CCGs) in England have committed to meeting this target. The Norfolk and Suffolk dementia diagnosis rate (DDR) is below the rate for England in some areas; across the CCGs included in this study, the average DDR was 39.9% with a standard deviation of 5.3. Aims This study aimed to explore and understand the low DDR in Norfolk and Suffolk and to learn what might be needed to support general practitioners (GPs) to meet the targets set by the UK Department of Health. Methods An online survey was developed including questions from the NationalGP Audit 2009. The link to the online survey was sent via email to all GPs in four participating CCGs in Norfolk and Suffolk. SPSS was used for descriptive analysis. Chi-square tests were conducted to identify significant differences in response rates between groups of GPs. Results The survey was completed by 28% (N = 113) of 400 GPs in 108 practices across three CCGs receiving the survey link. There was a significant difference in response rates from GPs in each CCG, but there were no significant differences in terms of their answers to the questions in the survey. GP respondents expressed confidence in their ability to identify cases of dementia for onward referral to memory services. Participating GPs also acknowledged the benefits to patients and their carers of a timely dementia diagnosis at an early stage of the disease. However, they reported concerns about the quality and availability of post-diagnostic support services for people with dementia and their carers. In this survey, GPs’ attitudesweremore positive about diagnosing dementia than those responding to the National Audit 2009. Conclusions Despite GPs’ attitudes being more positive than in 2009 about diagnosing dementia, the Norfolk and Suffolk DDR remains low. This may reflect lack of GP confidence in the quality and availability of post-diagnostic support services. This study has identified a need to map the existing postdiagnostic support services for people with dementia and to identify gaps in services. This could lead to the development of a resource which might enable GPs to provide relevant advice to newly diagnosed patients and their carers, facilitate signposting to support services, and give GPs confidence to increase the DDR in their area.