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NHS dementia tests 'futile and failing patients': Warning symptoms in up to 40% of patients are being missed in routine checks

Posted on 15/12/2017 by

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  • Up to 40 per cent of patients who have symptoms of dementia are being missed by doctors and nurses during routine assessments, new research has found

  • Up to a third of dementia sufferers have never been given a formal diagnosis

  • The Government introduced a target system for hospitals in 2013

 

Dementia patients and their families are being failed by a ‘futile’ target system in hospitals, the country’s top experts have warned.

Up to 40 per cent of patients who have symptoms of dementia are being missed by doctors and nurses during routine assessments.

Research by Cambridge University and the University of East Anglia also found that many patients who are flagged up as ‘potentially’ having dementia are never sent on for further tests.

The findings were presented at a key dementia summit in Central London this week aimed at improving the country’s poor diagnosis rates.

Up to 40 per cent of patients who have symptoms of dementia are being missed by doctors and nurses during routine assessments

Up to a million adults in the UK are thought to have dementia but as many as one third have never been given a formal diagnosis.

Without this diagnosis, they are being denied treatment to halt the progression of the illness and alleviate symptoms as well as vital care and support.

To try to improve detection rates, the Government introduced a target system for hospitals in 2013 which stated offer memory tests to patients over 75.

The rules – which are still in place today – state that doctors and nurses must ask patients over 75 who have been in hospital for three days whether they have felt forgetful.

If they reply ‘yes’, patients must undergo a memory test which asks them who the Prime Minister is, today’s date, and whether they can draw the time on a clock face.

Patients who perform badly in this test are flagged up as ‘potentially’ having dementia and staff are meant to inform their GP, so they can be referred for further tests.

But Dr Chris Fox, from the Department of Psychological Sciences at the University of East Anglia, said it was all a ‘pointless exercise.’

To try to improve detection rates, the Government introduced a target system for hospitals in 2013 which stated offer memory tests to patients over 75

His research followed 154 patients over 75 at who had undergone these memory assessments at 11 NHS hospitals.

This found that 61 patients were not flagged up by hospital staff as potentially having dementia - even though they scored very badly when researchers did their own tests.

Dr Fox said the assessments were flawed and not able to accurately predict dementia.

He also pointed out that many of the doctors and nurses asking the questions had not been trained and that different tests were used by different hospitals.

‘There are problems with these tests.

‘It’s not actually an accurate, psychometric, valid system to assess patients.’

‘The requirement is a pointless exercise.

‘It wasn’t ever properly validated, staff weren’t properly trained, the next steps weren’t thought through. Every hospital has a different test.

‘There’s futility, a lack of proper assessment, it’s not properly designed in a scientific way, it’s not tested to check it doesn’t harm patients.

‘Staff just want to tick the box to say “I’ve done that and I don’t need to do it again.’

‘One wonders what happened to those people,’

A second study by the University of Cambridge found that only a quarter of patients identified by staff has possibly having dementia were referred for further assessments by their GP.

Of the 28 patients identified as potentially having dementia in hospitals in Cambridge and Stevenage, only seven were sent to a memory clinic were the illness can be formally diagnosed.

Dr Jane Fleming, the lead author, the Department of Public Health and Primary Care at Cambridge University said: ‘We were hearing quite consistently from patients and their relatives that there had been very little follow-up by GPs and very few new investigations or services as a result.’

The findings were presented at the Dementia Diagnosis in Primary and Secondary Care summit held at the Royal College of GPs headquarters on Tuesday and attended by over 100 academics and doctors.

Dr George Savva, from the school of health sciences at the University of East Anglia said it was hugely important to improve dementia diagnosis rates.

‘There is an issue of unmet care needs where people are going through a huge burden – patients, carers and families – who could benefit. Early inventions can help people and improve quality of life if they are made available at the point people need them. 

Source: DailyMail