Impact review 2011/12

Wigan-based GP, Dr Alex Turnbull, has worked closely with Alzheimer's Society for several years, helping to develop a local dementia strategy and raise awareness of early diagnosis among colleagues.

What difference can an early diagnosis make to the lives of people with dementia and their carers?

'It can make a great difference - the earlier the assessments take place, the earlier treatment and advice can be given. A big plus of early intervention is that you deal directly with patients, allowing them to make decisions about their future care at a stage when it's easier for them to understand the issues. At a later stage, it can end up that the person with dementia is talked about by relatives and doctors, rather than being central to decision-making.

'Early diagnosis allows people to plan ahead as well as deal with the present. They can make decisions such as whether to move near family or stay in the community they know, and they may need to make financial decisions.

'Evidence shows that you get the best results if you intervene at the earlier stages. You can keep people with milder forms of the disease stable for longer and perhaps slow down the rate of deterioration, so quality of life for the person with dementia and their carers and families is often a lot better.

'We should be approaching early diagnosis positively. Once a diagnosis is made, GPs can continue to be supportive, adding to the good work of Alzheimer's Society and other health professionals in the field. GPs are increasingly rising to the challenge.'

Less than half of people with dementia are diagnosed. Why can diagnosis be difficult or take a long time?

'Diagnosis rates vary around the country - and things are improving. In Wigan, the figure for people with a dementia diagnosis has gone up from around 1,000, three or four years ago, to 1,500. That's a reflection of more people being referred and assessed.

'Many doctors are now more inclined to ask people about their memory or take note if it's not so good and refer people at an earlier stage for initial investigations, rather than perhaps sympathising but not doing anything about it.

'However, many people who start to have memory issues don't go to the doctor. They think they're just being a bit forgetful and worry they're wasting the GP's time. You also have to consider depression in older people. That can mask or confuse diagnosis because people who have depression can have poor mental responses.

'Professionals dealing with people who are ageing and getting forgetful need to encourage them to be tested for dementia. People need to know it's not okay to put up with memory problems; it's important to be tested, and there's help available.'

Why is it important for GPs to have information and support from organisations like Alzheimer's Society?

'It's vital that we get the support and resources we need to help people to the best of our ability. I find the Alzheimer's Society literature, particularly the training programme that was developed with the British Medical Journal, to be very informative and helpful.

'As a GP, you have to keep up-to-date with all aspects of medicine. In terms of a GP's time, dementia is an ever-growing area. It should have priority over many other issues because it's becoming more important to make a diagnosis through early assessments.'

During the year

• We continued our Worried about your memory? campaign, sponsored by Eli Lilly for a second year, targeting all GP practices with information about the early signs of dementia. Over 100,000 people worried about their memory contacted us as a direct result of this campaign.
• We worked with the Prime Minister to develop a series of government commitments on dementia as part of the Prime Minister's Challenge on Dementia. His public backing and influence add significant weight to our fight.
• We published Dementia 2012 - a landmark report on how well people with dementia are living in the UK. The discrepancy we highlighted between prevalence of dementia and diagnosis rates was also of concern to the All-Party Parliamentary Group on Dementia (APPG), which launched an inquiry aimed at improving diagnosis rates across the UK.
• Building on the success of our campaign for access to dementia drugs for people with Alzheimer's, we published information about the legal duties of primary care trusts (PCTs) to follow the NICE guidelines. Our local campaign groups have worked hard with PCTs to make sure that these guidelines are implemented.
• Our continuing campaign to improve hospital care for people with dementia helped to convince the government to introduce the National Commissioning for Quality and Innovation (CQUIN) dementia target, which encourages hospitals to identify patients with dementia in their care.