Dementia: commissioning for quality

摘要

Internationally and locally, the impact of dementia is increasing within primary care. GPs must now become actively involved in addressing the growing challenges presented to us on a regular basis by dementia. Internationally, dementia contributes more years lived with disability than stroke, musculoskeletal disorders, or heart disease. Nationally, dementia costs state health and social care systems more than stroke, heart disease, and cancer combined.1 Regionally, many areas are experiencing the challenge of providing locally-responsive services which can cater for the rising prevalence of dementia, within the objectives of the National Dementia Strategy.2 And, at a primary care level, it is well established that GPs still have many barriers to pursuing a diagnosis for their patients and, possibly more importantly, feel that they lack the skills and knowledge to be able to manage the problems these patients present to them on a day to day basis.3 This perceived shortcoming in management is apparently supported by measurement of our performance at dementia annual reviews.4