4. Assess

  • undertake an initial an initial assessment to rule out other causes of confusion or memory problems
  • consider who in your Primary Health Care Team could support the initial assessment process

Primary care: initial assessment

When patients present with memory problems, in order to exclude reversible or physical causes of presenting symptoms, GPs should undertake,

  • a clinical assessment, including history, examination and investigations,
  • an assessment for depression, anxiety and other mental health problems;
  • all patients should be offered blood screening for full blood count, calcium, glucose, renal and liver function tests, serum vitamin B12 and folate levels. This should be recorded in primary care notes.
Quality and Outcomes Framework for GMS contract 2011/12, DEM 3
No. Indicator Points Payment stages
DEM3 The percentage of patients with a new diagnosis of dementia from 1 April 2011 to have FBC, calcium, glucose, renal and liver function, thyroid function tests, serum vitamin B12 and folate levels recorded 6 months before or after entering on to the register 6 40-80%

Making a diagnosis

GPs may diagnose dementia where it is clear that the condition is already established. This may include patients at the more advanced stages of the disease, at home or in care homes. (South West Dementia Partnership, 2011)

Dementia Register

Primary health care teams should know who has a diagnosis of dementia, and maintain a general practice Dementia Register (QOF DEM 1).

Quality and Outcomes Framework for GMS contract 2011/12, DEM 1
No. Indicator Points Payment stages
DEM1 The practice can produce a register of patients diagnosed with dementia 5