This project aimed to find out whether it is possible to raise diagnosis rates through undertaking an exercise to ‘clean up’ dementia coding and records at a practice level. The hypothesis was that problems in GP coding may be contributing to the reported dementia diagnosis gap.

The project examined patient registers from 23 practices from across London, identified via 2012/13 London GP Dementia Development Programme.

The project undertook a range of methods to identify people who may have dementia that had not been given a dementia READ code, including:

• Ran searches on GP computer system of codes relevant to dementia
• Compared this list with the GP practice QOF dementia register
• Conducted a clinical review of those patients notes where there were discrepancies
• Coded dementia accurately in those found to have dementia previously diagnosed but not yet coded (back dating as appropriate)

The project resulted in an 8.8% increase in absolute recognition level and provides a useful first step to improve accuracy of records and management of patients, whilst also helping to close the diagnosis gap.

Read an article about the project published in the British Medical Journal
Russell, P. Banerjee, S. et al (2013) Improving the identification of people with dementia in primary care: evaluation of the impact of primary care dementia coding guidance on identified prevalence. BMJ Open 2013;3:12 e004023 doi:10.1136/bmjopen-2013-004023

In the presentation below, Dr Paul Russell, demonstrates how work in London to improve dementia READ coding in primary care could contribute to a reduction in the number and length of acute hospital admissions and delay the need for long-term residential care through better planning of care. Download Improving GP coding of dementia in London