Worrying changes to identification of depression in patients

By William Smith

There are worrying changes in the pipeline when it comes to the diagnosis and, therefore, the treatment of depression.

The Quality and Outcome Framework recommended by the National Institute for Health and Clinical Excellence has proposed changes which include the removal of three indicators related to depression.

If these recommendations are acted upon, GPs will no longer be assessed for identifying depression in diabetics, measuring the severity of depression in patients at the time of diagnosis or reassessing severity within a set period of time.

The Quality of Outcome Framework sets out the key indicators against which GPs’ performance is measured and rewarded.

At a time of economic uncertainty, NHS managers are ‘extremely worried’ that the demand for mental health services will increase. This increase would coincide with the proposals to reduce the onus on GPs to identify depression in their patients.

The NHS Confederation has warned, this week, that if the plans to remove financial incentives for GPs to monitor depression in patients is removed this could result in later diagnosis and move intensive treatment.

‘We are extremely concerned about proposals that, if enacted, would remove any financial incentives to identify the most common form of mental illness in GP surgeries’ said Steve Shrubb, director of the NHS Confederation Mental Health Network.

‘Primary care is the first point of contact for the vast majority of people using the NHS and one third of GP appointments are mental health related’ he added.

‘Looking over the next 12 months, the people running NHS mental health services are extremely worried about how the state of the economy will impact on demand for their services. Imperfect as the indicators are, our members think it would be reckless to remove the depression indicators from the GP treatment framework until suitable alternatives are in place.’ Mr. Shrubb concluded.

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