A National Survey Exploring Dementia Diagnostics and Care Provisions in Primary Care in England

Background: The 10 Year Health Plan for England indicates governmental intention to shift care from hospital to community. Disease Modifying Treatments (DMTs) and biomarker tests for dementia will likely be introduced, with potentially significant impacts on community care, particularly general practice. Aim: To explore dementia diagnosis, post diagnostic support and expectations around future care in primary care settings. Design and Setting: Codesigned survey with general practitioners (GPs), policy researchers, carers and people with lived experience. One GP per practice invited from five English Integrated Care Boards (ICBs). Methods: Inductive content analysis for qualitative responses and non-weighted means calculated for quantitative answers. Findings contextualised using national data. Results: Between September and December 2025, 80/1094 (7.3%) eligible practices participated (80 GPs). Most, (79/80, 98.8%) used cognitive assessments and 100% (80/80) blood tests to support dementia diagnosis, with 27/70 (39.7%) able to order brain scans directly. GPs primarily conducted annual physical, mental or care plan reviews for people with known dementia. Respondents considered it unlikely (47/80, 58.8%) they would formally diagnose dementia or assess (50/80, 62.3%) for DMT eligibility in the next five years. GPs considered it somewhat/most likely (54/80, 67.5%) they could offer blood biomarker tests and continue established DMT prescribing or monitoring (61/80, 76.3%). Resource, capacity and training needs were perceived barriers. Conclusion: GPs are the first point of contact for accessing a dementia diagnosis in England. Accommodating novel diagnostic tools and treatments requires a reimagining of the relationship between primary, secondary and social care to address GP reported constraints.