Dr. Seamus McNulty argues that dementia should be diagnosed through collaboration between primary and secondary care rather than exclusively in one setting. He advocates for a blurring of the distinction between primary and secondary care, with more secondary care services located in the communities they serve. This would involve physician-led primary healthcare teams working with specialists like old age psychiatrists to assess, diagnose, treat, and manage dementia in a multidisciplinary approach.

1. Should Dementia be diagnosed
in primary or secondary Care?
Dr Seamus V McNulty
Consultant Psychiatrist and
Chair, Faculty of Old Age Psychiatry
Royal College of Psychiatrists in Scotland

2. Secondary Care

3. Secondary Care

4. Secondary Care

6. Primary Care

7. Primary Care

9. Primary Care

10. New GP Contract
• We are arguing for a physican-led primary
healthcare team – it doesn’t mean you’re the
boss because you don’t employ the team but
you should be leading how to achieve the
outcomes, providing expert medical support
to those team members – Allan McDevitt,
Chair Scottish GP committee of BMA
• “Specialist Generalist :

11. Old Age Psychiatrists
• Lead multidisciplinary teams in the
assessment, diagnosis, treatment and
management of Dementia

12. Primary vs Secondary Care
• Argument should not be about primary versus
secondary care but about a deliberate blurring
of the distinction.
• Move more of secondary care services into
the communities they serve!