Only half of all patients with some killer conditions have been diagnosed and treated by their doctor.

Nationally, GPs are treating 52 per cent of people estimated to have chronic obstructive pulmonary disease and 52 per cent of those believed to have hypertension.

Twenty-two per cent of patients with coronary heart disease are not being diagnosed and treated. The figures are published today on hsj.co.uk comparing GP disease registers for 2007-08 with the disease prevalence model developed by the Eastern Region Public Health Observatory.

The biggest gaps between the epidemiologists’ estimates and GP treatment are in London.

Doctors in Haringey primary care trust detected chronic obstructive pulmonary disease at a fifth of the rate expected in the local area. In Southwark, coronary heart disease was detected at 41 per cent of the expected rate and in Kensington and Chelsea, GPs identified hypertension in just over a third of expected cases.

London problem

Tom Coffey, a GP in Wandsworth and polyclinic lead for the London PCTs, said the transient nature of London residents meant many patients were not seen. “We do what we’re supposed to for the patients we see, but we don’t get to see a relatively large number of them,” Dr Coffey said.

The disease registers are used to inform funding distribution across primary care and are expected to become more important when the allocation formula changes next year.

The gap between the GP registers and estimated true prevalence closed only slightly between 2006-07 and 2007-08, leaving some 6.7 million patients undiagnosed from those three conditions alone.

Outside London one of the PCTs with the biggest gaps was Sandwell, where heart disease was being detected at only 57 per cent of the expected rate. Primary choosing health manager Mary Fairfield said it had put new investment into a screening programme to help GPs identify patients most at risk.

Missed opportunity

“Some practices are aggressively looking for patients but some are not necessarily looking for every opportunity they have. In principle it is the GP’s job, but even when we are working with our better practices, we find patients they have missed,” she said.

Brighton and Hove City teaching PCT also had large gaps in the identification of chronic obstructive pulmonary disease and hypertension.

PCT commissioner for primary care Anne Foster said: “We read about [outreach programmes] in other parts of the country but it’s true to say that in Brighton and Hove practices haven’t done much [in those terms].

“We are quite a small city. People have good networks with each other within the city, but practices don’t know about good practice elsewhere.”

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