Cameron launches challenge to end “national crisis” of poor dementia care

The prime minister has launched a three pronged approach to making the UK a world leader in dementia care—by improving the health and care of people with dementia, raising awareness about the condition to make communities more responsive to patients’ needs, and putting more resources into dementia research.

David Cameron said it was a national scandal that dementia was so poorly managed. “The level of diagnosis, understanding, and awareness of dementia is shockingly low. It is as though we’ve been in collective denial,” he said on 26 March at a conference organised by the Alzheimer’s Society.

His “dementia challenge” includes screening all those aged 65 to 74 for early signs of dementia as part of routine health checks for older people to detect cardiovascular disease, kidney disease, and diabetes. From April hospitals in England will be financially rewarded for checking people over 75 years admitted as emergencies and referring those who need care to a psychiatrist.

Commissioning bodies are also being told to set local dementia action plans while trusts will have to provide information about local health and care services for people with dementia in one place, including performance data so that people can compare services in their local area.

Funding for research into dementia and neurodegenerative disease is to double by 2015 to £66m (€79m; $105m) each year, up from £26.6m in 2010.

At £19bn a year the cost of dementia in England is higher than that of cancer, heart disease, or stroke, said Cameron.

“And in less than 10 years, as we all live longer lives, the number of sufferers will reach a million,” he said. “So my argument today is that we’ve got to treat this like the national crisis it is. We need an all out fight back against this disease; one that cuts across society.

“We did it with cancer in the 70s. With HIV in the 80s and 90s. We fought the stigma, stepped up to the challenge and made massive in-roads into fighting these killers. Now we’ve got to do the same with dementia.”

In 2009 the then Labour government launched the National Dementia Strategy (BMJ 2009;338:b464, doi:10.1136/bmj.b464) with the aim of transforming the care of people with dementia in England by 2014. But a report from the National Audit Office less than 12 months later criticised the slow progress in improving services for dementia patients (BMJ 2010;340:c243, doi:10.1136/bmj.c243).

Mr Cameron’s challenge says that progress has been made since 2009; 94% of primary care trusts now have a dedicated memory service for dementia, the number of people using memory services in trusts has increased from 605 in 2008-9 to 951 in 2010-11, and fewer people with dementia are being prescribed antipsychotics.

But in a forward to the report Mr Cameron says that progress on dementia needed to “go further and faster” to deliver improvement in dementia care.

Mark Walport, director of the Wellcome Trust who is to champion dementia research across government, said “The dementia challenge will not be resolved by the natural sciences alone. It will also require progress in social care, so that patients can be helped to live at home for longer, and so that relatives who care for their loved ones receive the support they need.”

A report from the Alzheimer’s Society says that despite the “significant spend” on dementia in the NHS “this is often not being deployed effectively and is not delivering good outcomes for people with dementia and carers.”

A report, Dementia 2012, by the society shows that currently people are still not living well with dementia. “For many people with dementia and their carers, quality of life remains extremely varied. Not only do people face potential battles for a diagnosis and support from the health and social care system, but everyday things we all take for granted—having control over daily life, spending time with friends and family, socialising and enjoying hobbies—are made difficult by a lack of understanding of dementia in our communities.”

It calls for better understanding of the condition by society and for the government to implement the recommendations made by Andrew Dilnot in his review of social funding last July (BMJ 2011;343:d4261, doi:10.1136/bmj.d4261), although extra funding will also be needed to enable patients and their carers to access better quality and more care.