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

BMJ 2012; 344 doi: https://doi.org/10.1136/bmj.e2347 (Published 27 March 2012) Cite this as: BMJ 2012;344:e2347

Rapid Response:

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

Dear Sir

Drs Gordon, Hilton and Sharvill raise interesting points about the current position of dementia care highlighted by the Prime Minister's Challenge in the BMJ (Kmietowicz, Z. - Cameron launches challenge to end "national crisis" of poor dementia care, 27 March 2012, BMJ 2012;344:e2347; Gordon, P. - Taking dementia seriously, 18 April 2012, BMJ 2012;344:e2745; Hilton, C. - Investing in new services is key, 18 April 2012, BMJ 2012;344:e2746 and Sharvill, N. - What are the benefits of early diagnosis?, BMJ 2012;344:e2747).

Dr Gordon is right to highlight the challenge of turning the multi-faceted nature of dementia into a straightforward message. The detection of dementia when people are in hospital is important. Screening is not recommended by the National Screening Committee but we are suggesting enquiring about memory problems and diagnosing dementia (not screening) as a way of raising the profile of dementia and improving quality of care. Dr Hilton welcomes this approach and rightly highlights the need for people in hospital to be appropriately trained to back this up.

Dr Sharvill questions the benefits of early diagnosis. It is wrong to suggest that people with dementia are different to those with "serious disease" and that others who are "more needy" should take priority. An early and timely diagnosis is important because it gives people a definitive answer to complaints which could well be causing distress and anxiety (and reassures those who might have memory problems but do not have dementia). This is what people with dementia want and means interventions can take place to avoid crises (which occur inevitably and are predicted by Dr Sharvill). The economic benefit - avoiding unnecessary admission and institutionalisation - is well known.

In any other branch of medicine a diagnosis rate of 42% would be scandalous.

No one can argue that dementia is not one of the greatest health and social care challenges we face, that national crisis does not underestimate the challenge, and that the ability to push improvements in the quality of care for people with dementia and their carers further and faster by the PM’s Challenge is a great opportunity.

I would be very happy to visit Dr Sharvill in his surgery to answer his question personally.

Alistair Burns
National Clinical Director for Dementia - Department of Health
Professor of Old Age Psychiatry - University of Manchester
Clinical Director, Manchester Academic Health Science Centre
Consultant Old Age Psychiatrist - Manchester Mental Health and Social Care Trust

Competing interests: Editor, International Journal of Geriatric Psychiatry National Clinical Director for Dementia Occasional expert Court report

11 May 2012
Alistair Burns
National Clinical Director for Dementia - Department of Health, Professor of Old Age Psychiatry - University of Manchester, Clinical Director, Manchester Academic Health Science Centre, Consultant Old Age Psychiatrist - Manchester Mental Health and Social Care Trust
As above
Department of Health, Area 125, Wellington House, 133-155 Waterloo Road, London SE1 8UG