Progress may have been made in dementia care but a look back at the aims of the 2009 National Dementia Strategy that have not been achieved shows there is still much more to be done, says Jeremy Hughes

Jeremy Hughes

Jeremy Hughes

Last month HSJ exclusively reported on a review commissioned by Alzheimer’s Society with Deloitte on what had been achieved during the National Dementia Strategy 2009-14.

Shortly afterwards the government published the Prime Minister’s Challenge on Dementia 2020.

Both reports highlighted what had been achieved, and particularly how much has advanced as a result of the challenge, which was launched in 2012.

Although there has been success in the last few years – not least in the critical area of raising diagnosis rates – it would be wrong to say everything is rosy.

‘While there has been success, it would be wrong to say everything is rosy’

Indeed, some of the 17 ambitions in the 2009 strategy have not advanced greatly.

As both the new challenge and the Deloitte report acknowledge, areas such as support for carers and improved end of life care received limited attention in the first strategy.

Quick turnaround

The 2020 challenge sets out some clear ambitions for the next five years.

The next government, working with NHS England, local authorities and other stakeholders will quickly have to turn this into a costed plan.

‘A lack of proper support results in people with dementia being in hospital when they don’t need to be’

But what have we learned over the years that will be fundamental to the success of the new plan?

Behind progress on the detailed content of the strategy and prime minister’s challenge, there have been five key enablers that have ensured progress:

Listening to and involving people affected by dementia transforms the way we work

The seven “I statements” in the national dementia declaration make us look at outcomes not just output, but our data collection and management needs to adjust accordingly.

Where different parts of our health and care systems work together, we can achieve remarkable things

Dementia Action Alliance has become an inspirational forum for all national health and care organisations, driving forward the individual performance of members as well as developing high impact joint actions.

GPs, pharmacists, hospitals, care homes and the voluntary sector working together to cut by two-thirds the inappropriate use of anti-psychotics shows what can be done.

Action on today’s big health and care challenges demands wide societal engagement

Over 1 million people have participated in the Dementia Friends awareness programme. Around 80 towns and cities have committed to becoming dementia friendly communities, backed by British Standards Institute guidelines.

These initiatives harness the input of businesses, local council services, charities, faith groups and more, alongside health and care services, to transform the lives of local people.

Integrating health and social care

Nowhere are the costs, to the state and individual, of a lack of integration across health and social care more clearly seen than in supporting people with dementia.

‘The case must always be made for the financial reasons for change’

A lack of proper support in the community results in people with dementia across the country being in hospital when they don’t need to be.

The case must always be made for the financial reasons for change, alongside the imperative of improving care and support.

Leadership matters

The prime minister and health secretary have driven forward action on dementia, in care and in research, nationally and internationally, but leadership at the regional and local level has also been vital in tackling what have been neglected diseases.

There is of course much more to what has worked – and what hasn’t – in terms of tackling dementia.

Without these five, however, we wouldn’t have started making an impact on the greatest health concern in the over 50s. And without these we won’t make the much needed progress over the next five years.

Jeremy Hughes is chief executive officer of Alzheimer’s Society