The prime minister has declared that rising rates of dementia are “a national crisis” and launched a major drive to improve the lives of sufferers and their carers.
He revealed that hospital trusts will be able to earn up to £54m in total each year under the dementia commissioning for quality and innovation scheme announced last year and due to come into effect next week. Dementia diagnosis rates will be set “across the country”, while changes to the Outcomes Framework and GP contract will seek to incentivise improvements in dementia care.
The prime minister also announced that NHS South chief executive Sir Ian Carruthers will take up a new national role to “champion and support” the delivery of “the Prime Minister’s Challenge on Dementia”.
The dementia strategy will give backing to a new online service which was developed by NHS South West. The service allows users to compare the performance of local providers involved in dementia care, including GPs, and is set to be rolled out across England.
The number of people with dementia in England is set to increase by around 50 per cent to 1 million over the next 10 years.
Mr Cameron said: “It is a scandal that we as a country haven’t kept pace with [the increase in dementia]. The level of diagnosis, understanding and awareness of dementia is shockingly low.
“Already a quarter of hospital beds are occupied by someone with dementia. Already the total cost of the disease is around £19bn – that is higher than the costs of cancer, heart disease or stroke.
“So we’ve got to treat this like the national crisis it is. We need an all-out fight-back against this disease. We did it with cancer in the 70s. With HIV in the 80s and 90s. Now we’ve got to do the same with dementia. This is a personal priority of mine, and it’s got an ambition to match.
“That ambition: nothing less than for Britain to be a world leader in dementia research and care.”
The dementia “challenge” will have three themes: improving health and social care for people with dementia; encouraging greater research into dementia and reinforcing community support.
The health care element of the initiative will focus on early diagnosis and improving information about dementia services.
The government estimates only around 42 per cent of people with dementia receive a formal diagnosis.
Improved diagnosis of those admitted to hospital will be incentivised by the dementia commissioning for quality and innovation scheme. This proposal was born out of the Department of Health’s Innovation, Health and Wealth report released in December and authored by Sir Ian Carruthers.
Trusts will be required to use a find, assess and refer approach developed by the DH. This will see patients over 75 being assessed for “forgetfulness” during the previous 12 months. If a problem is detected then, depending on its severity, patients will be placed on a dementia care pathway or referred back to their GP.
From April 2013, the CQUIN will be extended to the “quality of dementia care delivered” and “will be dependent on delivering support for carers in line with the National Institute for Health and Clinical Excellence and Social Care Institute for Clinical Excellence guidelines.
In primary care, NHS Health Check will be used to improve the referral of patients to memory clinics. The government claims that “the whole country” will be covered by these clinics “next year”.
The new dementia startegy claims that “from April 2013, there will be a quantified ambition for diagnosis rates across the country”. It claims there will be “underpinned by robust and affordable local plans” put together by clinical commissioning groups and that “improved diagnosis rates” will be incentivised “by including a new indicator in the NHS Outcomes Framework 2013/14”.
In terms of improving access to information, the dementia startegy endorses NHS South West’s ‘Our Health’ online service.
Our Health focuses on dementia and stroke services. It includes information on what level of care patients and carers should expect based on standards set by NICE. It then details the “offer” from local NHS, local authority and voluntary services, as well as providing information about how to access care. The site allows users to compare the performance of services based on a set of relevant indicators.
Patients and carers can ask questions via the site, as well as sharing information and experiences.
The service will be “rolled out” across the NHS South region “by the end of 2012”.
Sir Ian, former chief executive of NHS South West before taking on his role as lead of the NHS South strategic health authority cluster, said: “We were pleased to lead this project in the South West and now look forward to developing this important initiative for the whole country.”
HSJ understands “similar information” to that included on Our Health will be available in “all other parts of the country” from April 2013. The government will also be setting out further steps to improve information to support care choices in the forthcoming social care white paper.
Other measures in the dementis strategy included:
- “Work with the [medical] profession to identify how best to improve early diagnosis of dementia through improvements in awareness, education and training andthrough potential improvements to the GP contract”.
- An NHS “guarantee” of “a written integrated personalised care plan” for people with dementia.
- The launch of a pilot dementia clinical networks by September 2012.
- “An Innovation Challenge Prize of £1m NHS staff can win up to £1m for innovative ideas for transforming dementia care”; and
- “A Dementia Care and Support Compact signed by ten care home and home care providers setting out their “commitment to deliver high-quality relationship-based care and support for people.”
In his role as dementia champion, Sir Ian Progress will lead a group to help implement the health and social care elements of the strategy. He will report progress to the PM in September 2012 and March 2013.
The prime minister announced that dementia research funding will be doubled to £66m by 2015.
A total of £36m will be directed over the next five years into a new National Institute for Health Research Dementia Translational Research Collaboration. It will attempt to translate discoveries from basic scientific dementia research into benefits for patients.
The Economic Research Council and the NIHR are joint funding a major new initiative for a programme of interdisciplinary research on ‘Living well with dementia’.