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Shaping the future of dementia care

Back in 2007, Donna Davenport wrote about the devastating effects of Alzheimer's disease on patients and their carers. In advance of the government's national dementia strategy, she outlines the need for primary healthcare teams to work collaboratively to meet the needs of older people ...

There are over 100 different types of dementia; but whatever the type, the devastating effects on patients and their families are the same. Two years on, we are still waiting for the government to publish its National Dementia Strategy and I understand it is imminent!

Following the release of a draft plan, massive consultation and close working with the national Alzheimer's Society, the strategy is due to be released in early 2009. It will aim to transform the care and support patients and their carers receive over the next five years – and about time too!1

The plan consists of 15 recommendations that are organised under three key themes:

  • Improving public and professional awareness among the general public and health care professionals.
  • Early diagnosis and intervention.
  • Improving quality of care for both patients and their carers.

In 2007, Dementia UK estimated that there were 700,000 patients with dementia in the UK at a cost of £17 billion a year with a projection that this would double in the next 30 years to 1.4 million sufferers at a cost of over £50 billion a year.2 It is recognised that there needs to be massive investment in this area if things are to improve and the awful stigma attached to dementia removed.

The National Strategy goes some way to addressing the needs of these patients and their families, ensuring that patient and public involvement is at the forefront in deciding how services are delivered. However, unless funding is provided at the same time, to be used solely for improving care in this area and not to pay off deficits in other areas, patients will not see the benefit of this.

The purpose of this blog is to raise awareness of the impending strategy. I would ask everyone working in primary care to critically look at the care being delivered in your area for these patients and their carers, and to analyse how and where improvements can be made. Carers save the government thousands of pounds in looking after their relatives at home 24/7.

While the new GMS Contract Quality and Outcomes Framework (QOF) went some way to encourage practices to look at dementia in terms of having a register for both patients and carers, I would argue that very little has changed for these patients in the quality of care and support they receive from diagnosis through to end-of-life care, and improvements need to be made.

Lack of training and continuing professional development for healthcare professionals, not just in dementia but in caring for older people in primary care, is apparent throughout the UK. As always, cancer, diabetes and coronary heart disease often take priority, but given that our aging population is ever increasing, and we know that dementia is affecting people in their 40s and 50s, it is essential that primary healthcare teams work collaboratively to meet the needs of these people in terms of health and social care and not continue, as is often the case, to feel they are delivering less than satisfactory care.

Practice staff are in an ideal position to deliver care for these patients and their carers and it is essential that ongoing training is provided for all staff, including receptionists who may be the first point of contact in a crisis. Relatives need to know that they will be treated in a caring and compassionate way and referred appropriately to the right person at the right time to avoid uneccassary admissions to hospital and increased stress for everyone involved. Better collaborative working across acute trusts and with the Community Mental Health Team (CMHT) are crucial if things are to improve.

So I would urge you to read the strategy as soon as it is published. Look at reinvesting some of your QOF income into this area, take your ideas to your team meetings, invite members of the CMHT and turn your ideas into real opportunities to shape the way future services are delivered.

Contact your local primary care trust to see what additional money is available to support you in delivering the recommendations in the strategy and improving the quality of life for both patients and their families living with dementia.

1. Alzheimer's Society. Dementia UK: the full report. London: Alzheimer's Society, 2007. Available from:
2. Department of Health. Transforming the quality of dementia care: consultation on a National Dementia Strategy. London: DH, 2008. Available from: