Last weekend the Prime Minister (PM) launched his second 'challenge on dementia' a five year vision aimed at positioning England as the best country in the world for dementia care and research by 20201. The PM's 2020 challenge is set against a backdrop of a growing body of evidence on the profound impact dementia is having on society (the Centre's blog published late last year detailed the latest evidence on the scale and extent of the dementia challenge). While it celebrates the significant progress made to date it also acknowledges that much more still needs to be done.

The 'Prime Minister's challenge on dementia 2020' continues the Government's focus on improving dementia care in England. A focus that began in February 2009 with the Department of Health's five year strategy: Living well with dementia: a national dementia strategy for England, and received a boost in 2012 when the Prime Minister launched his first three year challenge on Dementia.2 This latest step details why, how, when, and where the Government's focus will be over the next five years.

One of the main areas of progress to date is the investment of over £6 billion (both spent and pledged investment from charities, the public and private sectors). Some of the areas where measurable progress has been made include:

  1. Boosting early diagnosis: as a result of measures to identify those at risk and improve early diagnosis, 59 per cent of those identified to have dementia are now being diagnosed – an increase of 17 per cent since 2010-11.
  2. Improving quality of post diagnosis support: many health and social care professionals previously lacked training on dementia and care pathways were disjointed. Over 437,920 NHS staff have received Tier 1 (foundation level) dementia training and more than 100,000 social care workers have received dementia awareness training.
  3. Supporting carers: informal carers play a vital role supporting people with dementia to remain at home and active members of the community. However, there has been limited support for carers. Between 2011 and 2015, £400 million has been provided to give temporary respite for carers. Furthermore, under the Care Act 2014, local authorities now have a responsibility to assess and, where eligible, meet carers' support needs.
  4. Recruiting dementia friends and dementia friendly communities: the Alzheimer's Society have recruited over one million Dementia Friends – using a ground breaking social movement that raises awareness of the small things that can be done to help people with dementia. In addition, since March 2013, 82 communities across England have signed up to the national Dementia Friendly Communities recognition process.
  5. Encouraging Research: record numbers of NHS trusts were involved in dementia research in 2013-14 and total spending on dementia research doubled from 2009-10 to 2013-14 (£28.2m to £60.2m respectively). The UK has also grown its influence on the international research stage but dementia research still lags research into other conditions.
  6. Creating dementia friendly environments in hospitals and care homes. £50 million has been invested in projects to create dementia friendly environments. These projects have now been evaluated, with guidance on the key findings due in the spring.3

While the above progress is impressive, the PMs 2020 challenge recognises rightly that there is still much more to be done; with an urgent need to reduce the wide variations in quality of care experienced across the country, including many people receiving care that's totally unfit for purpose.

Consequently, while the 18 'key aspirations' in the Prime Minister's 2020 Challenge build on progress to date, it focusses specifically on the following areas:

  • Prevention: improving public awareness and understanding of dementia risk factors and how to reduce this risk by living more healthily – "what's good for the heart is good for the brain".
  • Quality: improving care quality across the entire disease pathway (from diagnosis, post diagnosis support through to end of life care) and across all care settings focussing on reducing variation and providing good quality of care in people's homes where appropriate. This involves growing the evidence base of what works and why, and how the adoption more widely of what works could be improved.
  • Building social action: increasing awareness of how all stakeholders, from hospitals to businesses and members of the public can become dementia friendly. Continuing to build dementia friendly communities and, for employers everywhere, making it easier for the one in three people who will end up caring for someone with dementia, to remain in employment for longer. For example, if the employment rate of dementia carers increased by just 2 per cent over the years to 2030 (by offering more flexible terms of employment) the retention of these skilled and experienced staff would deliver a saving of £415 million.
  • Research: stimulating investment in UK dementia research by increasing funding, encouraging investment from industry and increasing the participation of people with dementia in research. The ultimate goal is to develop a cure or disease modifying therapies/ interventions by 2025 which can be effectively implemented across the health and care sectors.

The Prime Minister's renewed focus on dementia is an important continuation of the priority that has been given to tackling this devastating disease. While the 18 'key aspirations' represent an important opportunity to improve the lives of an estimated 850,000 people living with dementia and 670,000 carers in the UK, they also have significant implications for the UK economy. For example, if we fast forward to 2020 and have successfully developed a treatment that can delay dementia onset by five years, we could expect accumulated savings of around £100 billion in first 15 years of use.4 Whatever the outcome of this year's general election, let's hope the next government can make the 2020 vision for dementia a reality.

Footnotes

1. The Prime Ministers Challenge on Dementia 2020. February 2015. See also: https://www.gov.uk/government/publications/prime-ministers-challenge-on-dementia-2020

2. Prime Minister's Challenge on Dementia – Delivering major improvements in dementia care and research by 2015, Department of Health, March 2012

3. The Prime Ministers Challenge on Dementia 2020. February 2015. See also: https://www.gov.uk/government/publications/prime-ministers-challenge-on-dementia-2020

4. Martin Knapp, Adelina Comas-Herrera, Raphael Wittenberg, Bo Hu, Derek King, Amritpal Rehill, Bayo Adelaja (2014) Scenarios of Dementia Care: What are the Impacts ion Cost and Quality of Life? London: PSSRU, LSE

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