CampaignsHealthcare RationingAlzheimer's treatmentDementia "not getting the priority it deserves" Dementia "not getting the priority it deserves"
12/07/2007
A new report by the National Audit Office (NAO) has highlighted the fact that, despite a steeply rising trend in cases of dementia, the condition is being given too low a priority by health and social services. Not enough people are being diagnosed early enough, and early interventions known to be cost-effective are not being made widely available.
The report also points out that, historically, dementia has suffered from poor awareness and understanding. There is a widely held perception that little can be done about the condition and a lack of urgency is attached to diagnosing and treating the condition. Parallels can be drawn between dementia now and cancer in the 1950s, when there were few treatments and patients were commonly not told the diagnosis for fear of distress.
But the reality is that dementia presents an urgent challenge to health and social care in terms of both numbers of people affected and the costs. At least 560,000 people in England have dementia, with the number of cases predicted to rise by over 30% over the next 15 years. And dementia costs the economy £14.3 billion a year, including direct costs to the NHS and social care of £3.3 billion a year.
The fact is that early diagnosis and intervention in cases of dementia is known to be cost-effective - yet only a third to a half of people with dementia ever receive a formal diagnosis. The UK is in the bottom third of countries in Europe in terms of the percentage of dementia patients receiving anti-dementia drugs, and the average time taken to diagnose patients in the UK is up to twice as long as in some other countries.
Sir John Bourn, head of the NAO, said: "This report shines a light on how significant an issue dementia is and how much scope there is to improve the way in which people who suffer from dementia are treated. Without a redesign of our services, provision for people with dementia is likely to become increasingly inconsistent and unsustainable."
It appears that it is frontline staff who often lack sufficient awareness and understanding of dementia. Less than two thirds of GPs surveyed by the NAO felt that it was important to look actively for early symptoms of dementia and only 31% felt they had enough training to diagnose and manage the disease. Half of the Community Mental Health Teams surveyed told the NAO that they felt acute hospital nurses were inadequately trained in dementia needs.
Failure to diagnose or treat patients with dementia can extend hospital stay - in fact, older people with dementia make up half of those whose discharge from hospital is delayed. For example, in the case of elderly people admitted to acute hospitals with a hip fracture, the NAO found that effective identification of dementia and more proactive, co-ordinated management of their care and discharge could produce savings of between £64 million and £102 million nationally.
Rebecca Wood, Chief Executive of the Alzheimer’s Research Trust said: "The report unambiguously laments the UK's historical failure to give dementia the funding it deserves, and clearly states that too few people are being diagnosed, or being diagnosed early enough, and that things are only going to get worse in the years to come.
"Yet the Government continues to stick its head in the sand when it comes to funding dementia care and research for better diagnosis and treatments. The lack of priority given to dementia is illustrated by the fact that only £11 is spent on UK research into Alzheimer's for every person affected by the disease, compared to £289 for cancer patients."
Whilst the NAO identified a number of examples of good practice, two thirds of people with dementia live in the community, largely looked after by the 476,000 or so "informal carers" in England. Informal carers can enable a person with dementia to continue living in their own home but usually lack the support they need to continue to play such a vital and cost-effective role for long period of time.
And in the care home sector, less than 28% of beds are a registered specialist dementia bed, which creates a lack of visibility of the need for specialist dementia training in care home settings. Appropriate end of life care for people with dementia is also very limited.
The NAO report concludes that the Department of Health, the NHS, social care and professional bodies need to work together to improve understanding of the needs of people with dementia, to plan services accordingly and raise awareness of dementia amongst health and social care professionals and to improve diagnosis and early intervention.
For more information on the report go to the second link below. Hard copies can be obtained from The Stationery Office on 0845 702 3474.
The Alzheimer's Research Trust is the leading UK research charity for Alzheimer's disease and related dementias. It is dedicated to funding and encouraging the very best UK-led research, and provides free information. To find out more call 01223 843899 or visit the link below.