[A version of this item appears in: Dementia: the Latest Evidence Newsletter (RWHT), Volume 1 Issue 11, June 2011].
This Health Systems in Transition (HiT) profile attempts to provide a detailed description of the health system and of reform and policy initiatives in progress or under development in the United Kingdom. It gives, as part of the broad picture, a top-level overview of recent developments in dementia care.
Specific polices relating to the care of older people reflect priorities for mental health and dementia. The National Service Framework for Older People (The operating framework for the NHS in England 2010/11. London: Department of Health, 2008) included a standard to promote good mental health in older people and to support older people with dementia and depression.
More detailed clinical guidance was provided jointly by NICE and the Social Care Institute for Excellence (Dementia: supporting people with dementia and their carers in health and social care. London, National Institute for Health and Clinical Excellence and Social Care Institute for Excellence, 2006). This promotes a coordinated and integrated approach between health and social care, included the needs of carers, with memory assessment services as the single point of referral for all people with a possible diagnosis of dementia.
In 2009, the Department of Health produced a National Dementia Strategy which recognizes the shortcomings in existing systems of care and puts forward strategies for improvement through increased awareness of the condition, earlier diagnosis and intervention, and higher quality of care (Department of Health, 2009).
Local services are expected to deliver improvements in care, but a report by the NAO in 2010 (Improving dementia services in England – an interim report. London, National Audit Office, 2010) is skeptical of likely progress, finding that the mechanisms required to bring about large-scale improvements are not in place because dementia is not – in practice – a national NHS priority. Some client groups remain poorly served even though NICE guidelines exist and it is only recently that systematic policies towards dementia are being developed.
In April 2009, the Department of Health launched a programme of 16 integrated care pilots designed to cross boundaries between primary, community, secondary and social care. This includes a GP-led service development of specialist intermediate care teams for patients with dementia, and various chronic disease management services. The teams include people from across the health care boundaries i.e. hospital consultants, GPs, community health staff and social care staff. (Integrated care pilots: an introductory guide. London, Department of Health, 2009).
Boyle, S. (2011). Health systems in transition: health system review. London: The World Health Organization on behalf of the European Observatory on Health Systems and Policies – United Kingdom (England), 2011. Vol.13(1), pp.1–486.
Editor’s Note: Readers may also be interested in a related recent item: Survey of London Doctors: a Warning About NHS Dementia Demand (ippr).