Dementia services in England are not getting the priority that was promised, the National Audit Office has said.
It urges the Department of Health to demonstrate that its dementia strategy, published last year, is not just words.
The plans include action to boost early diagnosis and better patient and carer support. The NAO praises the ambition but asks whether they can be delivered.
Care services minister Phil Hope welcomed the report but insisted the implementation plan was on track.
“We are in the first year of our ambitious five year National Dementia Strategy – change will not happen immediately,” he said.
“There is still much more to be done and we are working hard to put the plans outlined in the strategy into place.”
The NAO report describes the dementia strategy as “comprehensive and ambitious”. However, it says achieving the planned “transformation” in services will be very challenging.
In particular it criticises a failure to make dementia a national priority in the NHS Operating Framework – which sets out the key areas for the NHS in the year ahead.
Change can’t come soon enough for the millions of families battling daily with this devastating condition
NAO director of health value for money Karen Taylor said trusts would concentrate on other issues if they were not made to focus on dementia.
“They won’t be giving it the priority or the urgency that both ourselves and the Public Accounts Committee were led to expect dementia would get when we reported on it in 2007,” she said.
The strategy is expected to cost nearly £2bn over 10 years, funded largely through efficiency savings. But the NAO says the eventual cost will be more than that.
Announcing the plans last February the government said trusts would receive an extra £150m over two years to support the strategy.
But the NAO says it is not clear how that money is being spent, or even if it is going into dementia services.
Its report says many trusts are still working out what extra services will be needed in their area.
It also describes joint working with social care as “very patchy”, leading to people with dementia being unnecessarily admitted to hospital, and going into residential care prematurely.
‘Race against time’
Other concerns include a lack of basic training for doctors and nurses.
“Almost every health professional comes into contact with patients who have dementia,” says the report, “yet there is no required basic training in how to understand and support them. Addressing this training gap will require concerted action over several years”.
Public Accounts Committee chairman Edward Leigh said the Department of Health was in danger of not being able to follow up on its dementia strategy.
“The department should be given credit for developing the strategy, which is comprehensive and ambitious, but what is the point of a plan without the necessary tools to make change happen?” he said.
The Alzheimer’s Society director of external affairs Andrew Ketteringham stressed the urgency of the situation.
“Change can’t come soon enough for the millions of families battling daily with this devastating condition.
“The strategy will transform lives but only if local health authorities are compelled to give dementia the priority it deserves. Millions depend on the strategy succeeding. It’s a race against time.”