NAO report condemns treatment of dementia

A report released by the National Audit Office says that dementia is being given too low a priority by health and social services, despite rapidly rising numbers of people with the condition

It also states that too few people are being diagnosed or being diagnosed early enough and that early interventions known to be cost effective and improve quality of life are not being made widely available.

The National Audit Office document says dementia has suffered for many years from poor awareness as well as stigmas attached to mental illness and ageing. It draws parallels 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. The NAO, a government watchdog, recommends specific improvements and calls for a Department of Health campaign to raise awareness of dementia amongst health staff and the general public.

Head of the NAO, Sir John Bourn, said: “For too long dementia has not been treated as a high priority. Today’s 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. Our rapidly ageing population means that costs for addressing dementia will continue to increase and, without redesign, services for people with dementia are likely to become increasingly inconsistent and unsustainable. Dementia can no longer be set aside. The issues raised in this report need to be addressed as a matter of urgency.”

Only a third to a half of people with dementia receive a formal diagnosis, meaning many people do not receive the support they need. Fear and ignorance of the disease are common barriers to people and carers approaching their GP about suspected dementia. The report found GPs’ own attitudes could also hamper early diagnosis with fewer than two thirds believing it was important to look actively for early symptoms. Only 31% of GPs surveyed felt they had enough training to diagnose and manage the disease and 70% felt they had too little time to spend on people with dementia.

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. The NAO report demonstrates the significant and urgent challenge to health and social care that dementia presents in terms of both numbers of people affected and cost. It concludes that services are not currently delivering value for money to taxpayers or people with dementia and their families.

The annual economic burden of dementia is over £14 billion - more than stroke, heart disease and cancer combined - of which the majority falls to families. Delayed diagnosis ultimately results in spending at a later stage on more expensive services. Most community mental health teams surveyed felt that earlier diagnosis and intervention would save the taxpayer money, giving the example of delaying entry to care homes which is often precipitated by unpaid carer stress.

The report identifies other ways where money could be saved or used more wisely. For example, it suggests that between £64 million and £102 million could be saved nationwide by effectively identifying dementia in elderly people who have been admitted to acute hospitals with a hip fracture. A case study in Lincolnshire also showed that patients with dementia were often on acute wards when most no longer needed to be there. Redirecting funding to providing alternative bed- and home-based services and improving early diagnosis offered potential benefits to 500 people a year and reallocated at least £6.5m more effectively.

Rebecca Wood, chief executive of the Alzheimer’s Research Trust, said: "Hopefully this analysis will lead to the government finally getting its act together on tackling dementia in Britain. The report unambiguously laments the Department of Health and NHS'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 as the population grows older. 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.”

She continued, “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."

Dementia can no longer be set aside. The issues raised in this report need to be addressed as a matter of urgency

the government continues to stick its head in the sand when it comes to funding dementia care and research for better diagnosis and treatments