National Dementia Strategy joint lead Sube Banerjee says the five-year programme will only provide the foundations to tackle the effects of this long-neglected condition. Amy Taylor reports
Sube Banerjee is in optimistic mood. The professor of mental health and ageing at the Institute of Psychiatry at Kings College London is holding a copy of the first National Dementia Strategy for England, of which he is joint lead.
“The question is, will this shiny booklet do anything more than the shiny booklets that people have written about dementia before?” he asks before answering in the affirmative. “I think it will because there’s money behind it, it was in the NHS operating framework last year and this year, and the fact that it’s senior people in the Department of Health who are committing to this.”
The strategy, which is backed by £150m over the first two years and is jointly led by Jenny Owen, director of adult services at Essex Council, represents a change in attitudes towards dementia. Despite its prevalence, the disease has been until now largely ignored, even though it affects 700,000 people in the UK.
No longer an option
Banerjee, who is also the Department of Health’s senior professional adviser in older people’s mental health, says this is no longer an option. This view was backed up by the Alzheimer’s Society’s Dementia UK report in 2007, which predicted that, over the next 30 years, the number of people with the condition will double and the associated costs treble to more than £50bn a year.
The stigma attached to dementia has been a factor in its low profile. It is a disease people try to avoid receiving a diagnosis for two-thirds of sufferers are not formally diagnosed and many of those who are receive a diagnosis late. Banerjee has no time for the commonly held view that dementia is just a factor of old age.
“It’s been easy for people to be brushed off because people want to be brushed off,” he says. “The belief that nothing can be done is absolutely untrue. While we might not have a magic bullet – and that’s true for the majority of illnesses – we can control symptoms.”
The strategy tackles the stigma issue head-on. It recommends improved public awareness about the condition and an acknowledgement that early diagnosis should be sought in all circumstances. It says this allows individuals and their carers to plan for the future and for interventions to be put in place to help them remain in their own homes for as long as possible.
Keeping people out of residential care is a key financial driver behind the plan. Deliverance of this aim would be the responsibility of a network of memory services staffed by dementia specialists and run jointly by health and social care. A few of these services already exist, providing early diagnosis and intervention. Some existing models comprise multi-agency teams, which include social workers, and carry out group diagnoses.
New adviser role
Dementia care is widely recognised as inadequate. Few doctors have training in the disease, and many lack the confidence to diagnose it – something the strategy says must change.
It also recommends a new role of dementia adviser to act as a guide for people with dementia who need to navigate the system.
“It may well be that the dementia advisers are not the answer themselves but can put you in touch with the answer and I think there’s a really good role for the third sector in that,” says Banerjee.
The decision to produce the strategy was announced in August 2007 and Banerjee had to turn it around quickly. In an interview last year he was quoted as saying he expected the plan to run for three to five years. He is now convinced the decision to go for a five-year strategy is the right one, because the policies are only starting to tackle what has been a neglected disease. “It’s a five-year strategy but at the end of five years there will still be lots to do,” he says.
Sube Banerjee is speaking at a conference on dementia that Community Care is running. Dementia Dignity and the Challenge of an Ageing Society will be held in London on 26 February.