Eighteen hundred people with dementia are dying each year in the
UK as a result of being prescribed antipsychotic drugs, according
to a
Department of Health-commissioned review.
The probe, led by government adviser Professor Sube Banerjee,
also found that just one in five of the estimated 180,000 people
with dementia being precribed antipsychotics derived any benefit
from them.
The drugs are prescribed to manage the psychological and
behavioural symptoms of people with dementia, such as agitation,
aggression, wandering and shouting.
However, today's report said that systems developed to manage
these symptoms had grown "by chance rather than by specific
planning or commissioning" to the detriment of patient care.
The report estimated that prescriptions could be reduced by
two-thirds if appropriate support were made available.
Recommendations
accepted
The government has accepted all of Banerjee's 11 recommendations
to "reduce the use of these drugs to the level where benefit will
outweigh risk".
In his foreword to the report, Banerjee highlighted his
recommendation for each primary care trust to commission its local
older people's mental health service to provide support to care
homes, where use of antipsychotics is prevalent.
The report said this would require six extra full-time members
of staff in community mental health teams for older people in the
average PCT, so teams could visit care homes regularly and respond
to crises.
The report said it would cost £68m a year in England to
implement, but said the cost could be offset by an estimated £55m
saving through a two-thirds cut in the use of antipsychotics and
reduced admissions to hospitals.
Care services minister Phil Hope said that no new money would be
made available to implement Banerjee's recommendations.
He said "substantial resources" were already available, adding:
"It's about making sure that the money that is being spent is spent
well".
New national clinical
director
A number of Banerjee's recommendations will be taken forward by
a new national clinical director for dementia, a
post announced at last month's National Children and Adult Services
Conference, that should be filled in January 2010.
The DH said that the director would report on a six-monthly
basis to the care services minister on progress against the
report's recommendations and lead a national audit to generate data
on drug prescription levels.
This should be completed within six months of the director
taking office and then repeated on an annual basis for at least
three years, as recommended in the report.
The report was orginally due to be completed last year and
published earlier this year.
At a press conference to launch the report, Hope explained the
delay by saying: "We wanted to make sure that the report was
properly peer reviewed and I'm delighted that we've got a report
that is robust."
- Community Care is running a conference on dementia on
11 February 2010 in central London. Living well with
dementia marks the first anniversary of the national dementia
strategy.
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Dementia: DH promises targets to cut use of antipsychotics