Adass lead: Dementia money not being spent as desired

The £150m identified for primary care trusts to implement the national dementia strategy from 2009-11 has not been spent on its desired purpose, a local government leader has claimed.

Association of Directors of Adult Social Services dementia lead Simon Williams told a Community Care dementia conference yesterday that PCTs had already committed their budgets for 2009-11 when the funding was announced with the publication of the strategy last February.

Williams, who stressed that he was not blaming PCTs for the situation, also raised concerns, identified in a critical National Audit Office report last month, that dementia had not been made a national priority for the NHS.

Lobbied for implementation

He said Adass had lobbied for the implementation of the dementia strategy to be a “tier 1” priority for PCTs in the NHS operating framework – making it a national requirement performance managed by regional strategic health authorities. Instead, dementia is a “tier 3” issue for PCTs, making it subject to local decision-making.

However, Williams added that there were a number of “levers” available to drive forward progress on implementing the strategy, under which councils and PCTs are expected to ensure users receive an early diagnosis and high-quality ongoing care.

He said there was evidence of what worked in dementia care and of where existing services were wasting money, citing an Alzheimer’s Society report published last November that found that at least £80m a year could be saved from improved dementia care in hospitals.

Committed funding

David Stout, director of the NHS Conferation’s Primary Care Trust Network, agreed that PCTs had already committed funding up to 2011 when the £150m allocation was announced because they had three-year budgets set in 2008.

Though he admitted that local dementia spending varied by the level of priority PCTs placed on the condition as well as according to need, dementia spending would inevitably be a priority for trusts whatever the NHS operating framework said because of mounting demand.

The DH has predicted that implementing the strategy will cost PCTs and councils £1.9bn over 10 years.

Stout said releasing funding from less efficienct services to invest in new ones “was not easy at all” though stressed it would need to be done with the NHS facing financial constraints over the coming years.

The conference also heard the first major speech from Professor Alistair Burns since his appointment last month as the Department of Health’s national clinical director for dementia, with a remit to lead strategy implementation.

Burns, who takes office on 1 April, said he would be heading a public awareness campaign to tackle the stigma around dementia, launched next month, and leading an audit of dementia services across England, whose results would be available in the autumn.

He will also implement the DH’s action plan to reduce the use of antipsychotic drugs among people with dementia, off the back of a report by departmental adviser Professor Sube Banerjee last year.

However, PCTs have already raised concerns about the costs of implementating the action plan, given the government’s decision to provide no central funding.

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