Dementia patients and their carers will be encouraged to hold councils and the NHS to account for their performance on dementia care as part of a shift away from top-down intervention.
That was the message from care services minister Paul Burstow, as the government published a revised implementation plan for its predecessor’s national dementia strategy today.
Burstow told Community Care he wanted to use transparent information on service quality to drive improvement, not central government diktat, in what he characterised as a departure from Labour’s approach.
“We have tried in the past 13 years a top-down approach and we have seen how ineffective it can be,” he added, saying the Department of Health’s role would be to set out clear outcomes for dementia patients but not prescribe how commissioners and providers should deliver on them.
The DH has commissioned an audit of the current state of dementia care. Burstow said that information from this comparing areas against each other “had to be made available for local people so they could ask questions of local leaders about the differences”.
The action plan prioritises good-quality early diagnosis and intervention for dementia patients, improving care in hospitals and care homes for the client group and reducing the use of antipsychotic drugs.
Burstow said current levels of dementia diagnosis were “truly shocking” but rejected Labour’s plan to set up a national network of memory clinics to deliver on this goal.
“The outcome is higher levels of diagnosis. The how you get there is not something that I, sitting in Whitehall, can prescribe.”
However, councils and the NHS will face “specific, measurable indicators” on improving dementia outcomes that will be set up as part of planned outcomes frameworks for the NHS and social care, the action plan said.
The plan was welcomed by sector leaders.
“The government is being very clear that the dementia strategy must be implemented urgently,” said Ruth Sutherland, interim chief executive of Alzheimer’s Society.
“Action at a local level is now key if we are to translate paper into practice. The move towards local accountability will give a clearer picture of how work to improve antipsychotics, hospital care and early diagnosis can help save millions and improve lives. We know some areas are moving ahead quickly on the strategy and are already beginning to see the benefits.”
Martin Green, the government-appointed dementia champion for independent sector providers, said he believed the government’s audit of dementia services would enable users and carers would be able to hold councils and the NHS to account.
“If you see your authority is lagging behind others it gives you the authority to say to local providers and commissioners ‘you need to step up’. I think [the audit] will give us a clear idea of where the gaps are.”
However, care provider Anchor said the plan did not go far enough. Chief operating officer Sara McKee said: “Thousands of older people are at risk of misdiagnosis and sub-standard care because there is no statutory minimum level of training for staff working with people affected by dementia.
“Unless this changes, the sector will struggle to reduce the number of people with dementia who never receive a diagnosis or indeed stop the use of medication as ‘chemical restraints.”
In an echo of Community Care’s pre-election Dementia Declaration campaign, which called on the new government to prioritise the condition, the DH plans to launch a national dementia declaration this autumn. Signatories would set out how they intend to help improve services from 2010-14 as part of the declaration.