The government’s ambitious five-year strategy to transform dementia services in the UK is in danger of failing as it lacks the mechanisms for successful implementation, a hard-hitting report by the National Audit Office warns.

Dementia encompasses a range of progressive brain diseases that currently affect around 600,000 people in England alone. However, this figure is set to double within just 30 years at a huge cost to the economy – rising from £15.9 billion in 2009 to £34.8 billion by 2026, placing a massive strain on resources.

Back in 2007 the government first classed dementia as a national priority, and last year it launched a comprehensive strategy - Living Well with Dementia - designed to transform services across the country to help improve the quality of care and the lives of patients living with the condition, as well as place health services in better stead to cope with the burgeoning demand.

However, one year on it seems that primary care trusts have failed to make much headway in implementing the actions laid out in the strategy, primarily because it “lacks the mechanisms needed to bring about large scale improvements,” according to Amyas Morse, head of the NAO. Furthermore, he claims without these mechanisms “it is unlikely that the intended and much needed transformation of services will be delivered within the strategy’s five year timeframe”.

According to the NAO, commitments in the Department of Health’s dementia strategy were widely applauded for recognising the scale of the dementia challenge. However, “the Department has not yet matched this commitment with a robust approach to implementation, which aligns leadership, funding, incentives and information”, its report claims.

First and foremost, dementia has not yet been included in the set of national priorities which act as a benchmark for local health service performance, and so PCTs “do not see it as a ‘must do’”, the NAO explains. Still, effective local leadership, joined-up commissioning with quality incentives and comprehensive performance information could all help drive progress, “but these are not yet in place”, it adds. In addition, there is as yet no basic training for healthcare professionals on how to best care for dementia patients.

And while £60 million of additional baseline funding has already been put up by the government during the first year of the strategy, cash is another issue, as progress is also dependent on the release of £1.8 billion of efficiency savings generated by the acute hospital and long-term care sectors, to pay for earlier detection and intervention for dementia and better care in the community.

However, without the necessary levers described above and in the current difficult financial climate “actually releasing or re-directing resources from secondary to primary care, or from NHS to social care, is likely to be difficult to achieve in the short to medium term”, the report warns and, furthermore, concludes that there is a “strong risk” that the value for money of dementia services will not significantly improve over the next five years.

Commenting on the report, Jo Webber, deputy policy director at the NHS Confederation, said that the only way to respond to the dementia challenge is “to co-ordinate action across public services”, and “find new and improved ways of providing services that include all local bodies while at the same time finding efficiency savings”.

“How funding is arranged is also vital and this report is a reminder of how important it will be to produce a clear, long term solution to social care funding in the forthcoming Department of Health White Paper,” she added.