Local organizations will be held to account and expected to publish how they are providing quality care for people with dementia, including reducing the use of antipsychotic drugs, the government has said.
Cutting back on drug use is one of four priorities set out in the revised Dementia Strategy Implementation Plan, published this week. Last November, an expert review commissioned by Ministers reported that only about a third of the estimated 180,000 people with dementia being treated with antipsychotics were deriving benefits from the drugs, and that 1,800 excess deaths per year result from their prescribing.
The review, which was led by Professor Sube Banerjee of King’s College London, suggested that use of antipsychotic drugs could be cut by two-thirds within three years.
Professor Alistair Burns, the National Clinical Director for Dementia, is leading the work to implement Prof Banerjee’s recommendations, while the Department of Health has established an advisory group to inform the project, the revised Strategy Implementation Plan notes. The first part of this work – which seeks to establish the current position regarding prescribing of antipsychotics for people with dementia – is underway via the NHS Information Centre and the initial results are expected in the third quarter of the year, it adds.
The other three priority areas set out in the revised Plan are:
Good quality early diagnosis and intervention for all: – currently, two-thirds of people with dementia never receive a diagnosis, the UK is in the bottom third of countries in Europe for diagnosis and treatment and only a third of GPs feel they have adequate training in diagnosis of dementia;
Improved quality of care in general hospitals: – 40% of people in hospital have dementia, they stay longer in hospital and have high levels of co-morbidity with general medical conditions, all of which costs the average general hospital an additional £6 million per year; and
Living well with dementia in care homes: – two-thirds of people in care homes have dementia, where behavioural disturbances are highly prevalent and often treated with antipsychotic drugs.
Announcing the revised Plan, Care Service Minister Paul Burstow described dementia as “one of the most important issues we face as the population ages.”
“We spend £8.2 billion a year caring for those affected. In this tough economic climate, we must be realistic. It’s not about extra resources but how we can think smarter using the resources we already have,” said the Minister. “It’s about getting resource to the people that need them rather than tied up in backroom bureaucracy. Local organisations will be expected to publish how they are delivering on quality outcomes so that they can be held to account by local people,” he added.
“Investing sensibly in dementia now will improve people’s lives and could potentially save hundreds of millions of pounds. As a million people develop dementia in the next ten years, everyone has a role to play,” noted Ruth Sutherland, interim chief executive of the Alzheimer’s Society.
More than 750, 000 people in the UK are estimated to suffer from dementia and numbers are expected to double in the next thirty years, say government figures. While this is primarily a condition associated with older people, there are also a significant number of people (currently around 15,000) who develop the condition earlier in life.
