Future dementia care under threat

New commissioning models will not meet the challenge of the growing need for dementia care, reveals a new report by leading think tank the Institute for Public Policy Research (ippr).

A study of services in London, commissioned by the City of London Corporation’s City Bridge Trust, has found that the capital is facing serious problems in the future provision of care for dementia patients.

Rick Muir, Associate Director at ippr, said: “The extent and the quality of dementia care in London is clearly inadequate, particularly for the over 80s and for London’s fast growing population of elderly people from ethnic minorities. At the same time, GPs admit that they do not have the skills to deal with this growing care crisis.

“The health reforms which bring in new commissioning arrangements are an opportunity to ensure that the wedge between health and social care doesn’t grow, leaving dementia sufferers stuck in the middle with inappropriate or inadequate levels of care. But at the moment it is far from clear that changes will rise to the challenge.”

The report revealed:

• Less than a third of GPs in London say they are able to diagnose dementia or to provide sufficient help for dementia sufferers
• Dementia care is poor for the over-80s in London who receive a worse service than people with early-onset dementia
• There is a serious lack of dementia services tailored to meet the needs of black, minority and ethnic (BME) Londoners over 80 – and this group is set to triple over the next 20 years.
• Failures of integration between health and social care services

To help improve dementia care services, the report suggests the following:

• The NHS Commissioning Board should ensure that the quality of dementia care is included in the new outcomes framework by which GP Consortia should be held to account
• One of the new Pathfinder GP Consortia should pilot an early intervention approach to dementia care; this could provide the necessary evidence base to reassure future consortia that commissioning dementia services will make savings down the line
• Systems need to be put in place to strengthen the links between health and social care to ensure a more integrated service and a seamless care pathway for people with dementia
• The new Health and Wellbeing Boards should make dementia a priority
• Health and social care services should be ‘co-located’ to ensure closer working between GPs and other providers.

Clare Thomas, Chief Grants Officer of the City London’s City Bridge Trust who commissioned the report, said: “Dementia care has been a Cinderella service in London. It’s vital that we plan for the future new. The situation will worsen unless we act now and plan for more integrated services.”