A new specialist service to be trialled across England in 2023 was announced by the NHS on 26 December 2022.
NHS England will be investing £900,000 to launch two pilots in each of England’s seven NHS regions. The fourteen pilot schemes are to be launched in January 2023 following on the success of a pilot scheme held in Norfolk.
In the Norfolk pilot more than 100 care home residents were given a face-to-face assessment with 95 of them being given a dementia diagnosis.
Mark MacDonald, Associate Director of Advocacy and System Change at the Alzheimer’s Society said of the Norfolk pilot, “Diagnosing dementia is crucial to unlocking the right care and support, so we’re pleased NHS England is prioritising the diagnosis of people in care homes through this initiative. Knowing someone has dementia can transform their care, ensuring they receive the right kind of support, and that families and carers get the information and guidance they also need after a diagnosis. We know the vast majority of those who have received a dementia diagnosis see it as a positive step, albeit one which can often be life-changing. If successful, we want to see this pilot rolled out as soon as possible across England, as well as a focus on improving dementia for everyone, both in and out of care homes.”
Professor Alistair Burns, NHS England’s National Clinical Director for Dementia stated “The pandemic has naturally had an impact on the number of people diagnosed with dementia, with elderly people seeing fewer people in order to protect them from Covid-19. The NHS is determined to ensure those who developed dementia during the pandemic are given a diagnosis as it will open up doors to further support for people and their families who suffer from this heart-breaking disease. There are many things we can do in the NHS to care for and support people if they do get a diagnosis, and importantly there is support for their families and carers too.”
It is impossible to overstate the importance of an early dementia diagnosis. It facilitates access to vital care and support and provides a better quality of life for those with the condition.
The significance is highlighted in the Dementia Statements and Rights, published by the Alzheimer’s Society in 2021.
“We all have the right to an early and accurate diagnosis, and to receive evidence-based, appropriate, compassionate and properly funded care and treatment, from trained people who understand how dementia affects us. This must meet our needs, wherever we live.”
NHS data from May 2021 shows that 434,307 people in England had a dementia diagnosis. However, it was estimated that the real number of people living with dementia was 678,997. In simple terms this meant thousands of people are living with dementia without a diagnosis and in turn without the care and support that a diagnosis would facilitate.
In 2013, NHS England had agreed a national ambition for diagnosis rates, aiming for two-thirds of the estimated number of people with dementia to have a diagnosis. The 2021 figures fell somewhat short of achieving this ambition, but perhaps of greater concern is the very significant regional variation of diagnosis rates across the NHS regions.
A further consideration relates to the revolutionary new drug, Lecanemab, which potentially can improve the quality of life for people in the early stages of Alzheimer’s by slowing down the loss of quality of life for them and their carers.
The drug, however, must be given before too much damage has been done to the brain, whereas most people are referred to memory services in the later stages of the disease. Accordingly, the NHS and other healthcare systems must be able to improve on not just the early diagnosis of Alzheimer’s, but also to highlight potentially eligible patients.
To work towards achieving this goal, under the new dementia diagnosis drive, hundreds more people will now be checked for dementia. Care home residents will be practically assessed for Alzheimer’s by specialist nurses and other healthcare professionals. Family and friends can also play a vital role in spotting signs of dementia when they visit loved ones.
In this new dementia drive, GP’s will share a list of care home residents without a dementia diagnosis. The staff involved in the pilot will then check with the care home to see if those listed have memory problems and the residents will then be offered a full face-to-face assessment. The clinician will review the person’s use of medication, as well as speaking to the family and friends in order to determine whether the care home resident has dementia.
This diagnosis will help the NHS and care home staff to better to manage the resident’s condition and to ensure that they are not prescribed unnecessary medication and are given greater personalised care.
The new pilot sites will be run by the following NHS Trusts:
- Cambridgeshire and Peterborough NHS Foundation Trust
- East London NHS Foundation Trust
- South London and Maudsley NHS Foundation Trust
- Central North West London Trust
- Birmingham& Solihull Mental Health Trust
- Herefordshire and Worcestershire Health and Care Trust
- Humber FT
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust – North Community Locality
- Cheshire and Wirral Partnership Trust (CWP) in collaboration with Age UK Wirral
- Mersey Care NHS Foundation Trust
- Oxford Health Foundation Trust
- Kent and Medway NHS & Social Care Partnership Trust
- NHS Cornwall and Isle of Scilly
- Somerset NHS Foundation Trust
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