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The Government published a new outcomes focused implementation plan for the National Dementia Strategy on
Raising the quality of care for people with dementia and their carers is a major priority under this Government. The key purpose of "Quality outcomes for people with dementia: building on the work of the National Dementia Strategy" is to set out for health and social care localities and their delivery partners:
the Department of Health's role and its priorities during 2010-11 for supporting local delivery of and local accountability for the implementation of "Living Well with Dementia-A National Dementia Strategy"; the strategy's fit with the new vision for the future of health and social care as set out in the White Paper "Equity and Excellence: Liberating the NHS"; and the fit with the consultation document "Liberating the NHS: Transparency in outcomes-a framework for the NHS".
"Living well with Dementia-A National Dementia Strategy"(1) was launched in February 2009 following an extensive consultation process, with the aim of improving the quality of care for people with dementia and their carers. It is a five-year strategy containing 17 objectives to transform dementia services. Some £150 million has been made available to primary care trusts in the first two years-£60 million in 2009-10 and £90 million in 2010-11-to implement the strategy, but without a ring-fence on the funding or targets. Alongside delivery of the strategy, work is under way to implement the recommendations of Professor Sube Banerjee's report into the over-prescribing of anti-psychotic drugs for people with dementia(2). Professor Banerjee's report has been placed in the Library and is available at:
"Quality outcomes for people with dementia: building on the work of the National Dementia Strategy" provides an implementation plan that reflects the principles of the White Paper "Equity and Excellence: Liberating the NHS"(3), the consultation document "Liberating the NHS: Transparency in outcomes - a framework for the NHS"(4) and the current economic and political landscape, where the Department's role is more enabling and less directive.
The new implementation plan identifies four priority objectives for the Department's work during 2010-11 to support local delivery of the strategy. These areas provide a real focus on activities that are likely to have the greatest impact on improving quality outcomes for people with dementia and their carers. The four priority objectives are:
good-quality early diagnosis and intervention for all; improved quality of care in general hospitals; living well with dementia in care homes; and reduced use of anti-psychotic medication.
The Government have commissioned a national audit of dementia services, which is establishing the provision of dementia services across the country. The audit will provide local NHS and social care organisations with a measure of their progress in key areas including the use of senior clinical leads for dementia in hospitals, establishment of memory services, reducing the use of anti-psychotic medication and expenditure on dementia services, so that they can drive forward action to accelerate improvements in dementia care. The initial results are expected by the end of the year.
The revised NHS operating framework for 2010-11 highlights that the NHS and its partners must give a greater priority to dementia. 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. This expectation along with the data generated by the national audit will create much greater transparency.
The Government are working with the Alzheimer's Society to develop a National Dementia Declaration, which is due to be launched in autumn 2010. This is a sector-wide initiative, led by the Alzheimer's Society, which involves a wide range of national organisations. It will be a call to action to improve the quality of life outcomes for people with dementia and their carers.
The Government support the implementation of the "End of Life Care Strategy", published in 2008, which aims to improve end of life care for all adults, including those with dementia. The Government have also confirmed its commitment to improving quality and choice in palliative and end of life care in "Equity and excellence: Liberating the NHS", which includes the commitment to move towards a national choice offer to support people's preferences about how to have a good death.
"Quality outcomes for people with dementia: building on the work of the National Dementia Strategy" reflects the Government's commitment to ensure a greater focus on accelerating the pace of improvement through local delivery of and local accountability for achieving quality outcomes in dementia care.
At the heart of this vision is the Government's commitment to putting patients and the public first; improving health and social care outcomes; ensuring autonomy, accountability, democratic legitimacy and improving efficiency.
As highlighted in the National Dementia Strategy, the pace of implementation will vary depending on local circumstances and the level and development of services within each NHS and local government area. It describes what the Department of Health considers as its priorities for policy development in its role of enabler for continued progress in improving outcomes for people with dementia and their carers.
A key element of this new outcomes focused approach is ensuring greater transparency and provision of information to individuals so that they have a good understanding of their local services, how these compare to other services, and the level of quality that they can expect. 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.
(1)"Living well with dementia: A National Dementia Strategy", Department of Health,
(2)The use of antipsychotic medication for people with dementia: Time for action-A report for the Minister of State for Care Services by Professor Sube Banerjee,
(3)The NHS White Paper: "Equity and Excellence: Liberating the NHS", Department of Health,
(4)"Liberating the NHS: Transparency in outcomes-a framework for the NHS".