Speech

Speech: 29 November 2011, Andrew Lansley, Dementia Action Alliance

Andrew Lansley speaks at the Dementia Action Alliance.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government
皇冠体育app Rt Hon Andrew Lansley CBE

CHECK AGAINST DELIVERY聽

I鈥檓 delighted to be able to join you today.

In terms of the future of the health and care system, there are few more important issues than dementia.

In the context of major reform to both our health and care system, the priorities of the National Dementia Strategy are as relevant as ever, and we are committed to delivering them.

Earlier diagnosis so people can access the support they need more quickly and maintain their quality of life.

Improving the quality of care in hospitals and care homes - with a clear focus on outcomes.

Reducing the use of anti-psychotics.

And above and beyond that, much greater investment in research. More focus on personalisation and choice.

皇冠体育appse are all areas that have been championed by the Dementia Action Alliance.

Since I became Secretary of State, I have been impressed, time and time again, by the commitment of charities, the royal colleges and many other professional organisations to work together to find answers to tough questions.

皇冠体育app Alliance embodies this spirit -it鈥檚 not only its passionate advocacy that I value, but its constructiveness and optimism.

Not just in its push to reduce the use of anti-psychotics, but also its drive to improve education and training of nurses, GPs and many more working in health and care.聽

And the potential it sees in involving partners from outside the health and social care sector such as BT, who also want to play a part in improving the quality of life of people with dementia.

皇冠体育appse kinds of partnership are vital because of the scale of the issue we are facing.

Dementia is the condition that鈥檚 most feared among the over 55s.

It鈥檚 also perhaps the one that鈥檚 least understood.

Its symptoms easily confused or written-off as an inevitable consequence of ageing - sometimes by people who have dementia, and sometimes, by the professionals.

We鈥檙e not unique in this respect - this is a global issue. 皇冠体育appre are 36 million people with dementia in the world today.

And 28 million of them don鈥檛 have a diagnosis. In this country, we do slightly better, but not much.

Over three quarters of a million people with dementia in this country. Six out of ten of them without a diagnosis.

450,000 people unlikely to get help until their condition leads to a crisis for them or their carer.

皇冠体育app tragedy is that they will never discover that a diagnosis doesn鈥檛 mean the beginning of the end.

Often, it鈥檚 a gateway to more effective support and treatment, that will help them stay independent for longer and plan for the future.

This is why we鈥檝e now rolled out a national campaign on the signs and symptoms of dementia. And why improving diagnosis rates - particularly in areas that are low - is one of the priorities in this year鈥檚 operating framework published last week.

It鈥檚 why we鈥檙e investing in memory clinics and other forms of support that can help people in the early stages of dementia to cope.

It鈥檚 simply wrong to assume that because a condition has no cure, there鈥檚 no hope.

And no government should be immune to the struggle of people who have dementia to hold on to their sense of identity, their self worth, if their disease rapidly progresses.

But I won鈥檛 pretend there鈥檚 no financial incentive.

We know that good support at home for people with dementia can reduce the need for admission to a care home by a quarter.

Even in very complex cases, that require a highly skilled mental health team, good case management can reduce admissions to care homes and save money.

Carer support and counselling at diagnosis plays its roll too -聽 reducing care home placement by 28 per cent.

皇冠体育app National Audit Office estimated that the average general hospital could save 拢6 million a year if they improved treatment of older people on their wards with dementia.

皇冠体育app London School of Economics estimated that in relation to hip fracture alone, better management of patients who also have dementia could save between 拢64 and 拢102 million in England every year.

皇冠体育app case for both improving the quality of care, and developing new treatments is abundantly clear.

Investment in research is rising - up from 拢12.7 million in 2009-10 to 拢18.6 million in the last financial year

皇冠体育app National Institute for Health Research will provide an extra 拢18 million, over 5 years from April 2012, to set up new biomedical research units focused on world-class research.

皇冠体育app Medical Research Council will increase its funding on research on neurodegeneration from 拢34 million to 拢37.5 million per annum

皇冠体育appre has been a good response to the themed call for research, which, with enough high quality bids, will also lead to more money for research.

And many charities and other professional organisations will work together to promote funding opportunities to the dementia research community.

皇冠体育app benefits of this investment won鈥檛 be immediate. But I am confident in the foundation we are building.

Last week, we celebrated the six-fold聽 improvement in cancer survival rates of the last 40 years.

My hope is that in ten or 20 years鈥� time, we鈥檒l be able to point to a similarly significant breakthroughs in how we treat dementia.

皇冠体育appre are steps we can and should be taking now, however.

Last year, we set a challenge to the health and care profession. We said that we wanted to reduce the use of anti-psychotics to treat dementia by two thirds by the end of this month.

I know I鈥檓 preaching to the converted today. Members of the Alliance have been the driving force behind this agenda.

But even so, I want to underline the seriousness of this problem.

1,800 lives lost every year because people with dementia are being wrongly prescribed anti-psychotic drugs, the majority of which are not even licensed for dementia.

Thousands of people with dementia each year being denied their dignity, their right to self expression because some parts of the health and care system treat symptoms of distress as challenging behaviour聽 that must be suppressed.

We won鈥檛 know if the target we鈥檝e set has been met until well into next year. But early indications aren鈥檛 good.

And if we haven鈥檛 made significant progress, we will take tough action.聽

皇冠体育appre are some who argue that we鈥檙e asking too much: that in care homes and hospitals, there are few alternatives to anti-psychotics.

I disagree. 皇冠体育app best care homes get it right. And they do this by taking the time to understand the behaviour of people with dementia and to listen to them - by understanding their personal history and their life story.

Like the care home resident who was becoming agitated because he missed his garden.

In response, the home relocated his garden shed to the care home鈥檚 garden so he could work in the garden with his own tools whenever he wanted.

Or the lady who used to work as an administrator in a prison during the war and would try to find and remove keys from all over the building because she remembered the need for security.

聽Instead of prescribing anti-psychotics, the staff gave her a piece of wood with five locks on it and five keys that fitted on a key ring.

So every time she left her room, she鈥檇 turn the locks. And as a consequence, she stopped removing keys from the building.

Much of this is about the quality of the workforce in the care system. This is why one of the key themes of the engagement on the future social care is on how we support the workforce to deliver good quality care.

皇冠体育app CQC inspections have highlighted some shocking failures in care homes, hospitals.

I am determined that, just as we celebrate what鈥檚 good about the health and care system, we鈥檙e equally conscientious when it comes to shining a light on poor care.

But while we need to take a good hard look at the areas where things go wrong, we shouldn鈥檛 lose sight of is what makes care better - what good looks like.

皇冠体育appre was one thing that was particularly striking in the reporting around the EHRC鈥檚 study of home care visits.

When Linda Stephens, spoke about the quality of care her mother received in an interview on the radio last week, she said that she was in no doubt that the care assistants who were doing their job well knew this - they understood what good care was.

But she could see that those who weren鈥檛 doing a good job would have no consciousness that what they were doing was wrong.

This doesn鈥檛 excuse poor care, and it certainly doesn鈥檛 excuse abusive or aggressive behaviour. But it tells us more about the problem - that there鈥檚聽 tolerance - even an expectation - of dismissive or disrespectful behaviour which goes unchallenged by peers or managers.

Some of it is about the quality of leadership in different organisations - how leaders in the health and care system establish a culture that prioritises dignity and respect.

Nursing directors and medical directors in the hospitals will know when care on geriatric wards is not up to scratch. 皇冠体育appy have the power to do things that will help put it right.聽

But in dementia, as well as leadership, it鈥檚 about education and training. 皇冠体育app paucity of understanding about the symptoms of dementia and how it can be managed must be addressed.

That鈥檚 why we asked Skills for Care and Skills for Health to develop common core principles on supporting people with dementia, which set out the basic understanding of dementia that all health and social care workers need.聽

And this year, we鈥檙e investing in eight education and training projects on dementia, covering areas such as life story work, reminiscence, and training and support for family carers聽

It鈥檚 why Professor Alistair Burns, our national clinical lead on dementia will be surveying the content of curricula in those training to work in health and care to check that tomorrow鈥檚 doctors, nurses and care professionals have the right preparation to work with people with dementia.聽

And as in both health and social care, we begin to develop more sophisticated ways of measuring the quality of the care people receive, it will become increasingly obvious which services are meeting that challenge well and which aren鈥檛.

In the NHS operating framework, which we published last week, we鈥檝e made it clear that, in relation to dementia, commissioners must ensure that all providers are compliant with the NICE quality standards.

And that there must be more effort to improve diagnosis rates and reduce prescribing of anti-psychotics.

From 2012/13, through the Commissioning for Quality and Innovation (CQUIN) framework, we鈥檙e introducing a new goal to improve the diagnosis of people with dementia in hospitals.

When over 75s are admitted to hospital, they can expect to have a dementia risk assessment. If they are diagnosed with dementia, they should be referred to local memory services that can give them support.

This will not only help us improve diagnosis rates, it will help raise awareness and improve treatment of people with dementia in hospitals.

In addition, with the NHS information centre, we鈥檙e developing clearer indicators to measure the quality of care for people with dementia and their carers.

We would very much welcome the Alliance鈥檚 input into this work. Where there鈥檚 poor care, we want to be able to identify it, and where there鈥檚 good care, we need to celebrate and reward it.聽
Better quality of care in every setting. More opportunities for early intervention, more personalisation - that鈥檚 the challenge.

It goes hand in hand with putting people in control of their care.

As the Alzheimer鈥檚 Society has said in its statement on involving people with dementia in their care, it鈥檚 people with dementia who are the experts on what it鈥檚 like to live with their condition.

I know that as of yet, use of personal budgets for people with dementia has been comparatively low.

But when many people with dementia - particularly in the early stages - have a combination of health and care needs, and when their carers will often need quite specific support as well, I believe they could be truly transformative.

We鈥檙e currently evaluating a series of projects that use dementia advisers and peer support networks to support people with dementia and carers.

Because what people with dementia and carers tell us is that what they want is one point of contact who can help them develop the care package that will work for them.

皇冠体育app last thing they want is to be stuck navigating a complex system - the endless phone calls to their local GP surgery or to social services that never seem to amount to anything.

We still have a long way to go if we鈥檙e going to improve the quality of care for people with dementia. But I believe that, through the National Dementia Strategy, and the focus on outcomes, we鈥檙e building strong foundations.

With no sign that the number of people with dementia is going to decline, and there鈥檚 no miracle cure on the horizon, of course, there鈥檚 much more to do and we need to move faster.

Quite simply, the human and economic cost of not improving the quality of care of people with dementia is too big a price for society to pay.

That鈥檚 why I鈥檓 personally committed to the dementia strategy.

And I will do everything possible to make sure we improve the experience of people with dementia and their carers.

Updates to this page

Published 29 November 2011