NHS scraps targets for diagnosis of UK’s biggest killer in U-turn (Image: Getty)
Today (Thursday 30 January) the latest planning guidance for NHS England has been published with a glaring omission which will impact thousands of lives. The target for diagnosis of the UK’s biggest killer – dementia – has been removed. It’s no longer considered a health care priority in England.
The guidance is used by the NHS nationally and locally to form their own plans for the coming year and is a large part of prioritisation and focus, so it matters to all of us. The 2024/25 guidance, issued by the NHS last year, called for an increase of the dementia diagnosis rate to 66.7% as one of its main measures. This ambition has now been dropped to simplify plans and give Integrated Care Systems more freedom to meet local needs.
Those that know me will know that I would normally be hugely supportive of such an approach and have long believed that health and care services should be built by the population for the population, according to local need. However, central government targets are crucial. If dementia or diagnosis aren’t included, Integrated Care System leaders under pressure with budget restraints will naturally focus elsewhere.
This removal signals a serious deprioritisation of dementia and a staggering lack of national direction on this devastating condition. An early and accurate diagnosis establishes eligibility for treatment and support, creates opportunities to participate in ground-breaking research and allows people to plan for the future. We also know, from talking to people living with dementia, that diagnosis can also bring the simple dignity of clarity that they may have been seeking for a long time and which we would all expect for any condition.
Dementia prevalence is rising, so we must see continued attention on getting people the diagnosis they deserve. Right now, just 1.4% of all dementia healthcare spend goes towards diagnosis and treatment, which is not good enough.
The NHS will maintain the ambition for local systems to deliver dementia diagnosis and services. From my experience, some areas are fully committed to this challenge and have made notable progress. However, these systems face severe financial pressures, alongside this message from the UK government that dementia is not a priority.
There is already huge variation in delivery. Aside from those fully committed systems, there are others where diagnosis languishes below 55%. The national target of 66.7% has still not been met, leaving people with dementia without vital support. There is now no incentive for the underperforming systems to do better on dementia.
And I know that some will say there are bigger problems, more strategic shifts that need to happen first. But the very point is that dementia is a vital component of addressing them and, when managed well, can visibly support them. People with dementia want to be cared for at home, in their community, yet without a diagnosis are more likely to end up in A&E in crisis than those who have been diagnosed.
Diagnosing someone with dementia and the support it opens up lessens the chances of unplanned and lengthy admissions to hospital, where one in six beds is occupied by someone with dementia. So, if the Government takes the NHS’s focus away from diagnosis, it will fail to move healthcare from hospitals to the community, meaning pressure on hospitals will increase, further hampering efforts to reduce the waiting lists Ministers are so concerned about.
Just three weeks ago, Stephen Kinnock, Minister for Care, said that Government is “committed to improving dementia diagnosis rates and recovering them to the national ambition of two thirds of people with dementia to have a formal diagnosis.” Removing this from the core guidance will massively hamper this commitment and absolutely scuppers the chances of pushing further and delivering a diagnosis for the forgotten third.
This decision makes it crucial for the upcoming 10 Year plan for the NHS in England to provide concrete solutions for the future of dementia diagnosis and care. It is no longer acceptable for dementia to be an afterthought and the evidence and data backs this up. It’s the very least we can do for nearly the one million people living with dementia and their carers right now.
Tim Baverstock, Head of Local System Influencing, Alzheimer’s Society