Memory services expand in dementia push, but quality is variable

Almost all PCTs in England now commission memory services and numbers of patients accessing them have increased sharply, but less than a third of trusts have accredited schemes, a survey has found.

Figures from the NHS Information Centre suggest the DoH's national dementia strategy has led to a significant improvement in access to support services.

The vast majority of PCTs – 94% – now commission memory services, up from 82% in 2008/9, the year before the strategy began.

The government announced on Wednesday that it will inject a further £10m to increase the level of support the services can provide to patients.

Care services minister Paul Burstow (Lib, Sutton and Cheam) said: ‘While there is no cure for dementia, we know that early diagnosis and early intervention can help people take control of their condition and plan for the future.

‘With access to the right services and support, people with dementia can continue to live well for many years. Memory services have a really important role to play in this.’

Focus on quality
Jeremy Hughes, chief executive of the Alzheimer's Society said memory services had a ‘vital role’ to play in providing support for people with dementia.

‘However, we are still some way from having a nationwide picture of good quality care and support. It is vital that we continue to make advancements in the provision of memory services and work with hospitals to ensure best practice becomes the norm,’ he said.

The survey is the most comprehensive examination of the government’s national dementia strategy to date.

They show over 100,000 people accessed memory services in 2010/11 – almost double the 54,000 who used the services two years previously.

On average, each PCT commissions three memory service teams. There were 337 in England by April this year, and a further 106 are planned by next year.

Spending has risen 40% in this time, boosted by a £150m funding increase for 2009/10 and 2010/11 from the DoH. Data suggest the average PCT spent £593,200 on memory services in 2010/11.

But the quality of memory services varies considerably.

One in four PCTs does not offer all eight features of a memory service recommended by the government. These include home-based assessment, counselling and follow-up and review. Nine PCTs do not offer any of these features.

Just 29% of PCTs commission memory services accredited by the Royal College of Psychiatrists. Although 52 trusts are working towards or considering this, 19 said they had no plans to do so.

Plan for dementia services
Memory services are deemed vital to receiving a diagnosis. In the UK, 60% of people with dementia live with no formal diagnosis and so cannot access treatment and support.

NHS Information Centre chief executive Tim Straughan said: ‘This information provides a valuable basis from which to examine, compare and plan future provision of these services, which are clearly a key part of the NHS strategy to tackle dementia.’

Responses to the voluntary survey were incomplete. One in five PCTs did not respond at all, and some questions were left unanswered among those who did.

The report is part of the national dementia audit, which will assess the progress made against the national dementia strategy.

This began in February 2009, aimed to improve awareness, diagnosis and treatment of dementia.

The DoH is investigating how PCTs have spent £150m of extra funding provided between 2009 and 2011.

Alongside assessing use of funds and provision of memory services, the audit will examine two other strategy aims, on the use of antipsychotics and the number of clinical leads for dementia in acute hospitals.

The £10m injection is expected to fund follow up and review services including peer support, assessment of carers’ needs as well as advice and support on planning for the future, the DoH said.

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