PCTs fail to develop dementia plans

One in three PCTs do not know how they will implement the National Dementia Strategy (NDS) and half cannot account for their share of NDS funding, a GP investigation has found.

The National Dementia Strategy aims to 'transform quality of care' (Photograph: SPL)
The National Dementia Strategy aims to 'transform quality of care' (Photograph: SPL)

A third (38) of the 116 PCTs responding to a Freedom of Information Act request said they had not yet completed an action plan showing how they will achieve the goals of England's NDS.

Almost half (47 per cent) could not explain how they had spent their share of the £60 million they were given in 2009/10 to support implementation of the strategy.

When the NDS was launched last year, the DoH said it would 'transform the quality of care' for the 570,000 people with dementia in England.

PCTs were expected to produce an action plan for their region by 31 March, setting out how they would meet aims of the strategy.

But by mid-May, many PCTs had still not completed this work, leaving dementia services patchy and, in places, sidelined.

In early April, NHS chief executive Sir David Nicholson wrote to PCTs to remind them of their duty to complete an action plan.

But information provided by PCTs shows that many are failing to make the strategy a priority for implementation locally.

NHS Enfield in north London admitted it had not allocated its share of NDS funds to dementia. A spokesman for the trust said: 'Within the current demands dementia has not been accorded specific priority locally under the joint specific needs assessment and no additional funds have therefore been allocated.'

Several PCTs said they could not account for NDS funding because it was added to base-lines and not ringfenced, although many other PCTs were able to give full accounts of how they had allocated funds.

David Stout, director of the NHS Confederation PCT Network said trusts could decide their own local targets, adding that dementia is not prioritised in the 2009/10 NHS Operating Framework.

GP's findings are a further setback for the NDS, which has been criticised by the National Audit Office for failing to provide value for money or accountability over spending.

Buckinghamshire GP Dr Johnny Marshall, chairman of the National Association of Primary Care, said GPs needed to take a leading role to revitalise the strategy. 'Dementia is a key disease area but doesn't seem to get the priority it deserves,' he said. 'Engaging GP commissioning with PCTs would be a much better way of pushing (the strategy) forward.'

His comments echoed calls from the All Party Parliamentary Group on Dementia, which in January advised every PCT to appoint a clinical lead in dementia, a role GPs could fill.

However, stalled progress on the strategy means many GPs have no confidence in referring patients to secondary services, according to Andrew Chidgey, head of policy and public affairs at the Alzheimer's Society.

'The GP is essential in this work, because it's often through GPs that people first identify they have a problem and where they seek help,' he said.

How PCTs are failing
  • One in three PCTs missed a deadline to produce an action plan for the NDS, and half could not account for first-year spending.
  • This key plan was meant to outline how the PCT would implement the strategy over the next four years.
  • The survey comes as GPs say they are losing confidence in referring patients to secondary services.

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