'Insufficient progress on the national dementia strategy'

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Baroness Greengross writes for ePolitix.com ahead of her oral question on the national dementia strategy

On 17th March I am asking a question of HMG in the House of Lords as to what assessment they have made of the effect of their National Dementia Strategy.

Dementia is a very topical issue at the moment, covering a range of progressive, terminal brain conditions which affect an estimated 600,000 people in England. This number is rising rapidly and it costs £8.2bn a year in direct health and social care costs.

The National Audit Office (NAO) published a report on the government's 2009 dementia strategy in mid-January, and it said that insufficient progress had been made in implementing the strategy.

This was followed by a public accounts committee (PAC) hearing on the NAO report on 25 January, and yesterday in the Commons Mr Paul Burstow MP tabled a Westminster Hall debate on the strategy.

In its report published on 16th March the PAC comments how, a full year after the strategy launch, it feels badly let down by the lack of urgency shown by the Department of Health (DH). It finds that the department has failed to match its commitments to raise the quality and priority of dementia care with a robust approach to implementation.

In the committee's view it has also failed to ignite passion, pace and drive or to align leadership, funding, incentives and information to help deliver the strategy. Indeed, the committee go on to allege that in 2008/09, spending on dementia research actually fell by seven per cent to £29.9m.

The committee heard from witnesses that, despite the absence of dementia from the NHS Operating Framework, by the end of March 2010 each Primary Care Trust (PCT) and local authority must have in place a joint action plan to take forward and deliver the strategy.

Regarding the fate of the extra expenditure allocation, DH has commissioned a baseline audit of dementia. This local assessment, due on 31 March 2010, will include data on costs and how PCTs have spent the money allocated to them.

These assessments are the key performance indicators for deputy regional directors and regional teams for the first year of implementation of the strategy. The results should tell us by how much the health and social care information, which is available nationally on dementia services, has improved.

However, from the evidence of the 2010 NAO report and other investigations, it seems likely that not every PCT will meet this deadline. Moreover, isolated examples of good practice existed before the strategy, and it was hoped that these examples would be followed and built upon elsewhere.

There seems to be little evidence that this has, in fact, occurred, and unacceptable regional variations still exist in access to services and drugs

The all-party parliamentary group on dementia, of which I am vice-chair, has recently enquired into this subject and will produce a report on 18th March looking at the progress PCTs are making locally and whether they have spent their strategy allocation.

Early findings indicate that some PCTs may come up short on the department's aspirations for both spending and reporting performance. A key issue for me is therefore: how will PCTs who do not meet the department's March deadline be monitored, and will they have the urgency of the strategy restated to them?

So while a start has been made with the strategy, I am seeking to shed further light on what, in the government's view, has been a positive outcome. How are they monitoring those outcomes, and what is their overall assessment of progress and their aspirations for the future?

In addition, I will seek to discover what progress has there been on developing dementia research since the government announced a ministerial task force in early November. Although it's very early days, how will the department respond to the PAC's quite profound deeper criticisms?