Wales: a dementia friendly nation?

16 June 2015

Article by Amy Clifton, National Assembly for Wales Research Service

Assembly Members will be discussing dementia in Plenary on Wednesday 17 June 2015.

According to Alzheimer’s Society, around 850,000 people live with dementia in the UK, 45,000 in Wales.

Image from Flickr by Smanatha Ing. Licensed by Creative Commons.

Image from Flickr by Smanatha Ing. Licensed by Creative Commons.

However over half of these people remain undiagnosed and therefore unable to access specialist support – diagnosis rates in Wales are just 42.8 per cent. Alzheimer’s Society provides further information in its report: Wales Dementia Diagnosis rates 2014 (PDF, 138KB).

Alzheimer’s Society’s Dementia 2014 Wales report (PDF, 131KB) states:

In Wales, diagnosis rates are among the worst in the UK, with little improvement in recent years.

(…)

There has been insufficient monitoring of the funding allocated from the National Dementia Vision* and there is an urgent need for a specific dementia strategy with clear lines of accountability. There is a clear need for robust evaluation and national prioritisation of dementia. Without a national focus, the lives of individuals affected by the condition cannot improve.

[*Welsh Government’s National Dementia Vision for Wales (PDF, 162KB)]

One of the 2014 report recommendations is for all statutory health and social care bodies in Wales to set targets for stepped yearly improvement in diagnosis rates up to 75% by 2017.

The results of its Dementia 2014 survey revealed that only 58% of people with dementia say they are living well.

Reviews by the Older People’s Commissioner for Wales have revealed that improvements are needed in dementia care both in care homes and hospitals.

The Commissioner’s residential care review report states that care homes are often not dementia friendly, despite the fact that 80% of older people living in residential care will have a form of dementia or cognitive impairment. For example the review found that care homes often lack helpful features such as pictorial signage, and residents’ emotional and communication needs are often misunderstood and neglected.

The Commissioner’s update report, Dignified Care – Two Years On on hospital care reported that the pace of change and improvement in dementia services is still too slow, and that more needs to be done to raise staff knowledge and awareness, and improve the quality of care. The report also found that older people struggle to access the specialist dementia services and support they need.

The latest National Audit of Dementia Care in General Hospitals (July 2013) identified continuing problems in the quality of care received by people with dementia in hospitals in England and Wales (see our previous blog post on this). The third round of the audit (2015 – 2017) is currently underway.

Care and Social Services Inspectorate Wales (CSSIW) conducted a national review into commissioning of social care in Wales, including dementia care services in 2014. Its conclusion was that local authorities and health boards needed to make major changes to the way they plan and commission services for people with dementia. The review concluded that current commissioning arrangements for dementia services will not deliver sustainable services for adults who need care and support in Wales. It found significant gaps in the planning and provision of early intervention services for people with dementia, and states that local authority commissioning practice is not sufficiently focused on the quality of care or quality of life.

Recent developments

In April 2015 the Minister for Health and Social Services stated that he ‘wants to see Wales becoming a truly dementia friendly nation’. He set a new target for the Welsh NHS to increase dementia diagnosis rate to at least 50% by 2016. The Minister noted in an update statement that he expects this challenge to be met by the time the Alzheimer’s Society publishes its 2015-16 figures. He also announced £1m investment to help people with dementia and their families; £800,000 of which will fund 32 new primary care support workers to provide face-to-face support and advice on accessing care and services.

In May 2015 the Older People’s Commissioner announced that she is working with Age Cymru to give a voice to older people in Wales living with dementia and raise awareness of the challenges they face. Evidence will be gathered from older people living with dementia, their families and carers, between July and September 2015.

On 5 June 2015, the Minister announced an extra £8m for adult mental health services; more than £4.5m will be invested in supporting people with dementia. The Minister stated there will be extra investment in occupational therapy and activity support on older people’s mental health wards – two areas which were highlighted in the recent programme of spot checks on these wards in hospitals across Wales (undertaken as a result of the Trusted to Care report).