National Institute for Health and Clinical Excellence (NICE)
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Commissioning health and social care for people with dementia

NICE has produced a guide for commissioners on dementia, which aims to help improve the commissioning of health and social care support for people with the condition, and for their carers.

There are currently around 630,000 people with dementia in the UK- a figure that is expected to double by 2035 due to an ageing population.

Recent findings from the Care Quality Commission (CQC) revealed that the current health and social care system is struggling to provide adequate care for people with dementia and their families.

This is partly due to dementia not being diagnosed early enough, with the report highlighting that knowledge and recognition of the signs are the first steps to improving the quality of care that people receive.

Commissioning services for dementia is also complex, and a whole systems approach and collaboration between health and social care commissioners and providers is necessary to achieve a good level of personalised care.

To help commissioners with this, NICE has produced a guide which provides practical advice on integrating health and social care. The guide aims to ensure more people with dementia receive an early diagnosis and can access the care and support that they and their carers need to live well and independently.

The guide draws on NICE's quality standards and pathway on dementia, to support the commissioning of services on three specific areas.

The first is on improving the early intervention, assessment and diagnosis of the condition. Research shows that more than half of people with dementia never receive a formal diagnosis, and so do not access the most appropriate health and social care services available to them.

Among the support the guide provides for early diagnosis and management are links to resources for identifying dementia early on, and case studies for memory assessment services that specialise in the diagnosis and initial management of the condition.

The second area covered is supporting people to live well with dementia. NICE says that commissioners should recognise the increasing demand for services that support people with dementia to live well and independently as long as possible.

Evidence shows that this care can help prevent crises, avoid unnecessary hospital admissions, reduce the avoidable use of residential care and improve quality of life.

The guide provides advice on planning and coordinating care, supporting people to live well in their homes, and enabling people with dementia to enjoy their lives.

A commissioning tool produced to accompany the guide also enables commissioners to estimate the potential savings that may result from a reduction in hospital costs through avoiding unplanned hospital admissions.

The third area covered in the support for commissioning focuses on improving the support for carers, which is a key component of the Prime Minister's challenge on dementia.

There are around 670,000 people in the UK acting as primary carers of people with dementia. As carers can often experience high levels of anxiety, depression and stress, the guide provides advice on how commissioners can support their needs.

Dr Jill Rasmussen, Clinical Champion for Dementia at the Royal College of GPs, said: "Although much has been done since the publication of the 2009 National Dementia Strategy for England to improve the health and social care support for people with dementia and their carers, the recent Update Report on dementia from the Care Quality Commission indicates there is clearly still much to do.

"Sadly, the number of people with dementia is steadily increasing and so are the challenges we face in ensuring that people with dementia and their carers are able to live as well as they possibly can with their condition.

"This support for commissioning covers the full breadth of social, medical and psychological treatment and care for people with dementia and their carers, from early detection through to end of life that commissioners need to consider if they are to meet that challenge."