A tough new action
plan to tackle the over prescribing of antipsychotic drugs to
people with dementia was today announced by Care Services Minister
Phil Hope.
The action plan responds to an independent review by Professor
Sube Banerjee, commissioned by the Department of Health. Professor
Banerjee’s review shows that too many people with dementia are
routinely prescribed antipsychotic drugs to treat aggression and
agitation, contrary to National Institute of Health and Clinical
Excellence (NICE) guidance.
The action plan will include:
a new National Clinical Director for Dementia; measures to
ensure people with dementia and their carers have access to
psychological therapies to tackle the root of agitation and
aggression; an audit to establish definitive prescribing
figures;clear local targets to cut antipsychotics use as a result
of the audit;better regulation; collaboration with the General
Medical Council (GMC) and Royal Colleges to ensure all health and
social care staff have specialist training in dementia; andjoint
Department and Alzheimer’s Society guidance on what to do if a
family member is given antipsychotics.
Antipsychotics prescription is necessary in certain
circumstances. In line with NICE guidance, the drugs should only
be used when a person is a risk to themselves or others, and where
all other methods have been tried. This should be for a short
period of three months only, whilst a care plan is put in place.
Care Services Minister Phil Hope said:
“It is unacceptable that antipsychotic drugs are routinely
prescribed to people with dementia. More than half of people with
dementia will experience agitation or aggression at some point,
but NICE guidance is clear – antipsychotics should only be given
when this is really necessary.
“Excellent examples of practice do exist, but our action plan
will help make sure this is the norm, not the exception. Our new
Clinical Director will provide strong leadership, supporting the
NHS and Social Care to safely reduce antipsychotics use and drive
up quality.
“We know there are situation where antipsychotic drug use is
necessary – we’re not calling for a ban, but we do want to see a
significant reduction in use.
“We expect the findings and recommendations to be taken into
account by PCTs and all other relevant organisations.
“Tackling the root of the problem is vital, which is why we are
improving access to psychological therapies. We are also working
with the Royal Colleges to ensure all health and social care
professionals are able to care for people with dementia without
routinely resorting to these drugs.”
Professor Sube Banerjee, the report author,
said:
“Antipsychotics are used too often in dementia; up to two thirds
of the estimated 180,000 people with dementia receiving these are
prescribed them unnecessarily.
“This review identifies the potential risks and benefits of these
medications in dementia and presents actions that we can take to
address this problem. In doing so we would provide international
leadership in this complex clinical area as well as improving the
quality of life and quality of care for people with dementia and
their carers in England.”
Chief Executive of Alzheimer's Society
Neil Hunt said:
“This, long awaited, landmark review is a welcome recognition of
the scale of the issue and Alzheimer's Society's
view that these drugs should only ever be used as a last resort.
The scandalous over prescription of antipsychotic drugs leads to
an estimated 1,800 deaths a year, it must end .
“The report suggests prescriptions could be reduced by two thirds
in three years, this is vital and the new action plan cannot
afford to fail. Change will only be achieved with commitment from
government, PCT’s and health professionals and clear local
targets. Almost 150,000 people are being inappropriately
prescribed these drugs as a chemical restraint. Today must mark a
change in dementia care.”
Notes to Editors
1. Key Statistics
700,000 people have dementia in the UK and this number will rise
to one million in the next ten years. Dementia is one of the main
causes of disability in later life, ahead of some cancers,
cardiovascular disease and stroke.One in three people over 65 will
die with a form of dementia. There are 15,000 people under the age
of 65 with dementia.Dementia costs the economy £17 billion a
year.The independent review estimates that 150,000 people are
inappropriately prescribed antipsychotic drugs.
2. National Institute for Health and Clinical
Excellence ( NICE )
guidance
People with dementia should only be given antipsychotics when the
person is a risk to themselves of others.
Contacts:
Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk