The government has begun to publish detailed information about which areas of England give people with dementia the best support, in an effort to reduce wide variation in the quality of care provided.
The Department of Health’s online “dementia atlas” will show, for example, how many sufferers have their care reviewed every year, as they all should, and how likely they are to end up dying where they normally live, usually at home or in a care home.
It will also reveal how many people with dementia end up being admitted to hospital as an emergency and how many “dementia friends” each area has.
Ministers hope that publication of the information will prompt local NHS bodies in parts of England which are not doing as well as others to step up their efforts to prevent dementia, diagnose the condition earlier and support those who have it.
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The information exposes wide differentials in aspects of dementia care that some may conclude reveal a postcode lottery in a patient’s chances of getting good care.
For example, while in some parts of England, 85.8% dementia patients have their care looked at every year, in others just 49.3% receive the same service. Those checks are seen as important because, as dementia is a long-term and degenerative condition, “reviewing those with a diagnosis at least annually will ensure that the needs of people with dementia and their carers are discussed and appropriate care plans can be implemented”, the atlas says.
Similarly, while some areas have as many as 8,000 “dementia friends” available to help sufferers, others have none at all. There is also a more than three-fold variation in the number of those with dementia being admitted to hospital as an emergency. That ranges from 1,840 for every 100,000 people aged 65+ to as many as 6,046 for every 100,000.
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“Making more user-friendly information on dementia accessible online is a step in the right direction”, said George McNamara, head of policy and public affairs at Alzheimer’s Society. “People can now see which parts of the country are leading the way with developing dementia-friendly communities, and how many dementia friends there are in each area.”
However, the atlas should be expanded to become even more useful by including the experiences people with dementia have had of the health and care systems, in order to enable NHS bosses to make improvements in areas which are lagging behind, McNamara added.
The atlas shows that care is unsatisfactory in some places, the Alzheimer’s Society added. “The atlas exposes varied care, with some areas reporting much higher numbers of emergency hospital admissions. We must urgently explore why people with dementia’s needs are escalating to this point and what can be done in the community to prevent crisis admissions among this vulnerable group. It’s currently easier to find out about your hospital’s finances than the quality of dementia care they provide. To make hospitals more transparent and accountable, we are calling for them to publish an annual statement on dementia care.
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“Additionally, in some parts of the country, people with dementia were much less likely to have had their care reviewed in the last 12 months than in others – something which is extremely important given that dementia is a progressive condition and a person’s needs become more severe over time. The causes of variation need to be investigated to ensure care is never a gamble”, added McNamara.
The new tool will also outline how many people in each area smoke – the average across England is 18% – in the hope that this will spur GPs and other health professionals to redouble their efforts to get people to quit smoking, which is recognised as a major risk factor for dementia.
Jeremy Hunt, the health secretary, is also seeking to improve NHS early diagnosis of dementia by ensuring that people aged between 40 and 64 are asked about it when they have an NHS health check. The new component of the health check will now be trialled through more than 250 GP surgeries in four places: Birmingham, Bury, Manchester and Southampton.
New "care atlas" reveals disparity in dementia care across UK
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