This report published by the All Party Parliamentary Group (APPG) on Dementia examines the scale of difficulty faced by people living with both dementia and other health conditions, and how the health and social care system can provide holistic, person-centred care and support for this growing body of people.
There are 850,000 people in the UK living with dementia, 42,000 of whom are under the age of 65. Many people with dementia also live with one or more other health conditions. Studies have shown that:
- 41% have high blood pressure
- 32% have depression
- 27% have heart disease
- 18% have had a stroke or transient ischemic attack (mini stroke)
- 13% have diabetes (Barnett et al, 2012  ).
This inquiry led by the APPG has brought to light the scale of difficulty faced by people living with dementia and other health conditions. Despite significant progress to deliver integrated care services and support, the health and social system frequently treats conditions in isolation so that people with dementia and other health conditions receive disjointed, substandard care and treatment. Key findings from the report include:
- 7 in 10 people living with dementia are also living with another medical condition. The severity of someone’s dementia can have consequences on their ability to manage their other conditions
- The current health and care system is fragmented and does not have the capacity to manage the complexity of these multiple conditions. Conditions are often treated in isolation from one another which can lead to disjointed care and confusion with medication management. It can also result in avoidable hospital admissions
- The Care Quality Commission (CQC) inspects individual providers rather than care pathways
- One of the biggest challenges facing society today is building a health and social care system that can provide holistic, person-centred care for people living with multiple conditions
- Without radical change, the current health and care system will consign thousands of people to substandard care and a poor quality of life, wasting millions of pounds in the process
The report identifies the changes needed across the healthcare system so that the NHS can meet the challenge of caring for people living with dementia and other conditions, supporting them to live fulfilled lives. These include:
- Public Health England should mandate a dementia component in the NHS Health Check for people aged 40 to 65 years old to enable people of all ages to take action to reduce their risk of dementia.
- The Quality Outcomes Framework should be revised by the relevant bodies to ensure people with dementia and comorbidities receive a minimum of one GP-led holistic review of their care and support per year.
- The Royal Pharmaceutical Society should develop new guidelines on polypharmacy for England that address how to treat people with dementia living with multiple long-term conditions.
- Public Health England should include data on dementia and common comorbidities in the Dementia Intelligence Network to provide health and social care commissioners with the data to commission integrated care pathways.
- CQC inspection regimes should assess the quality of care pathways across health and social care settings alongside the performance of individual providers