Dementia 2017: Implementing Better Care

1. www.england.nhs.uk
Dementia
Alistair Burns
National Clinical Director for
Dementia & Older People’s Mental
Health

2. www.england.nhs.uk
Dementia rarely travels alone
• 80% of people with dementia have another long term condition
• Diabetes: twice the risk of dementia
• Cardiovascular disease: increased risk of dementia (a third)
• 30 times more likely to develop delirium
• Delirium: increased risk of developing dementia
• 100,000 people with dementia have sight loss
• Deafness a risk factor for cognitive impairment
• Parkinson’s disease: 80% cognitive impairment after ten years
• Down syndrome and learning disability associated

3. Preventing well
Diagnosing well
Supporting well
Living well
Dying well

4. www.england.nhs.uk
0
50000
100000
150000
200000
250000
1995 2015
Newdementiacasesperyearin
theUK
Reduction

5. 0%
10%
20%
30%
40%
50%
60%
70%
80%
0
50
100
150
200
250
300
350
400
450
500
2010-11
2011-12
2012-13
2013-14
31-Aug
30-Sep
31-Oct
30-Nov
31-Dec
31-Jan
28-Feb
31-Mar
30-Apr
31-May
30-Jun
31-Jul
31-Aug
30-Sep
31-Oct
30-Nov
31-Dec
31-Jan
29-Feb
31-Mar
30-Apr
31-May
30-Jun
31-Jul
31-Aug
30-Sep
31-Oct
30-Nov
31-Dec
Annual 2014-15 2015-16 2016-17
Diagnosisrate
Countofdementiadiagnoses(thousands) Dementia diagnoses – 2011 to 2017
Count of diagnoses - all ages

6. www.england.nhs.uk

7. www.england.nhs.uk
➢ Older people are underrepresented among the population
accessing IAPT.
➢ The proportion of people over 65 years old referred to
IAPT (8.2%) is improving, but lower than their share of
the general population (approx.12%).
➢ 2017/18 and 18/19 Quality Premium includes an
incentive for CCGs to improve access for older people
Improving Access to Psychological
Therapies (IAPT)
Accessing treatment
➢ Once referred, a similar proportion of older adults
complete treatment compared to their working age
counterparts.
➢ Recovery rates for older people consistently outperform
working age people: 62.2% in Q2 2016/17 compared to
47.6% for working age adults.
Recovery
0.0%
1.0%
2.0%
3.0%
4.0%
5.0%
6.0%
7.0%
8.0%
9.0%
10.0%
0
5,000
10,000
15,000
20,000
25,000
Q1
14/15
Q2
14/15
Q3
14/15
Q4
14/15
Q1
15/16
Q2
15/16
Q3
15/16
Q4
15/16
Q1
16/17
Q2
16/17
Numbers and proportion of referrals
for older people
20.0
30.0
40.0
50.0
60.0
70.0
80.0
Q1
14/15
Q2
14/15
Q3
14/15
Q4
14/15
Q1
15/16
Q2
15/16
Q3
15/16
Q4
15/16
Q1
16/17
Q2
16/17
IAPT Recovery % for working age and
older adults
18 to 64
65 and over

8. www.england.nhs.uk
PHE Fingertips Tool
https://fingertips.phe.org.uk/profile-group/mental-health/profile/dementia
Clinical Commissioning Group Improvement and Assessment Framework
https://www.england.nhs.uk/commissioning/ccg-assess/iaf/
https://www.england.nhs.uk/stps/
NHS Right Care
https://www.england.nhs.uk/rightcare/intel/cfv/data-packs/
Dementia United
http://dementiaunited.net/
Dementia Advisers
https://www.alzheimers.org.uk
Dementia Pathway
https://parkinsonsacademy.co/2017/02/15/new-dementia-toolkit
NHS Benchmarking
https://www.nhsbenchmarking.nhs.uk/
Modelling Dementia
http://www.modem-dementia.org.uk
Care planning
https://www.england.nhs.uk/mental-health/resources/dementia/

9. www.england.nhs.uk
Dementia perceptions
Alistair.burns@nhs.net
07900 715549