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Dementia strategy will fail unless cash is diverted to GPs, says spending watchdog

By Lilian Anekwe

The Department of Health has been criticised for launching its national dementia strategy without investment in primary care and a ‘robust approach to implementation' by the public finances watchdog.

An interim report by the National Audit Office concluded the strategy, launched amid much fanfare in February 2009, is unlikely to deliver value for money unless ‘weaknesses are urgently addressed' in funding and GP training.

As the DH does not have evidence on current and future costs and benefits of the strategy it is ‘likely to cost much more than the estimated £1.9 billion over ten years', and will fail unless cash is diverted from the acute sector to primary care, it warned.

It is also doubtful whether the implementation of the strategy can be funded through NHS efficiency savings. Instead, the DH should shift cash from the acute sector to primary care.

‘The Department expects implementation of the strategy to be mostly funded through efficiency savings arising from the acute hospital and long-term care sectors.

‘However, this will be difficult to achieve without the releasing or redirecting of resources from secondary to primary care …particularly in a time of financial constraint.'

The funding should be used to develop outcome measures for dementia in the quality and outcomes framework, the report recommended.

‘Since 2007 GPs receive financial rewards for two aspects of dementia care: maintaining a dementia register, and review of dementia patients every 15 months. Although performance has improved, it focuses on inputs and not outcomes', it states.

Edward Leigh MP, chairman of the parliamentary committee of public accounts, called on the DH to ‘demonstrate this strategy is not just fine words'.

‘The Department should be given credit for developing the strategy, which is comprehensive and ambitious, but what is the point of a plan without the necessary tools to make change happen?

Shadow minister for health Stephen O'Brien said: ‘This report gives the lie to the Government's so-called commitment to dementia. It is clear that Ministers think that warm words are enough, and have washed their hands of delivery.'

Phil Hope, care services minister, said the Government would give careful consideration to all the recommendations made in the report.

The dementia strategy may not deliver value for money, the NAO report said Improving Dementia Services in England – an Interim Report


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