Scottish Parliament Update December 2007

Parliamentary question - Dementia priority

Mary Scanlon (Con – Highlands and Islands) asked the Government how it plans to prioritise improvement in the diagnosis, care and treatment of people with dementia, as referred to in Scottish Budget: Spending Review 2007.

Shona Robison Dementia is a priority for the Scottish Government. I have established a Dementia Forum to provide input and advice on all aspects of the dementia agenda. The forum has contributed to the consideration underway on the development of a dementia based HEAT target for NHS Scotland to drive further change, particularly to reduce undiagnosed dementia.

GP’s are already paid for maintaining a register of those with dementia and for undertaking an assessment of their mental and physical health needs. A new standard for an integrated care pathway for dementia will be published next month which amongst other key aspects will highlight the need to help both the person with dementia and their carer. A lead clinician has been appointed in each area to take forward the implementation of this and other standards.

The needs of those with dementia and their carers are also being considered in the current review of NHS Continuing Care which reports early next year. We are also considering what aspects of health improvement and awareness raising are needed for the dementia interest and will be involving stakeholder organisations including Alzheimer Scotland, Help the Aged and Age Concern in this attention.

The Scottish Government Chief Scientist Office is currently funding three research
projects on dementia and we have provided over £1million this year to local authorities to support local dementia projects across Scotland through our Mental Health Specific Grant scheme. Funding is also provided to the Dementia Services Development Centre and to Alzheimer Scotland for events and materials that advance understanding and better responses for those with dementia and their carers.

Prescription charges
The cost of prescription charges and pre payment certificates will reduce over the next 3 years and will be abolished for everyone in Scotland by 2011. The initial intention was to expand the list of chronic conditions exempt from prescription charges with immediate effect, but this was considered too time consuming and difficult to ensure that the list was comprehensive.

Better health better care action plan
The Scottish Government has published its action plan for the NHS and dementia has received a reasonable amount of coverage including:

• From 2008 dementia will be regarded as a national priority.
• A HEAT (health, efficiency, access and treatment) target will be set to increase the early diagnosis of people with dementia. Each health board will be measured on an agreed target for the number of people newly diagnosed with dementia each year by March 2011.
• The Government has stated it will develop guidance and support tools to help make all primary care buildings dementia friendly, identifying and building on examples of good practice across Scotland.
• A Mental health Collaborative will be launched in April 2008 to share good practice and drive the delivery of new commitments on dementia.

The publication is available to view at:
http://www.scottishexecutive.gov.uk/Publications/2007/12/11103453/0

Standards for integrated care pathways for mental health

NHS Quality Improvement Scotland has just published integrated care pathways for mental health, which include condition specific standards for dementia. The standards have four parts:

• Process standards that describe the keys tasks which affect how well integrated care pathways are developed in a local area.
• Generic care standards describe the interactions and interventions that must be offered to all who access mental health services.
• Service improvement standards that measure how integrated care pathways are implemented and how variations from planned care are recorded and acted on.
• Condition specific care standards that build on the generic care standards and describe the interactions and interventions that must be offered by mental health services to people with a specific condition. The condition specific standards are for dementia, depression, borderline personality disorder, bipolar disorder and schizophrenia.

The publication is available at
http://www.nhshealthquality.org/nhsqis/3874.html