Scottish Government’s Programme for Government 2026-2031

The Scottish Government’s Programme for Government 2026-2031, Ambitious for Scotland, promises a stronger focus on prevention, better integration between health and social care, and more care delivered in people’s homes and communities.

These ambitions matter enormously to people living with dementia, their families and carers. Despite this, dementia and brain health are not explicitly mentioned in the Programme.

Dementia is already a major part of Scotland’s health and care landscape. In 2025, dementia and Alzheimer’s disease was the leading classified cause of death in Scotland, accounting for 10.8% of all deaths (6,685). In available health and social care data, more than 60,000 people were recorded as living with a confirmed diagnosis of dementia, although we know the true number is likely to be much higher. Moreover, a recently published report by University College London found that one in six hospital beds in the UK are occupied by people with dementia.

Alzheimer Scotland’s new Dementia in Scotland 2026 position paper – submitted to the Scottish Government and Dementia Policy Team earlier this month – argues that the problem is not a lack of policies or good ideas. We have a 10-year national dementia strategy, Everyone’s Story, evidence of what works and many examples of good practice. What is missing is consistent implementation. People still experience delays in diagnosis, uneven access to support after diagnosis, fragmented services, geographical variation, and a lack of timely support that can leave families dealing with problems on their own until they reach a crisis point.

This is where dementia has an important connection to the wider Programme for Government.

Take prevention, for example. Prevention is sometimes simply understood as trying to stop someone developing a disease. For dementia, though, prevention also means preventing avoidable deterioration, crisis, and hospital admission once someone has a diagnosis. It means providing the right support early enough to help people remain independent and well in their own homes and communities.

It is for this reason that services such as Post Diagnostic Support (PDS) and dementia day care matter.

Scotland has had a commitment to offer at least a year of support following diagnosis for more than a decade. While a recently published, independent evaluation of Scotland’s Dementia Post Diagnostic Support (2026) highlights the significant positive outcomes of receiving PDS, the report also estimates that only 50.6% of people newly diagnosed with dementia in 2023/24 were referred for the service. It goes without saying that a guarantee people cannot reliably access and depend on is not yet a guarantee in their lives.

Alzheimer Scotland’s research into day care, Dementia Day Care Matters (2025), tells a similar story. Evidence shows that day care can improve wellbeing, reduce loneliness, maintain independence, and support family carers. It can also help prevent earlier admission to hospital or residential care. However, at the same time, our research highlighted that access to and charges for day care vary substantially across Scotland, while services face continued funding and staffing pressures.

The Government’s commitment to care closer to home is also directly relevant to people living with dementia. The Programme for Government promises to expand “Hospital at Home”, strengthen community services and create better connections between health, social care, and housing. These are exactly the kinds of changes that can help reduce avoidable hospital admissions and delayed discharge for people with dementia.

The same is true of the proposed reform of social care and public services. Over the coming months, the Government intends to consult on the future shape of social care, while also changing NHS structures and seeking greater integration between health and social care. For people with dementia, the test of these reforms should not be whether organisations have successfully rearranged themselves but whether they experience a simple, more joined-up system,

There are other important connections. Better housing and adaptations can help people remain safely at home for longer. Investment in the social care workforce is essential to delivering community-based support. Improved data could help identify unacceptable inequalities in care provision between different parts of Scotland. Meanwhile, the proposed Human Rights Bill provides an opportunity to strengthen the rights of people with dementia and their carers.

Alzheimer Scotland’s manifesto, the Dementia Care Pathway Guarantees, offer a practical way to bring these ambitions together. They set out the minimum expectations that people should have at different stages of dementia: from timely diagnosis and PDS, through care coordination, community and respite support, dementia-skilled care at home and appropriate specialist and palliative care.

The Guarantees are not a new set of aspirations sitting alongside the Government’s plans. They are a way of making existing ambitions tangible, measurable and accountable. They could help Scotland shift resources upstream: away from unmanaged deterioration and emergency responses, and towards planned support, prevention and care in people’s homes and communities.

For this reason, dementia must be part of the conversation about Scotland’s wider programme of reform. Getting dementia care right is not only about improving services for one group of people. It is also a practical test of whether Scotland can deliver on its promises of prevention, integration and care closer to home.

Scotland has the evidence, it has the experience, and crucially it has people living with dementia and carers who have repeatedly helped shape what better care should look like.

The question now is whether they will see those aspirations translated into expectation; or, as we conclude our position paper:

“Can a person living with dementia, or someone caring for them, identify what has become tangibly better in their lives because of Scotland’s dementia strategy?”

The next two-year delivery plan of the dementia strategy must make sure the answer is yes.