Where does dementia policy go next?

“Tony Blair explained his priorities in three words: education, education, education. I can do it in three letters: NHS,” David Cameron told his party conference in 2006.

‘Having an international summit on dementia is no small achievement when some of the countries involved do not see dementia as a significant issue’

While we can debate whether the prime minister has lived up to this statement, there is little doubt the health issue he has become most associated with tackling is dementia (a personal commitment other areas of disease are envious of).

This will be clearly demonstrated at tomorrow’s G8 summit on the issue, hosted by the PM. That we are having an international summit on dementia is no small achievement when some of the countries involved do not see dementia as such a significant issue. But what can it deliver and how will it play out at home?

Treatment: the ultimate goal

One of three pillars of David Cameron’s “dementia challenge” is to improve research into dementia. This is arguably a pillar in which he can demonstrate immediate success, through doubling the UK’s investment in research by 2015 and celebrating the G8 summit’s outputs.

‘In the absence of any long term treatments, global leaders need to show how they are helping people with the disease to live well’

However, the ultimate goal − an effective treatment or cure − remains out of reach for now. This is where the hopes of many people affected by the disease lie.

Success here will mean showcasing examples of research that have advanced our knowledge of the disease, as well as highlighting areas with potential, now that the issue has a global platform.

In the absence of any long term treatments, global leaders also need to show how they are helping people with the disease to live well.

Equity and excellence

Two years ago, MHP Health’s work with the Alzheimer’s Society found that the government’s reforms of the NHS, while hugely controversial, provided a real opportunity to improve care for people with dementia and their families.

‘National ambition has stalled, with a focus on diagnosis and a lack of incentives to prioritise care and support’

Achieving this required dementia to be embedded within the new system to allow services to be commissioned and incentivised based on the principle of quality.

Today, dementia is a key priority in the NHS mandate and all three outcomes frameworks; providers are rewarded for improvements in care through the national commissioning for quality and innovation, the quality and outcomes framework and enhanced service agreement; and two quality standards for dementia have been published.

But national ambition has stalled, with a focus on diagnosis and a lack of incentives to prioritise care and support.

This has had a knock-on effect; figures published by Parliament for April 2010 to March 2012 show there were nearly half a million emergency hospital admissions for people with dementia, highlighting a fragmentation of care.

The second national audit found dementia patients were persistently receiving poor care in hospital from undertrained staff.

Mr Cameron knows his government’s reforms to the NHS could be toxic for his party in 2015, but in many ways their true impact on patient outcomes is unknown. Showing the G8 and − importantly − the country their potential could reap electoral rewards.

Dementia friendliness

The final element of the prime minister’s dementia challenge is making people and communities more “dementia friendly” − a concept borne out of the World Health Organization’s age friendly initiative and David Cameron’s own attachment to the “big society”.

‘The challenge remains for organisations that have invested in the concept to show what tangible differences dementia friendly communities are making’

In just 20 months, more than 50 towns and villages have committed to becoming dementia friendly communities; industry leaders have published organisational charters; and the process towards national recognition is under way.

But the initiative doesn’t appear to have yet captured the public’s imagination and is still some way from becoming the kind of social movement comparable with, for instance, Movember.

Latest figures show just over 35,000 dementia friends have been recruited so far (I should declare that one of those is me). This is a long way from the target of 1 million by 2015 set by the PM.

Proving the benefit

The challenge remains, too, for organisations that have invested in the concept − and I declare another interest having worked with them − to show what tangible differences dementia-friendly communities are making to people affected by the disease now, compared with 2012.

‘Coming into this summit, David Cameron will know he has to communicate with an international and a national audience’

A further challenge will be making the case for why the same level of state funding should continue beyond 2015.

Would prime minister Ed Miliband − a dementia friend himself − fund a programme so closely attached to his Conservative predecessor?

Coming into this summit, David Cameron will know he has two audiences to communicate with: an international audience in need of a leader to fight a global epidemic and a national audience that is still trying to understand what his personal challenge means for them.

Appease both and he will walk away successful. Failing that, his personal ambition risks falling at the first hurdle.

Ben Nunn is senior account manager at MHP Health