Now is the time to transform dementia care

November 15, 2024

Nurse comforting senior patient — image: ©MartinPrescott | iStock

Dementia is the leading cause of death in the UK, having a huge impact on people living with the condition, their families and the health systems supporting them. We hear from Dementia UK’s Andrew Pike, Head of Policy, Campaigns and Public Affairs, about how the UK Government can help to alleviate these pressures, most notably through aiding specialist nursing support

The UK Government has issued what it has called a rallying cry to the nation—Wes Streeting, the Secretary of State for Health and Social Care, has called on us to take part in a consultation to shape an overhaul of the NHS.

The consultation will run over several months, the urgency of its message that reform is needed amplified by the annual winter pressures that put strain on our NHS and its acute care provision. It won’t be until next spring, as the pressures start to recede, that we’ll hear what solutions emerge, but it is vital that the remedy offered meets the needs of those living with and affected by the UK’s leading cause of death, dementia. (1)

The prevalence of dementia in the UK

During the first year of this new Government, the number of people living with dementia in the UK is expected to exceed one million.(2) Yet, despite the best efforts of health and social care professionals, the needs of those living with the condition remain in a perilous state, exacerbating the worst aspects of NHS winter pressures for both individuals and the healthcare systems that support them.

People with dementia make up an estimated quarter of all patients using hospital beds, and these numbers are rising – the number of people with dementia who were admitted to hospital in an emergency increased by 70% between 2012 and 2018. (3) On average, people with dementia also experience hospital stays more than twice as long as those over 65 who don’t have the condition (4) and are at a greater risk of seeing a deterioration in their condition during their stay. (5)

With a system under strain, we know that existing teams in hospitals can’t always dedicate or provide the specialist knowledge and support needed. Families affected by dementia tell us that there can be a lack of understanding on issues such as how to support someone to eat and drink, obtaining consent for blood tests, end-of-life care or how to help people with rarer and more complex forms of dementia, such as young onset dementia (where symptoms occur before the age of 65).

Dementia specialist Admiral Nurses

Fortunately, there is a solution that some hospitals have already been successful in adopting. Dementia specialist Admiral Nurses support people affected by dementia during hospital stays and discharge processes. Experts in providing integrated, person-centred care and supporting complex needs, they use their specialist knowledge to provide emotional support and practical advice for unpaid carers and encourage families’ active participation in decision-making. They also educate and advise health and social care professionals on dementia care best practice so that any issues that arise during the hospital stay are understood and addressed by staff.

Fundamentally, a dementia specialist nurse service ensures the person with dementia’s needs are met both inside and outside of the hospital, providing the reassurance, empathy, consistency, and dementia-specific knowledge vitally needed within acute care.

As the UK’s specialist dementia nursing charity, at Dementia UK we hear every day from people who are supported by our Admiral Nurses and see first-hand the improvement they make. In one year, an Admiral Nurse service within Southport and Ormskirk Hospital supported 365 people with dementia and their families and provided 171 staff with Dementia Champions training, ensuring a greater understanding of dementia across the trust.

And if the human impact isn’t enough, having Admiral Nurses embedded in acute trusts saves money. In an eight-month audit of an existing Admiral Nurse hospital service, it was found that up to £100,000 was saved through preventing avoidable readmissions, and an estimated £500,000 was saved from enabling people to return home as opposed to a care home or residential home. All told, with other cost savings from across the system, there were estimated savings of over £790,000.

Despite this, there are currently only 68 Admiral Nurse posts across 38 hospitals in England. In 2023, there were 704 hospitals in England, and quick maths concludes that only 5% of hospitals in England are currently benefiting from the support of an Admiral Nurse, leaving thousands of people with dementia in hospital settings without the support they so urgently need.

The last iteration of an NHS Long Term Plan, the one the new consultation seeks to replace, committed to specialist diabetes nurses in every acute setting to improve recovery and reduce lengths of stay and future readmission rates. With a new Health Secretary at the reigns, a chancellor seeking to save public money, and what is billed as the biggest national conversation on the future of the NHS since its birth, the timing couldn’t be better for a new commitment for those living with dementia.

As the new Government reassesses the fabric of how our health service is delivered, it must take the opportunity to deliver the specialist nursing support that people with dementia need to reduce avoidable hospital admissions, tackle unnecessary length of stays, and ensure that discharge is safe and sustainable. It’s good for those living with and affected by dementia and those working in the NHS, and it would relieve overstretched capacity and strained budgets. But when one in two of us will be affected by dementia in our lifetime, for a new Government, it’s also good politics.