The Stability of the NHS May Lie in Dementia Cure

Within the NHS, private residential care homes stand at the center of the UK’s healthcare system. Providing housing and ongoing care for the elderly (those aged 85 and over) is necessary for one in every six individuals, equating to over 425,000 in Britain alone. These individuals represent one of the most vulnerable population groups, as many struggle with maintaining a quality of life while undergoing treatment for mental health concerns such as dementia, placing a heavy burden on the country’s health system. As the total population of individuals over the age of 85 continues to grow, with the estimated 1.4 million increasing to 3.5 million by the year 2035, threat of instability and underfunding within NHS looms. One report cites that within five years, the funding gap for the NHS will exceed £1.1, per year. Without action, the NHS faces a stark battle in providing a high level of quality care to the patients who need it most.
 
The Cost of Dementia
 
The Alzheimer’s Society produced a research report focused on the patient population with dementia within the UK, citing more than 850,000 suffer from the mental illness currently. The cost of caring for those with dementia spans a number of institutions, including the NHS, and the individuals who formally and informally provide care, such as family members. The total number of patients with dementia costs the UK £26 each year, broken down into unpaid care, private social care and financial burden to the NHS directly. This total cost reveals a 24% increase over the last Alzheimer’s Society report on dementia in the UK, conducted in 2007.
 
As the population continues to age, and prevalence of dementia remains a constant among older patients, the total cost of care has nowhere to go but up. These trends negatively impact the funding structure of NHS, given that care for dementia is free at the point of use for patients but requires a substantial amount of caregiving in the form of medication administration, assistance with activities of daily living, and ongoing treatment of ancillary medical issues.
 
Achievements to Date
 
Although the concerns over the aging population prove challenging, headway has been made with current achievements. To date, more than 600,000 NHS and care staff that focus on social assistance have received training in how to better support patients with dementia. Additionally, more diagnoses of dementia are being provided, now equating to nearly two-thirds of patients suffering from the disease, and over 142 communities within England have agreed to be dementia friendly.
 
Above and beyond advanced training, diagnosis shifts and community involvement, the UK dementia issue is receiving the attention and funding it needs from Government leaders. In 2014, the UK Government held the first ever summit specifically focused on Dementia, and established the Dementia Discovery Fund backed by investors around the world. Nearly £50 million was allocated to creating dementia friendly environments within hospitals and care homes, and £150 million was made available for the development of a national Dementia Research Institute. The Government also drastically increased funding for dementia research, now more than £60 million per year, resulting in record numbers of individuals participating in research on diagnosis and treatment.
 
Future Promises
 
The efforts to create a dementia friendly health care system within the UK is notable, but even more progress is on the horizon. In March of 2016, Health Secretary Jeremy Hunt committed to winning the race to cure dementia, publishing a nationwide plan to increase diagnosis rates, encourage research and raise overall awareness. The plan announced a series of pledges aimed at producing the following results:

• Extending the NHS Health Check to those 40 and older, previously set at 65 and older, in partnership with the Alzheimer’s Society and Alzheimer’s Research UK organizations
• Quality of care comparisons made available to the families of patients with dementia
• Care plans personalized for each patient with dementia direct from their GP
• Initiatives to encourage 10 per cent of dementia patients to participate in medical research studies
• Published standards of dementia care by the Care Quality Commission
• Daily reviews during ward rounds every day of the week for dementia patients (by 2020)

 
National leaders in medicine, including outgoing chairman of the World Dementia Council, Dr. Dennis Gillings, have applauded the recent announcement made by Hunt, and back the initiatives laid out. Gillings is especially optimistic about progress toward the treatment of dementia based on recent studies that show promise, stating in a recent interview that he would not be surprised if disease modification was available as early as 2020. The views of Gillings are supported widely by the medical community, with most focused on a customizable approach to treatment as opposed to a singular tactic.
 
With a cure on the horizon, the need for additional research is paramount. The Dementia Research Institute – initially created in 2015 – aims to be a fully functioning entity by the year 2020. The organization is geared toward bringing together leading experts in the field of dementia diagnosis and treatment in a strategic effort to expedite development of new treatments. The combination of a renewed focus on NHS initiatives directly impacting dementia patients, promising treatment trials and the establishment and funding of the DRI set the stage for a wave of change within the UK for dementia patients.
 
Integration Between Health and Social Care a Necessity
 
As part of the solution to the UKs dementia care problem, the Better Care Fund was established by the Government in 2013. The intent of the organization is to create a partnership between the health care needs of dementia patients and the social aspects of care – a stark difference from the NHS’ primary focus on health care. In a decision to split the allocated funds between the NHS and social care providers was widely accepted across the varied proponents of integrated care solutions, as it had the potential to have a direct impact on the aging population. However, some caveats remain.
 
The dementia care concerns continue to rise as the population ages, causing the cost for care to spiral. Unless a viable system is established and implemented well, caregivers along with those who suffer from the disease stand to reap the negative consequences. According to a representative from Patient Claim Line, a firm of medical solicitors in the UK, the combination of social care and health care is crucial to enabling a degree of independence through at-home care for patients with dementia. Currently, individuals with dementia have little choice but to receive care in a hospital setting, given the overwhelming lack of space in their homes or an otherwise unsuitable environment.
 
Allowing dementia patients the ability to stay home while receiving quality care is a critical component of reducing the costs associated with ongoing treatment facing the NHS. Unfortunately, instead of working toward collaboration between social and health systems, the NHS retaining the lion’s share of the budget only exemplifies its debt load and continuous struggle to promote quality care.
 
In an attempt to promote partnership and budget sharing, the Alzheimer’s Society recently urged the Government to combine its resources with those available through social care programs. The organization reasons that a divided system between health and social care paves the way for a lackluster treatment regimen for patients with dementia who all too often require a combination of services to sustain quality of life. The to-date achievements of the UK Government and promises laid out by Hunt offer a glimmer of hope in correcting the dementia care problem facing the country, and the NHS, but only if collaboration is at the helm.