The role of integrated care systems in improving dementia diagnosis (18 April 2024)

Summary

Alzheimer’s Society estimates that there are currently around 900,000 people living with dementia in the UK. Unlike other major conditions, there is no national clinical pathway for dementia, and despite there being a national target, there is wide variation in dementia diagnosis rates across England. 

Alzheimer’s Society commissioned The King’s Fund to explore the development of Integrated Care Systems (ICSs) through the lens of dementia diagnosis—to consider what opportunities ICSs present to approach dementia differently and to improve diagnosis rates by doing so. The research team explored enablers and barriers to improving dementia diagnosis through interviews with stakeholders and people affected by dementia in three case study ICSs.

Content

Key messages

• High-quality dementia diagnosis and care involves many different parts of the health and social care system working together effectively. Integrated care systems (ICSs) were created to achieve this kind of whole-system approach.
• Early and accurate diagnosis means people living with dementia can access support that can help to improve their quality of life, and potentially treatments that can help with managing symptoms. Diagnosis also enables people and their families to plan ahead.
• Improvements in dementia diagnosis in the three case study sites involved in our research are the result of several years’ work and are not attributable to the introduction of statutory ICSs in 2022. However, their broad emphasis on working together as a system over the past decade has helped to create positive conditions for improvement.
• Key enablers of improvement in the sites we examined included efforts to strengthen relationships between primary care, memory clinics and other services; public awareness-raising activities; and the introduction of new extended roles for GPs (for example, to improve diagnosis in care homes).
• In the longer term, ICSs need to build the capabilities and processes required to support testing new approaches, learning, and scaling and spreading successful innovations. This will need support from the government, NHS England and other national bodies.

ICSs can contribute to improved dementia diagnosis by:

• ensuring all partner organisations have shared priorities and an agreed plan for delivering improvement
• providing visible cross-system leadership and effective governance arrangements for overseeing the delivery of the plan
• connecting people working in different parts of the system, building mutual understanding and reinforcing a culture of collaboration
• sharing learning and spreading good practice
• supporting action at scale across larger geographies
• addressing inequalities by ensuring sufficient attention is paid to improving diagnosis rates in underserved communities.