National dementia strategy: 2017-2020

Forewords

Foreword by Maureen Watt MSP, Minister for Mental Health

Improving care and support for people with dementia and those who care for them has been major ambition of this government since 2007. Over the last decade, dementia services have been transformed, with excellent contributions from staff working across health and social care, the public, third and independent sectors. Scotland can be proud of its work on dementia, which is regarded as world leading.

The Scottish Government has the ambition to go further, and we know this ambition is shared across Scotland. We share Alzheimer Scotland's vision where people with dementia and those who care for them have access to timely, skilled and well-coordinated support from diagnosis to end of life which helps achieve the outcomes that matter to them.

This is Scotland's third National Dementia Strategy. It is based on our learning developed from delivering the previous two strategies. Our first strategy was published in 2010 and focused on improving the quality of dementia services through more timely diagnosis and on better care and treatment. The second focused on improving post-diagnostic support and strengthening integrated and person-centred support.

Our third strategy maintains a focus on improving the quality of care for people living with dementia and their families through work on diagnosis, including post-diagnostic support; care co-ordination during the middle stage of dementia; end of life and palliative care; workforce development and capability; data and information; and research. Crucially, within this strategy, there is a recognition of the importance of taking a person-centred and flexible approach to providing support at all stages of the care journey.

Changing and modernising dementia care to ensure our shared vision is realised is an enduring commitment for this government and one on which we will continue to give a distinct and strong focus. I look forward to working with you all over the next three years to meet this ambition.

Foreword by Convention of Scottish Local Authorities ( COSLA)

COSLA welcomes the third Scottish National Dementia Strategy and the progress which has been made to date. The third strategy rightly challenges us to go further for people and their families. It is critical we continue to improve the care and support for people with dementia, and COSLA welcomes the focus on anticipating people's care needs and on palliative and end of life care. Earlier diagnosis and more flexibility to deliver services will improve outcomes for people with dementia, their partners, families and carers.

We cannot ignore that there are financial restraints facing all sectors and it is only right that we and all our partners review how we provide support to individuals with dementia. If we want people with dementia to live at home or in homely settings, which we do, we need to ensure we support families and carers. We also need to continue to move resources into community care. This means we need to press on with the re-design of local dementia care services. To deliver these improved services strategic planning involving health & social care partnerships and the third and private sector will be vital in ensuring we have the skilled health and social care workforce necessary to deliver improved services for individuals.

By working with our partners, local government will strive to deliver better services and better health outcomes for people with dementia now and into the future.

Councillor Peter Johnston
COSLA Health and Wellbeing Spokesperson

Foreword by Alzheimer Scotland

Alzheimer Scotland welcomes this third national dementia strategy for Scotland. We believe that it demonstrates a long term commitment of the Scottish Government to improving the lives of people with dementia and those who care for them in Scotland.

We welcome the new commitment within this strategy to go beyond the initial guaranteed minimum of one year's post diagnostic support and to offer those individuals diagnosed early with a named Link Worker who will continue to use the 5 Pillar approach and who will now support each person for the duration of their time living with dementia, until such times as their needs change and they require greater care co-ordination. We also welcome the commitment to ensure that those individuals who are diagnosed later and whose needs are more appropriately delivered using the 8 Pillar model receive their post diagnostic support from a named Dementia Practice Coordinator from that point through to the advanced stages of the illness.

We believe that these changes will further enhance the quality and person centred nature of the support we provide to each person living with dementia and their family and will continue to build on Scotland's reputation for world leading progressive dementia policy. Alongside this the commitment to test the Advanced Dementia Practice Model and the focus on end of life care takes us closer to achieving our shared vision of the best possible support for people living with dementia from the point of diagnosis to the end of life.

The opportunity to start testing how we can best provide earlier support to people within a primary care environment and to continue to work to ensure that communities throughout Scotland are as dementia friendly as possible are both critical elements in the transformation of our system and society. The ongoing commitment to Promoting Excellence and the commitment to the new Allied Health Professionals framework Connecting People, Connecting Support will add depth to our practice base, as does the ongoing work to improve our Acute Hospitals, Specialist Dementia Units and Care Homes.

It is ten years since dementia was made a national priority for Scotland and in that time we believe that significant progress has been made. However, despite this progress much more remains to be done. The gap between the policy commitments found in all three strategies and the real life experience of many people is far too wide.

We recognise that delivering the aspirations of this strategy will require local investment. The returns on this investment for people with dementia and their families are immeasurable. The potential return for the system however can be measured and will include significant delays in admission to residential and other formal care services, avoiding unnecessary admission to hospitals and preventing unhelpful crisis driven service responses, building capacity across our community to become the mainstay of support. Investing in and delivering the strategy is the only way to realise these returns and it must become a key priority for every local area.

We will do all that we can to work with local partners to deliver on this strategy and to make sure the collective voice of people with dementia, their families, carers and our members are as strong and as engaged as possible throughout Scotland.

Henry Simmons
Chief Executive, Alzheimer Scotland

Foreword by Scottish Dementia Working Group Office Bearers

We at the Scottish Dementia Working Group ( SDWG) are pleased to be asked to write the foreword to Scotland's Third National Dementia Strategy. Over the course of the previous two strategies, we have seen how dementia services have continued to develop in line with the commitments of those strategies, whilst acknowledging that there is still much to be done. We truly value being an equal partner in this work alongside our colleagues in Scottish Government, Alzheimer Scotland and the National Dementia Carers Action Network. Through contributing to the dialogue events which informed the strategies and speaking up at the National Expert Advisory Group overseeing their implementation, we continue to make sure that the voices of those living with dementia are heard.

In particular, our members value the on-going recognition of the importance of appropriate post-diagnostic support, based on their own experiences. We support the plans to develop this service further to ensure that it is delivered in a person-centred and flexible way.

We believe the moves to test post-diagnostic services within primary care settings and to provide support to Integration Authorities will be vital in ensuring the best outcomes for people with dementia. Having worked for a long time with our colleagues in NHS Education for Scotland and the Scottish Social Services Council, we are also delighted to see a further commitment to supporting the implementation of the Promoting Excellence framework in the third Strategy.

Increasing the use of technology with our members is one of our own priorities, so we look forward to seeing the impact of the Technology Charter in enabling people with dementia to live safely and freely. This, combined with the growing work around dementia friendly communities has the potential to impact positively on the daily lives of individuals with dementia and their families.

Within SDWG, we will continue to strive to represent the voices of people with dementia across Scotland, in particular by developing our local links so that together we can be listened to by Integration Authorities. We think that the commitments outlined in this strategy will help ensure the right care and support at the right time and place for everyone and we look forward to seeing this happen.

Foreword by National Dementia Carers Action Network

Alongside colleagues from Alzheimer Scotland and the Scottish Dementia Working Group ( SDWG), the National Dementia Carers Action Network ( NDCAN) has been involved from the beginning in the development of Scotland's third dementia strategy. Our particular emphasis is to ensure that the challenges faced by dementia carers are reflected and addressed. NDCAN has encouraged dementia carers from across the country to contribute their ideas and concerns through the dialogue events and also through written contributions. We have also had representation at the National Expert Advisory Group. NDCAN welcomes the strong emphasis on dementia carers in the new strategy; particularly the acknowledgement that carers own needs must be recognised and addressed. The links to other, related policies such as the Carer's Act are important and NDCAN commits to encouraging local decision-makers to join up the various strands of support.

Carers of people with dementia repeatedly tell us that, when their family receives high quality and consistent post-diagnostic support, it is 'transformational' to the lived experience. Early diagnosis, coupled with access to appropriate information and support delivered by skilled link workers, helps build resilience for dementia carers, and this can positively benefit their health and well-being. NDCAN is keen to support the testing of post-diagnostic support in primary care. This model has the potential to improve the experience of caring at home, as do many of the other commitments.

All the commitments are welcomed. NDCAN is particularly supportive of the explicit commitment to modernisation of the care home sector. This, in conjunction with the on-going implementation of the Promoting Excellence framework, has the potential to transform the lives of many residents and their families, as well as improving the work experience of staff. NDCAN is passionate about the commitment to improve palliative and end of life care for people with dementia, and hopes that this will extend to care homes as well as NHS settings and the community. We remain convinced that recognising and encouraging the critical input of family carers into all these improvement activities will ensure stronger and more positive outcomes. NDCAN has a vision of a dementia-friendly and carer-friendly Scotland, from acute hospital services to local communities. The commitments in this third dementia strategy provide many practical ways to enable this. NDCAN recognises that the strategy will be realised in local communities and that there is much to do with representatives on integrated health and social care boards to make the vision a reality. Working with Alzheimer Scotland and other carer organisations, NDCAN plans to ensure that local dementia carer groups are empowered to influence their local boards about the potential positive impact and benefits of implementing this wide-ranging and exciting strategy.