National dementia strategy: 2017-2020

1. Introduction

Our vision

Our shared vision is of a Scotland 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.

Context

People are generally living longer and their health is better, thanks to improvements in standards of living and healthcare support. Increasing longevity means we need health and social care services that work well together for people who are living with multiple conditions, complex needs and illnesses such as dementia.

In Scotland, the integration of health and social care services has created the conditions needed to ensure coordinated, seamless and person-centred services for those who require support. Integrated services support our approach in responding to the shared public health challenge of dementia. Currently there are 90,000 people living in Scotland with dementia. By 2020 it is estimated that there will be around 20,000 new cases diagnosed each year. We know that more people are developing dementia much later in their lives than previously assumed. This demands that our services are responsive to the range of challenges that people and their families face.

This is Scotland's third national dementia strategy. It builds on our progress over the last ten years in transforming services and improving outcomes for people with dementia, their families and carers. Setting out 21 new commitments, the strategy provides a framework for further action to ensure the realisation of our shared vision for people with dementia and their carers.

Preparation of the strategy

This strategy is the product of collaboration between colleagues from across health, social care and the third sector and includes direct input at every stage from people with dementia, their families and carers. To facilitate this input, the Scottish Government and Alzheimer Scotland hosted a series of National Dementia Dialogue events in 2016 and 2017, which gave people the opportunity to share their views on our proposals. Following these events, the Scottish Government published its proposal for our next three-year strategy. A National Expert Advisory Group also advised us on the nature and development of the strategy and its associated commitments.

Understanding the challenge

There are three main challenges that we must address over the course of this strategy:

1. we must continue to offer timely, person-centred, coordinated and flexible support for people living with dementia and their carers across a range of settings, including hospital and the community. This support should be consistently available to every person living with dementia and their carers

2. building on the progress made around the provision of support after diagnosis and throughout the course of the illness, we must consistently ensure that support is truly person-centred and flexible to take account of individual needs and circumstances

3. we must respond to the increasing proportion of older people developing dementia later in life. While dementia prevalence in Scotland and elsewhere in the world has stabilised, we know from our recent research on dementia incidence that more people are developing dementia even later in life than previously estimated, and are living - often with other significant and life-limiting chronic conditions - for shorter periods of time. ^[1] This means we should continue to embrace the process of redesign and transformation of services. More care should be delivered in our communities, but we must also ensure that palliative and end-of-life care services for people with dementia are flexible and responsive to individual need.