Dementia strategy in Scotland: College comments

The Scottish Government published its new dementia strategy on 31 May, which it describes as a "10 year vision for change". The strategy can be read here. The College has a deep interest in medicine of the older adult, including dementia. 

In response to the strategy, Professor Andrew Elder, President of the Royal College of Physicians of Edinburgh said:

Dementia already affects the lives of many people in Scotland and many more will be affected in the decade this strategy covers. Whilst the College welcomes the new dementia strategy, more detail is needed if we are to fully understand how the needs of patients and their families will be met.

Key to this ambitious plan is delivery, and in order to do that, services require adequate support and staffing levels. Fundamentally, we need a properly funded workforce in health and social care with sustained investment across the sector. Specific services such as psychiatry, geriatric medicine and neurology and brain health must be developed, with clear referral and care pathways and much shorter waiting times, so that people can access therapy and information when they most need it. Workforce shortages across medicine, nursing, allied health professionals, social work and social care all impact on dementia care.

It’s also vital that geographical inequality in staffing and resources is addressed. For example, the north of Scotland has 1 geriatrician per 65,000 population compared to the national average of 1 per 36,000. Addressing this issue would help ensure consistency of care across Scotland. In addition, services to support informal carers, such as respite care must be developed.

Finally, people living with dementia frequently suffer from additional comorbid physical conditions and thus use many parts of the health service – not just those directly charged with dementia care. As such, all areas and all staff within our health service must be trained to care for the patients with dementia that they will increasingly encounter.

If the care of people with dementia is to meet the aspiration of equality noted in the strategy, all hospital and community staff - in almost all disciplines and specialties - must be trained to cater to the specific needs of this growing patient group.