New NHS data reveals a record number of dementia diagnoses in England, but significant regional disparities and a failure to meet pre-pandemic diagnostic targets underscore ongoing challenges

In a striking development, recent NHS figures reveal that England has reached a new peak in dementia diagnoses, with 487,432 individuals receiving a diagnosis by June 2024. This record number, however, comes with a sobering caveat: the diagnosis rate still lags behind pre-pandemic levels and falls short of the NHS’s 66.7% target, which was last achieved in 2019.

England stands out for having one of the highest dementia diagnosis rates globally, a testament to the dedication of its healthcare professionals. High-income countries generally have diagnosis rates between 20-50%, and England’s success is attributed to proactive assessments conducted by specialist nurses and staff in care homes. These efforts have been instrumental in identifying those suffering from dementia, but they have not eliminated the gaps in the system.

A significant barrier is the disparity in access to diagnostic services across different regions. A recent report from the all-party parliamentary group (APPG) on dementia highlights that over 115,000 people with dementia remain undiagnosed due to geographical variations in healthcare quality. The discrepancy is stark, with some areas showing up to a 45 percentage point difference in diagnostic rates.

Several structural challenges contribute to this inequality. Cultural differences, difficulties in accessing general practitioners, long wait times for memory assessments, and a lack of resources such as scanners and transport options all play a role. The APPG has urged the government to enhance scanning capacity and the workforce and for NHS integrated care boards to develop strategic local plans to address these disparities.

Timely diagnosis is crucial as it allows individuals to access the necessary support and care to manage their condition effectively. The NHS is encouraging those who exhibit early symptoms of dementia, such as memory loss, repetitive speech, difficulty in following conversations, and confusion about time and place, to seek medical evaluation. Family members and friends are also encouraged to support individuals who may be showing these signs to visit their GP.

Dr. Jeremy Isaacs, NHS England’s national clinical director for dementia, acknowledged the significant progress made over the past year. “NHS staff have worked diligently to recover services, resulting in a notable rise in dementia diagnoses. However, we must continue to improve,” he said. The NHS has seen a substantial increase in monthly diagnoses and medication reviews, with 86,434 individuals having their medication reviewed in the past 12 months, up from 77,112 the previous year.

Dr. Alex Osborne, policy manager at the Alzheimer’s Society, emphasized the importance of early and accurate diagnoses. “An early diagnosis is crucial for accessing care and treatment,” she said. “Yet, a third of individuals with dementia in England lack a diagnosis, missing out on essential benefits. Regional variations in diagnosis rates need to be addressed urgently.”

Research from University College London (UCL) suggests that dementia incidence in England and Wales has been rising since 2008. Projections indicate that up to 1.7 million people could be living with dementia by 2040, a 40% increase from previous forecasts. This rise is largely due to an ageing population, though it is also evident within age groups.

The researchers have labelled dementia an “urgent policy problem” that necessitates increased investment in social care to manage the growing demand.

Analysis:

• Political: The record number of dementia diagnoses reflects both progress and ongoing challenges in the NHS. While the rise in diagnoses showcases the effectiveness of proactive healthcare measures, the failure to meet pre-pandemic targets and the regional disparities highlight the need for government intervention. The APPG’s call for increased scanning capacity and strategic local plans underscores the necessity for political action to address these gaps and ensure equitable healthcare across England.
• Social: The data reveals a significant social issue, with a considerable number of individuals remaining undiagnosed due to regional disparities. This reflects broader societal inequalities in healthcare access and underscores the importance of addressing social determinants of health. The emphasis on early diagnosis and support also highlights the need for greater public awareness and family involvement in managing dementia.
• Racial: Although the data does not specifically address racial disparities, it is important to consider that healthcare inequalities often disproportionately affect minority communities. Ensuring equitable access to diagnostic services and addressing cultural barriers are crucial steps in reducing disparities and ensuring that all individuals receive timely and appropriate care.
• Gender: Dementia diagnosis rates may also be influenced by gender, with women being more likely to develop dementia due to their longer life expectancy. However, the data does not provide a gender-specific breakdown. Addressing gender-related factors in dementia care and diagnosis is important for ensuring that both men and women receive the support they need.
• Economic: The economic implications of dementia are substantial, with increasing incidence driving up healthcare costs. The need for greater investment in social care and diagnostic services is evident from the current data. Addressing these economic challenges requires strategic planning and resource allocation to manage the growing demand for dementia care and support effectively.