The shift to system working has helped to improve the diagnosis of dementia, according to research by think tank The King’s Fund.
The study looked at the development of ICSs, how they approach dementia and the opportunities to improve diagnosis of the condition using three case studies: Staffordshire and Stoke on Trent, Cornwall and North East London ICSs.
It found that there were pockets of improvement across the ICSs due to better collaboration between parts of the system, with efforts to strengthen relationships between primary care, memory clinics and other services particular ‘enablers of improvement’.
The authors noted that most of the progress in dementia care was rooted in partnerships created before ICSs were introduced two years ago.
But, they added that ICSs would have a ‘crucial’ role in the future of dementia care.
The report said: ‘Progress so far has been mixed. The two years since ICSs took on their current statutory form have been among the most challenging for health and care services since the NHS was founded. In this context, it is unsurprising that the examples of improvement we looked at in this research tended to have longer roots, pre-dating the formal existence of ICSs.
‘However, the underlying shift towards system working over the past decade has been part of the improvement journey and ICSs are now the vehicle for taking this forward.
‘In the short term, ICSs can play a crucial role by helping local organisations agree shared priorities for dementia and a plan for delivering improvement, and then providing visible cross-system leadership and effective governance for overseeing the delivery of this plan.’
Improvements to be made
The report suggested there were further opportunities for improvement, for example organisations within ICSs could work more closely to shift resources towards prevention and early diagnosis, and to coordinate training on this. Poor links within the system also still existed, with variation in ownership, leadership and prioritisation at local level.
The authors recommended that the government and NHS England ensure there is national policy and accountability arrangements to help promote partnership working, and to give ICSs the support they need to test and scale up new approaches to dementia diagnosis.
The report said: ‘In the longer term, ICSs need to be systematically building capacity across the system for testing new approaches, learning, and scaling and spreading successful innovations and ways of working. The possibilities regarding dementia diagnosis and care may change significantly over the coming years, and ICSs need to have the infrastructure in place to support ongoing adaptation and improvement as changes occur.’
It added: ‘To make the most of their potential, ICSs need to be supported and permitted to work differently. Government and NHS England have an important role to play here – ensuring that national accountability and policy helps rather than hinders collaboration and partnership working in local systems.
‘Doing so will give ICSs the best chance of delivering meaningful improvements for people with dementia and other long-term conditions.’
