Modern Service Framework for Dementia and Frailty

Baroness Pidgeon Excerpts

Thursday 9th July 2026 Grand Committee

[Baroness Pidgeon (LD)]

My Lords, I am grateful to the noble Lord, Lord Weir of Ballyholme, for tabling this Question for Short Debate and for his comprehensive opening words which set the tone for this short but perfectly formed debate, giving us the opportunity to consider what the modern service framework for dementia and frailty needs to deliver. If it is to succeed, it should set clear national standards backed by funding and accountability so that a diagnosis opens the door to real support and access to new treatments as they become available.

As we have heard, dementia is the UK’s leading cause of death, with almost 1 million people currently living with the condition. This is projected to rise to 1.4 million by 2040. The noble Baroness, Lady Nargund, pointed out that two-thirds of them are women and referred to the interesting research on hormonal changes, the menopause and its links to developing dementia. That is important and something that we need to consider.

Research is advancing rapidly. There are, I understand, 158 drugs in 192 clinical trials globally. The first disease-modifying treatments are now licensed in the UK. However, people can access trials for innovative treatments only when they are diagnosed early—making diagnosis at the earliest stages increasingly important. It would be good to hear from the Minister what work the Government are undertaking to ensure easier access to trials. Alzheimer’s Research UK estimates that close to one-third of people over 65 living with dementia in England still do not have a recorded diagnosis, so closing that diagnostic gap is critical.

A UCL-led trial—supported by the Alzheimer’s Society, Alzheimer’s Research UK, the National Institute for Health and Care Research, Gates Ventures and players of the Postcode Lottery—began testing a blood test for Alzheimer’s disease in NHS memory services last year, offering a simpler, less invasive route to diagnosis than current methods. If this proves reliable, the framework should be ready to support its rollout across the NHS.

As we have heard, Alzheimer’s Research UK has launched a new policy report today, Ready for the Cure: A Blueprint for UK Leadership in Dementia Research, which sets out a series of recommendations to address the key structural barriers to advancing dementia research. I hope to hear, perhaps, an initial reflection on that report when we hear from the Minister.

However, a diagnosis on its own is not enough. NHS England’s data shows that more than one-quarter of people living with a dementia diagnosis did not receive a care plan in the past year and that specialist support, such as Admiral nurses, remains patchy and dependent on where someone lives. That gap matters most in the weeks after diagnosis, when families are trying to understand what has changed and what support is available to them. The noble Baroness, Lady Wyld, set out her family’s personal experience. As for others, with that diagnosis of dementia, the question is: where should we turn? What happens next? It is a picture about which we hear so often from many families.

Dementia UK and others have called for specialist dementia nursing to be part of every neighbourhood health team. If the framework is genuinely to modernise dementia care, diagnosis, treatment, care planning and support for carers, which is so important, it must be designed and funded as a single pathway. As the ageing population grows and new dementia treatments emerge, the demand for diagnosis will inevitably rise. The forthcoming framework presents a clear opportunity for standardising the pathways for referral, assessment and treatment, for robust data capture and reporting and for reducing the variation in service across the country, which we hear about so often. As the noble Lord, Lord Weir, rightly stressed, we need to get this right. Our discussion on prevention is also an important part of this.

I turn to frailty, which makes up the other half of this framework. Around one in 10 people over 65 live with it, and the figure rises to as many as half of those aged over 85. Last month, the Commons Public Accounts Committee reported that only 17% of patients aged over 65 had had a frailty assessment recorded by their GP in the past year, well short of what is needed to ensure that those living with frailty have access to treatment. For those already identified as being most at risk, only 16% had had a medication review and 18% had had a falls risk assessment. This is in a service that is meant to reach everyone in that group. If frailty is to sit alongside dementia in the framework, it deserves the same focus on early identification, consistent standards and timely intervention. Bringing these two conditions together in one framework creates a real opportunity to establish common principles across both. If the framework is going to achieve everything, it must make a meaningful difference to people living with dementia and frailty, as well as to their families and the support networks that care for them.

I look forward to the Minister’s reply to this debate and hope to hear of a timescale and resource commitment to this important area.