Modern Service Framework for Dementia and Frailty

Baroness Merron Excerpts

Thursday 9th July 2026 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Baroness Merron) (Lab)]

My Lords, I start by congratulating the noble Lord, Lord Weir, on securing this debate. It has clearly engaged so many and I, for one, am pleased about the positive reaction. He mentioned at the outset that we are all agreed. I am sure that this outbreak of unanimity is always helpful when trying to make progress.

A number of noble Lords, including the noble Baroness, Lady Wyld, and the noble Lord, Lord Kamall, just now, spoke about the personal impact—as did the noble Lord, Lord Weir, and all other noble Lords—on the person but also on their families, their communities and those around them. That is very much at the core of the modern service framework. The noble Baroness, Lady Wyld, described the challenge of a lonely, crisis-driven system. That is not how it should be, and it is not serving as it should.

I want to set out at the beginning that everyone with dementia and frailty, and their loved ones, deserves high-quality, compassionate, joined-up care and support. Indeed, I say to the noble Baroness, Lady Wyld, that the framework will take a view of the whole person and the whole system. That is the way in which we will deliver. I am grateful, not just for the welcome but for the description of this as a golden opportunity, which the noble Lord, Lord Weir, talked about, and as a once-in-a-generation opportunity, as the noble Baroness, Lady Wyld, said. We absolutely recognise the points being raised by all noble Lords because the system we have has to, and will, change.

That is why we are developing and will deliver the first ever modern service framework for frailty and dementia. It will be all about the outcomes—to pick up some of the points asked. It will be a blueprint for how we develop that shift that we are all seeking. It will also work across both health and care settings, which is absolutely crucial. It is important that the MSF is delivered in this way because it acknowledges that dementia and frailty so often coexist. They are hard to distinguish and there is no need to do so. The MSF will also outline, when we look to the future, how we harness the innovations that have the potential to transform care.

I say to the noble Lord, Lord Weir, that I am grateful for the engagement that we have had with such a wide range of stakeholders, including those with lived experience, and carers, without whom we could not develop this in the right way. They also include clinicians, adult social care, the NHS and charity partners. As noble Lords will have seen, the immediate findings from the noble Baroness, Lady Casey, on social care made some immediate recommendations on dementia, and we have embraced them straight away. That includes the establishment of a new dementia leadership role in the department with the power to drive action forward. I agree with the noble Lord, Lord Kamall, on the tests that he set; I am totally on board with those. It is only by action, outcomes and change for the better that we will be able to judge it. Otherwise, it is just a piece of paper, and there is no point in doing that.

On the question about timelines from the noble Lord, Lord Weir, we seek to publish the full modern service framework by the end of the year, as recommended by the noble Baroness, Lady Casey; we are glad to accept that. To answer the question from the noble Lord, Lord Kamall, it will set national standards and redirect NHS priorities, because we cannot pretend that we can do this as things are.

There has rightly been a discussion about clinical data, which the noble Lord, Lord Kamall, raised, and performance matrix. There are many interventions to consider as we improve dementia and frailty care. That is why we are considering all options—I emphasise that. We want to look at the interventions with the best evidence and outcomes. Through the MSF, we will set standards, so we can measure against them, on how interventions should be used, and we will review the metrics and performance data necessary to monitor these standards.

I turn to the question of timely and accurate diagnosis, which we know is vital to delivering excellent care. It is, in effect, a gateway to vital advice, information and support. That is why we are committed to recovering the dementia diagnosis rate to the national figure of 66.7%. Importantly, that includes a validated diagnosis of dementia subtype—it is important not to just lump everything together. The framework will look at how we improve diagnosis waiting times, which are too long in many areas, as well as addressing unwanted variation in dementia diagnosis rates across the country and across different groups, as raised by the noble Lord, Lord Kamall, and my noble friend Lady Nargund.

The noble Lord, Lord Weir, referred to the Ready for the Cure report, which deals with research and access to treatments and is very pertinent to the immediate recommendations of the noble Baroness, Lady Casey. I can say in response that, through government funders such as NIHR, we continue to invest in dementia research, including speeding up the development of potential treatments, which was also much called for in today’s debate.

The noble Lord, Lord Weir, rightly raised the risk factors and the noble Baroness, Lady Wyld, talked about the Lancet commission, which has been very helpful in identifying global risk factors for dementia and the extent to which they are reducible. The NIHR-funded dementia and neurodegeneration policy research units are supporting the development of our understanding of where we have an opportunity to reduce risk. I will be pleased to keep updating the House on that ongoing work.

The noble Baroness, Lady Pidgeon, asked about easier access to trials. We are working to fast-track clinical trials, because we want to drive global investment in life sciences as well as provide opportunities for individuals. I have spoken about the acceleration of the development of medicines. I say to the noble Lord, Lord Kamall, that we have made the UK an infinitely more attractive place for clinical trials, not least by stripping out bureaucracy and unnecessary obstacles. We have reduced the period to way below the 150-day ambition that we set.

We are ensuring, as my noble friend Lady Nargund asked, that research opportunities are available, irrespective of who people are and where they live. The women’s health strategy makes particular reference to the point she raised on the link between menopause and dementia. The NIHR continues to work on funding for applications for research into any aspect of human health and care, including that link. Our investment continues. We have already adopted the target of 2,000 people participating in dementia trials within the next five years; it currently stands at 377. I believe that by improving the UK’s attractiveness for dementia trials, we will be able to drive forward improvements beyond what we have currently.

There was a number of particular points, and I will be very pleased to write to noble Lords on specifics. All the specifics raised today are key to how we improve the potential of the MSF, and we are keen to continue to work on that.

The Government absolutely recognise, and are with noble Lords on, the need to improve diagnosis and to have that robust data and the access to innovative treatments. I believe that the modern service framework will deliver that and drive them forward, as well as the other provisions, in a way that we do not have access to now. It is a time to be positive, and I am glad noble Lords spoke in that way, because I, too, share that feeling.

Committee adjourned at 4.01 pm.