Shunichiro Kurita, HGPI Associate, delivered a lecture titled “Current Dementia Measures in Scotland” at a pre-event in the Dementia Friendly Japan Summit(DFJS) 2017, hosted by the Dementia Friendly Japan Initiative(DFJI).

 

 

 

 

(Pre-event: symposium & network session)

Date & time: Friday, September 15 19:00-21:30 (doors open at 18:30)
Venue: Shibaura House

Pre-event guest speaker:
British Council: Manami Yuasa, “Dementia Friendly Communication and Art: Examples from the UK”
Health and Global Policy Institute: Shunichiro Kurita, “Current Dementia Measures in Scotland”
Dementia Friendly Japan Initiative:  Takehito Tokuda,  “Dementia Friendly Community and its Global Movement”

*For more information about this event, please see here.
**Available only in Japanese.

 

■Summary of lecture

Health and Global Policy Institute has been carrying out the “Initiative for the Advancement of Dementia Research and Social System Innovation through Global Public Private Partnerships (PPP)” with the aid of Japan Agency for Medical Research and Development since last year.

As a member of the “Initiative for the Advancement of Dementia Research and Social System Innovation through Global Public Private Partnerships (PPP)”, I conducted many multi-stakeholder interviews domestically and internationally. During these interviews, I started to realize that the common notion regarding early diagnosis and early treatment do not always bring about good results. Our society has become fixated on early diagnosis and treatment regardless of the circumstances and from that I became interested in the idea of a link worker; someone who can provide post-diagnosis support in order for patients to bravely face their illness.

Healthcare services in Scotland and England are provided through National Health Service, in which citizens are not responsible for any payment upon receiving health services at the point of delivery

The healthcare system is also different. GPs are responsible for primary care and all citizens must go through designated GPs in their areas when seeking medical attention. Unlike Japan, free access in which people can seek health care at any hospital they want despite restrictions on expense of first-visit, is not guaranteed.

The reason for wanting to use Scotland’s dementia measures as a basis is due to “National Dementia Strategies”. In Scotland, the number of people with dementia is estimated to be at 90,000 and is projected to increase by another 20,000 by 2020. Scotland’s National dementia strategy was first presented in 2010, then in 2013, and now for a third time in June 2017. There are a total of 21 commitments and 2 of those are designated to the link worker system; 1. Extending support period, 2. introduction into primary care.
Health services provided under link worker system is currently based on NHS. At the time of its implementation in 2011, it was an independent service provided through a dementia support charity group called Alzheimer Scotland instead of being a formal public system.

As a healthcare provision service based on NHS, they have been continuously negotiating with the government in order for all citizens who needs link worker service to utilize it. Link worker system began providing its services under NHS in 2014.

In order for the whole nation to use it, its service provision system must be reorganized. As a general rule, Alzheimer Scotland Link Workers are based either in local NHS Community Mental Health Teams or in Alzheimer Scotland Resource Centres from where they deliver an outreach service to people with a diagnosis of dementia in their own homes.  Alzheimer Scotland Resource Centres also offer a range of informal support services to people with dementia and their carers and are a hub for fundraising, volunteering and advice about dementia.

Not all Link Workers are employed by Alzheimer Scotland. In some areas the NHS directly provides post diagnostic support services. Therefore, 2 routes of service provision, indirectly via Alzheimer Scotland and directly from NHS, are in place. In order to decrease the gap in the quality of services provided, the Scottish Government, NHS, and Alzheimer Scotland began to collaborate to standardize services and education programmes. For example, Alzheimer Scotland’s 5 Pillar model of post diagnostic support is increasingly recognized as the optimum model of post diagnostic support in Scotland.

Post diagnostic support is essential for people with dementia and their families to understand their illness and plan for life after diagnosis. It is part of a continuum of intervention, and support to people with dementia that should start with a timely diagnosis, moving through to community support complemented by work to make communities more dementia friendly. In Scotland, Alzheimer Scotland’s ambition is to directly support people with dementia and their carers at the same time as reducing stigma in promoting inclusive communities. This is most clearly reflected in the work of the Scottish Dementia Working Group, of Alzheimer Scotland Dementia Advisors and Dementia Friendly Community work. 

Post diagnostic support will soon be in its 6th year  and issues such as quality control, expansion of users and period of usage as well as financial matters have come into the spotlight.

Japan is a developed country with high life expectancy and all eyes around the world are on the Japanese government. We have much to learn from other foreign countries. In order to correctly deal with common issues of dementia, continuous collaboration with other countries and sharing of knowledge and experience are needed.

This lecture included summarized reports of observations made regarding Scotland’s link worker system during July 25-27 with the support of Global Health Innovation Policy Program (GHIPP).