Modern Service Framework for Dementia and Frailty

Lord Weir of Ballyholme Excerpts

Thursday 9th July 2026 Grand Committee

Asked by

[Lord Weir of Ballyholme]

To ask His Majesty’s Government how the Modern Service Framework for Dementia and Frailty will improve dementia diagnosis, ensure robust and acceptable clinical data and performance metrics, and enable access to innovative treatments.

[Lord Weir of Ballyholme (DUP)]

My Lords, I welcome the opportunity to raise what is both an important and timely issue. There is a truism which certainly affects my family, indeed most families: many years ago, it would have been said that the terrible scourge of cancer had touched pretty much every family in the country and that most had lost at least one loved one. With dementia now being the single largest cause of death in the United Kingdom, that truism about cancer is becoming more and more relevant and accurate for describing dementia as well.

Given what I think is the universal nature of the dementia issue, we should all be on the same side and the same page on this, and I believe that we are. To that extent, the modern service framework offers a golden opportunity to set the strategic direction, and its practical implementation, for the future of dementia services within the United Kingdom. I am encouraged to learn of a number of groups with which there has been co-operation from the department in drawing up that document. It would be helpful for the Minister to give us a little more detail today of the extent of the co-design of the modern service framework, and to update the Committee on the timescale for the interim and final reports of the framework. It is therefore important that we get this right, because none of us want to see the modern service framework become a missed opportunity. That is why the details need to be right.

In the brief time available to me today, I will touch on four areas which are critical to the modern service framework. First, there is reduction of risk. A recent survey carried out by Alzheimer’s Research UK indicated that 84% of people wanted to know more about what they could do to reduce the risk of dementia, but, in that same poll, only 8% had any level of confidence that anything they could do could help to avoid or delay it. We know from international global studies that, currently, about 14 risk factors have been identified. I think this will become more and more relevant as our medical knowledge develops over the years to come.

It is important that reduction of risk is built into the modern service framework. That means looking at practical steps and at what is being done to try to identify high-risk groups—for example, how we will incorporate positive brain-health messaging into NHS health checks—and at how we can increase access to secondary prevention, through methodologies such as the memory assessment services and emerging brain health clinics, and integrate these with neighbourhood health centres. Reducing risk therefore has a critical role.

Secondly, there is the critical issue of diagnosis. We know it is estimated that perhaps a little over one-third of people with dementia are as yet undiagnosed. When we delve into that for early-onset dementia, the figures fall to probably less than half currently being diagnosed. There is a wide variety—a very patchy provision—across the country in the speed and extent of diagnosis. For example, if we look at early-onset dementia, the time taken for diagnosis is, generally speaking, about twice the length of time as for anybody else with dementia.

There is also an issue about the quality of the data generated from that diagnosis and the specificity that is able to be provided in the diagnosis. Therefore, it is important that the modern service framework looks at what the pre-existing options are for diagnosing Alzheimer’s. For example, if we look at PET scans and CSF testing, how can we embed those more and then embrace the next-generation technology of blood tests? Having commitments to that within the MSF is important, but it is also the case that we need to standardise coding across health and care settings, so that we can have standardised data in that regard. I say to the Government that it is important that they look, through the modern service framework, towards increasing the rate of diagnosis and ensuring that there is a greater level of consistency of diagnosis across the country.

Thirdly, and related to that, is the issue of research. We know that research and diagnosis in many ways go hand in hand, because if we do not have the volume of people being diagnosed, or if it is slower, that obviously impacts on the ability for clinical trials but will also impact the individual’s ability to get that early intervention as quickly as possible. Many of us see a golden opportunity in the years ahead. We are hopefully at the cusp or dawn of a new era of medical advances as regards dementia, which could either delay or even at some stage, we hope, prevent dementia in many cases. I commend to the Government the very recent publication of Ready for the Cure, which has been produced by the Alzheimer’s Research Society. I urge them to look at it. Within that, we need to learn how the Government see additional commitment to research through the modern service framework. Will it be focused on strengthening the research pipeline, and perhaps on creating a national dementia innovation team and national dementia datasets, so that we do not have a wide variety of those?

There is also a challenge, when looking at treatments, with the current position of NICE. There is a concern that its cost-benefit analysis does not take fully into account the extent of the burden on carers, even from the financial point of view. That needs to be fed a lot better into the system. As part of that, we need to ensure that not only do we get the research, but that the NHS is research-ready, so that whenever we have it available it can be implemented quickly.

Finally, I want to touch on the issue of pathways. Obviously, diagnosis is just the start rather than the end of a journey. Again, we have somewhat patchy quality in the pathways across the country. We need to standardise that and create a pathway applicable to everyone, probably with a level of variation—we would need something slightly different for those with early-onset dementia. Arising out of that, we will need to address gaps in infrastructure and staffing levels. In looking at pathways, we should not forget end-of-life palliative care and how we can invest in that. I welcome the debate and look forward to the contributions of others and the response of the Minister.