The Modern Service Framework for Dementia and Frailty intends to reduce unwarranted variation and narrow inequality for those living with dementia, and will set national standards for dementia care and redirect National Health Service priorities to provide the best possible care and support. The LGA stressed that it is essential that Modern Service Frameworks are developed in partnership with local authorities and reflect the role and responsibilities of councils in supporting people with mental health needs or dementia in the community.
Introduction
This feedback is based on positions agreed by the four existing LGA Political Groups in Spring 2025 (Labour, Conservative, Liberal Democrat and Independent). A Reform UK Group has now been constituted within the LGA, but is not formally incorporated into the decision-making process until the start of the LGA’s Committee year on 1 September 2025. This feedback should therefore be read on the basis of having been agreed by the four previously existing Political Groups.
Feedback
ASK 1: Define an aspirational, long-term outcome goal for dementia and frailty. What should this goal look like?
1. A long-term goal should be enabling people with dementia and their carers to live their lives to the full, within their capabilities and ensuring they are safe and supported.
2. Promoting the wellbeing of people with dementia requires a broader plan of action across all relevant council services not just social care, but including housing, transport, leisure and green spaces.
3. The MSF should also encourage local areas to establish dementia friendly communities. To ensure a place-based approach, dementia friendly communities need the involvement of a range of local partners including local authorities, health, the voluntary and community sector and local business.
The Alzheimer’s Society describes these communities as: "A city, town or village where people with dementia are understood, respected and supported, and confident they can contribute to community life. In a dementia friendly community people will be aware of and understand dementia, and people with dementia will feel included and involved, and have choice and control over their day-to-day lives.”
Many local authorities have committed to create an inclusive environment where people with dementia feel supported and can live their lives with independence and dignity. Examples include Newcastle City Council and the City of York Council.
4. It is important that the role of the voluntary sector and community sector in providing information, advice and support is recognised in the MSF, and that they are supported and resourced to continue to deliver. Locally they provide many of the dementia support groups and key services, such as dementia cafes.
5. The National Quality Board needs national local government representation to help embed the Modern Service Framework (MSF). Future representation could include the LGA or Association of Directors of Adult Social Services (subject to availability).
ASK 2: Identify the best evidenced interventions that would support progress towards this goal, with a focus on those with the best means to drive up value and equity. What are the best interventions to support the above goal? What evidence exists to support them? How do they impact value and equity?
6. It is crucial that the contribution of local government and social care to dementia care and support is recognised in any future framework. Adult social care through councils supports many people with dementia at home or in care homes so are key to delivery of the aspirations of the MSF.
7. A focus should be how all care and support services across health, care, the voluntary and community sector and other sectors enable people with dementia, and their carers to lead their lives as they wish, independent within their own communities wherever possible.
8. The best interventions are well funded, locally based and person-centred. A well-trained and knowledgeable workforce, working in partnership with the local community and voluntary sector, is essential for high quality care and support for people with dementia. Ensuring sustainable levels of funding for adult social care is critical.
9. A cross partnership local dementia strategy also provides a strong foundation to progress change. The MSF could include examples of local strategies.
10. The LGA and ADASS Partners in Care and Health, supported by DHSC and NHSE, have developed and published a High Impact Change Model (HICM) for Improving the timely and effective discharge of people with dementia and delirium into the community. This model offers a practical approach to support health and care systems to deliver best practice for an individual’s journey to, during and following discharge from an acute hospital. It includes best practice examples and helps systems to self-reflect on where they are at and create an improvement plan to address areas of development. 11. Further information can be found in the High Impact Change Model: Improving the timely and effective discharge of people with dementia and delirium into the community.
ASK 3: Set standards on how those interventions should be used, alongside a clear strategy to support and oversee uptake by clinicians and providers. What standards will need to be established to ensure effective delivery?
12. It is not clear whether the MSF standards established will be for NHS clinicians and providers only or if they will be for all services. The previous National Service Frameworks did have a very clinical focus. Local authorities support many people with dementia in the community, particularly with social care, so have a clear role in delivery and ensuring that the MSF achieves its goal.
13. Further discussions would need to be had with local authorities on any standards and measures that may apply to the adult social care sector.
14. It is important to note that adult social care and public health already have frameworks that they report on annually that measure quality of life outcomes - but these are not dementia specific. Social care assessments are not generally focussed on the medical condition, such as dementia, but instead are focussed on a person’s care needs and their daily living activities.
15. It is also worth noting that ‘frailty’ is not a commonly used term in social care. A fuller outline of what is meant by frailty and how it can align with social care policy and practice would be helpful to include in the MSF. It will be useful for the adult social care sector to comment on the concept of frailty as it is included within the MSF. It is also worth noting that having dementia does not automatically mean someone is physically frail.
ASK 4: Above and beyond the scope of original national service frameworks, set out ‘challenge areas’, where we anticipate significant progress being possible, but where innovative ideas and products are needed. What could these challenge areas be? What innovations would be needed to realise the challenge?
16. A challenge area will be supporting the increasing numbers of people with dementia and complex needs in the community with high quality and personalised care. Pressures include adult social care workforce retention and recruitment.
17. Also important is ensuring that diverse cultural needs and understanding/awareness of dementia are addressed appropriately, as well as supporting increasing numbers of older people with learning disabilities and dementia.
18. Further emphasis is needed on achieving ongoing meaningful care and appropriate information, advice and support beyond diagnosis to people with dementia and their carers.
19. Ensuring workforce training by social care providers to raise care standards for people with dementia and their carers is also crucial.
20. The MSF needs to have a focus on people’s rights and experience of care. It needs to include reference to the dementia ‘I statements’. The statements reflect the things people with dementia have said are essential to their quality of life. They have a strong human right focus and can be used to help develop person centred approaches and understand better the experiences of people with dementia.
21. It is important that the MSF is coproduced with people with dementia and their carers, and people with lived experience are engaged with its implementation and delivery both at a national level and locally. This will help create a shared purpose and ownership of the framework and ensure the voices of people with dementia are being recognised and acted upon.
ASK 5: Alongside a plan to partner with the wider eco-system, support the creation, adoption and spread of novel new ideas. How can we ensure new ideas are accepted and embraced?
22. New ideas should be backed by evidence of effectiveness – in particular, how they improve the life of people with dementia and their carers. Evidence of preventative approaches (where appropriate), effective co-production and cost effectiveness would be helpful
23. Sharing of best practice and successful interventions/projects is helpful.
24. Any new effective interventions will likely need funding to ensure they are embedded and sustainable.
Additionally, we would be interested in your reflections on previous Government initiatives, including:
- National Service Framework for Older People (2001)
- Living Well with Dementia: A National Dementia Strategy (2009)
- Prime Minister’s Challenge on Dementia 2020 (2015).
What was successful about these former initiatives and why? What lessons can be learnt from their development and implementation? What should we do differently this time?
Contact
Arian Nemati, LGA Public Affairs and Campaigns Adviser
Email: [email protected]