Modern Service Framework for Dementia and Frailty
House of Lords · Grand Committee · 9 Jul 2026 · 10 speeches · Official Report
Question for Short Debate
Asked by
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.
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...
My Lords, I am grateful to the noble Lord, Lord Weir of Ballyholme, for securing this important debate, and I welcome the Government’s commitment to delivering the modern service framework for dementia and frailty. Dementia is not gender neutral. We may not have a cure at the moment, but we can cure the inequity in access to research, clinical trials, early diagnosis and effective treatments. In England, more than 500,000 people now have a recorded diagnosis of dementia, and nearly two-thirds of them are women. Dementia and Alzheimer’s disease have been the leading cause of death for women in England and Wales since 2011. Almost two-thirds of unpaid carers for people with dementia are also women. Women live longer, but longevity alone does not explain this disparity. The APOE4 gene increases women’s risk of Alzheimer’s disease more than men’s. The emerging evidence suggests that the hormonal changes associated with menopause may increase vulnerability. The hormone oestrogen is vital for memory formation, as it is essential for effective communication between neurons in the part of the brain involved in memory. The link between dementia and menopause extends beyond misdiagnosis, yet until recently, the relationship between menopause and dementia received remarkably little scientific attention. We need more research about the risks of developing dementia in women who undergo early or premature menopause. As the noble Lord, Lord Weir, mentioned, we need to work on reducing risk...
My Lords, I too thank the noble Lord, Lord Weir of Ballyholme, for securing this debate and for setting out the issues, as he did so comprehensively and with great expertise. We are very grateful to him. Like so many people up and down the country-and, as I know, in your Lordships’ House-I too have experience of helping to care for relatives with dementia. The first time was over 20 years ago, and now our family joins many others in trying to navigate the challenge of a recent diagnosis. I have been reflecting on what has changed since I first tried to help a relative over 20 years ago, and I want to start on an optimistic note, because the medical landscape is different. As we have heard, we have entered an era where the first disease-modifying therapies have been licensed. Innovation in diagnostics is enabling us to accurately identify disease earlier in the trajectory, and blood tests in NHS trials could make the diagnostic pathway easier. So, recent breakthroughs have at last delivered hope, if we build a healthcare and research system that is ready to adopt and deliver these innovations at scale as soon as they become available. I am grateful for the briefings I have received. The joint letter from Dementia UK, Alzheimer’s Research UK and the Alzheimer’s Society in the very helpful Library briefing confirmed that there is “a clear opportunity to change the trajectory of dementia-if the system is ready to act”. However, it also stressed that “we must recognise that the...
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...
My Lords, I, too, thank the noble Lord, Lord Weir of Ballyholme, for securing this important debate. I also thank all those who sent us briefings, as well as all noble Lords who have spoken in this debate. Dementia remains one of the greatest health and social care challenges facing our country. As the noble Baroness, Lady Pidgeon, rightly said, and as other noble Lords agreed, dementia is said to be the leading cause of death in the UK, with nearly 1 million people in the UK currently living with dementia, a figure that is expected to rise significantly over coming decades as our population ages. As the noble Lord, Lord Weir, said, this is a condition that touches most, if not all, families. My noble friend Lady Wyld spoke movingly about her experience. I have started to experience it in my own family because my mother is in the early stages; I have to fly over every so often to give her some sort of respite, as it were. That demonstrates that behind every diagnosis is not only the individual but their families, their friends and their carers, whose lives are profoundly affected. As my noble friend Lady Wyld said, it calls for a whole view of the person as much as a whole view of the system. Against that backdrop, I think we all welcome the modern service framework and see it as an important opportunity. However, for it to succeed, it must do more than simply list aspirations. It must provide a practical road map on, first, improving diagnosis, secondly, strengthening the...
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....
Committee adjourned at 4.01 pm.