Dementia

Dementia remains one of the leading public health challenges in England, with substantial impacts on individuals, carers, communities and the health and care system. It is important to note that dementia is not a single disease, but rather a syndrome characterised by progressive deterioration in cognition, behaviour and functional ability. Alzheimer’s disease is the most common cause of dementia, accounting for 60–70% of cases.

The number of people living in the UK with dementia continues to rise in line with the ageing population. Approximately 944,000 people are currently living with dementia in the UK, with this figure projected to exceed 1 million by 2030 and reach 1.6 million by 2050. Dementia remains the leading cause of death in England, accounting for 12.2% of all deaths between 2015 and 2024, with the highest mortality rates among those aged 95 and over and a significantly higher mortality rate among women. Around 65% of dementia related deaths occur in care homes, underlining the importance of high quality residential and nursing care in later stages of the condition. The health and social care costs for dementia are higher than cancer and coronary heart disease.

The wider burden of dementia on society is also considerable. Due to their frailty, multimorbidity and against a backdrop of finite community support, individuals with dementia are disproportionally greater users of urgent and emergency care. Where social care or community resources are inadequate for individuals with dementia, ambulance conveyance rates are increased, placing further demands on secondary care.

Dementia is associated with a greater complexity of need in patients and consequently is also linked to longer hospital stays and delayed discharges. People living with dementia are often supported by a combination of unpaid care and formal social care, with increasing need for the latter as their disease progresses. Individuals’ needs are often under met or wholly unmet, leading to a greater burden on unpaid carers.

Carers of people with dementia are thought to provide over 1 billion hours of unpaid care each year, and are themselves at increased risk of stress, depression and other health complications. Two thirds of these unpaid carers are women, and a third of unpaid carers who support a person with dementia will spend more than 100 hours a week delivering unpaid care. 

National dementia policy has undergone significant transition in recent years.  

The previously planned Dementia 10 Year Plan (2022) was superseded by the Major Conditions Strategy (MCS) in 2023; however, in July 2024 the new government paused work on the MCS and instead embedded its findings within the Fit for the Future: 10 Year Health Plan for England, published in July 2025.

The 2025 plan includes a commitment for a modern service framework for frailty and dementia, aiming to: 

• set clear standards 
• define long-term outcomes 
• align evidence-based interventions  
• prepare the NHS for new treatments emerging for early Alzheimer’s disease.

National organisations, including Alzheimer’s Research UK, view this as a potentially major shift in improving consistency and quality across dementia pathways. 

Locally, Lincolnshire County Council and the NHS published the Joint Strategy for Dementia 2018 to 2021. An updated strategy covering 2025 to 2030 will be published imminently. 

Furthermore, the County also now has a dedicated Dementia Programme Board. The Board’s remit is to both realise and, with cross organisational collaboration, develop, drive, and coordinate the delivery of the Lincolnshire Dementia Strategy. 

The primary objective of the Board is to deliver the programme implementation and work collaboratively, across statutory and non-statutory commissioners, providers and with people with dementia and their families and carers. The Board aims to do this within the broader Health and Care system, to address health inequalities and social determinants of dementia within a population health management framework.

A key tenet of the Board’s work on health inequalities is to focus on the Core20PLUS5 population groups – that is adults in the most deprived areas, those who are traditionally marginalised or excluded from services (ethnic minorities, people with learning disabilities, people with multiple long-term conditions etc.) and five clinical areas (maternity, severe-mental illness, hypertension, chronic respiratory disease and early cancer diagnosis).

The Board has been instrumental in implementing the Dementia 100 toolkit in Lincolnshire. Developed to support system-wide improvement, the toolkit is being implemented in Lincolnshire to assess the quality and coverage of dementia services across ten key domains. It will highlight gaps in provision and areas for development, providing a robust evidence base to guide future commissioning and ensure services are equitable, person-centred, and aligned with the national dementia strategy.

The following guidelines and Quality Standards are published by the National Institute for Health and Care Excellence (NICE).

Dementia: assessment, management and support for people living with dementia and their carers [NG97] – This guideline covers diagnosing and managing dementia (including Alzheimer’s disease). It aims to improve care by making recommendations on training staff and helping carers to support people living with dementia.

Dementia, disability and frailty in later life- mid-life approaches to delay or prevent onset [NG16] – This guideline covers mid-life approaches to delay or prevent the onset of dementia, disability and frailty in later life. The guideline aims to increase the amount of time that people can be independent, healthy and active in later life. 

Dementia Quality Standard [QS184] – This quality standard covers preventing dementia, and assessment, management and health and social care support for people with dementia. It describes high-quality care in priority areas for improvement.  

The overall prevalence of dementia in Lincolnshire is 1.08%, placing the area in the highest quintile nationally and showing an upward trend. The national prevalence in England is 0.8% (Source: Quality and Outcomes Framework, 2024-25 – NHS England Digital). The recorded dementia prevalence is the number of people with dementia recorded on GP practice registers as a proportion of the people (all ages) registered at each GP practice. As dementia prevalence increases significantly with age, estimated at around 20% among people aged 80, Lincolnshire’s ageing population is likely a key factor contributing to its higher-than-average proportion of residents living with dementia. 

In Lincolnshire, the Dementia Diagnosis Rate (DDR) for people aged 65 and over was reported at 69.7% in December 2025. Based on prevalence estimates, around 12,942 residents aged 65+ were expected to have a coded dementia diagnosis, compared with 9,016 people who had an actual recorded diagnosis. DDR performance in Lincolnshire improved over the 12 months leading up to December 2025, rising from 68.3% and showing a gradual increase. The Lincolnshire Integrated Care Board (ICB) DDR was 3% above the national standard of 66.7% and 3.4% higher than the national average of 66.3%, indicating stronger performance than both benchmarks (Source: NHS England Digital).

Since December 2024, 113 people in Lincolnshire have received a dementia diagnosis, equivalent to 11.5 per 1,000 residents. For individuals with young onset dementia (diagnosed before age 65), the rate is 0.77 per 1,000. Both the overall dementia diagnosis rate and the young onset rate are significantly higher than the national averages of 7.43 per 1,000 and 0.55 per 1,000, respectively (Source: NHS England Digital).

The national average proportion of patients on the dementia register who had a recorded dementia care plan or care plan review in December 2025 was 64.7%, which is the same as the rate in Lincolnshire ICB, placing the area in line with the national average. This represents an increase from 63.8% in December 2024 (Source: NHS England Digital).

Alongside care plan reviews, medication reviews for patients with dementia are essential for people with dementia, helping to ensure their treatments remain safe, appropriate and the patients achieves the best possible outcome. Reviews are completed within the patient’s GP practice and the national proportion of patients on the dementia register with a medication review is 42.2%. Within Lincolnshire, performance is higher with 47.9% of patients receiving a review in December 2025 (Source: NHS England Digital).

Research has shown 14 risk factors that may increase an individual’s risk of dementia and researchers have calculated that they account for approximately 45% of dementia cases worldwide (Source: Alzheimer’s Research UK). Social and psychological factors include quality of education in early life and social isolation. There is a well-established local response and commitment to continually improve the quality of education in Lincolnshire. Locally 44.8% of adult social care users do not have as much social contact as they would like (Source: Department of Health and Social Care), evidencing a population that would benefit from increased social interaction. There is a complex relationship between depression and dementia risk, and not everybody with depression will develop dementia, however risk may be higher in those with depression (Source: Alzheimer’s Research UK). An overview of depression prevalence in Lincolnshire can be found on the Lincolnshire Health Intelligence Hub.

Lifestyle related factors such as Physical inactivity, Smoking, Excessive alcohol consumption and Obesity have been shown to influence risk of dementia, and within Lincolnshire substantial work has been undertaken and continues to develop to understand these populations, identify unmet needs and shape future interventions to improve long term health outcomes. Air pollution is an environmental factor that also contributes to dementia risk. The local response to improving air quality in Lincolnshire can be found on the Lincolnshire Health Intelligence Hub.

Traumatic brain injury is recognised as an injury related factor that increases an individual’s risk of dementia. This can result in neurological conditions. Additional physical conditions which may increase dementia risk include diabetes which is the eighth highest burden of disease in Lincolnshire. Sensory impairment including hearing loss and uncorrected vision loss is also listed as a risk factor for dementia, local intelligence can be found on the Lincolnshire Health Intelligence Hub. Additional at-risk groups include people with high blood pressure and high cholesterol. The NHS Health Check, offered to adults aged 40 to 74 without pre-existing health conditions, helps identify these and other risk factors for dementia at an early stage. In Lincolnshire, 4.2% of the eligible population were offered health checks in 2025/26 Q2. This is significantly worse than the England performance in the same period where 5.9% of the eligible population were offered the check (Source: Department of Health and Social Care).

Nationally, 73.0% of people with dementia have at least one comorbidity. In Lincolnshire, the proportion is slightly higher at 74.3%, representing 6,715 patients (Source: NHS England Digital).

In Lincolnshire, over 1 in 5 (22.5%) of those with a dementia diagnosis are receiving palliative care. This is notably higher than the national figure of 17% (Source: NHS England Digital). Dementia and Alzheimer’s disease is a leading cause of death in England. The rate of mortality for people with dementia in Lincolnshire is decreasing falling from 1,065 per 100,000 people in 2020, to 819 per 100,000 in 2023. The rate of mortality is lower in Lincolnshire than nationally, where there is a rate of 828 per 100,000 (Source: Department of Health and Social Care). 

Specifically looking at mortality rate by gender, 98 per 100,000 males in Lincolnshire (all ages) had dementia or Alzheimer’s recorded as the cause of death in 2024. This is not statistically significantly different to the England rate of 101 per 100,000 males (Source: Department of Health and Social Care). Mortality from dementia and Alzheimer (all ages) is notably higher among females compared to males, at 108 per 100,000 people. However, the rate in Lincolnshire is lower than the national rate for females at 116 per 100,000 (Source: Department of Health and Social Care).

It is important to understand the trends and variations in place of death for people with dementia or Alzheimer’s disease. In Lincolnshire, 66.1% of people with dementia mentioned in death registration died in a care home in 2023, up from 64.1% in 2022, though this does not indicate a significant long-term change. Nationally, 56.4% of people with dementia died in a care home, statistically significantly lower than the Lincolnshire value. 17.1% of people aged 65 and over with Dementia died in hospital in 2023, which is significantly lower than across England where 26.3% died in hospital. The proportion of those dying in a home is increasing and reaching 14.5% in 2023 and this upward trend mirrors the pattern seen across England (Source: Department of Health and Social Care).

To help future planning for service provision to provide the best care it is important to understand the projections for the number of people with dementia. By 2030 it is predicted that 15,592 adults aged 65+ in Lincolnshire will have dementia. This is expected to increase to 21,215 people in 2045. By 2045, the highest volume of over 65s with dementia will be in East Lindsey, with 4,775 patients, compared to 1,583 in Boston. The highest percentage change from 2025 to 2045 is expected in South Kesteven where the population of over 65s with dementia is expected to increase by 62% (Source: Projecting Older People Population Information System (POPPI)).

The financial cost of dementia continues to rise, with total costs in Lincolnshire projected to increase from £664 million in 2025 to £850 million by 2030, including unpaid care (Source: Care Policy and Evaluation Centre – LSE). 

There are also substantial costs linked to people living with dementia who remain undiagnosed, as they are more likely to rely on A&E and other acute services. With an estimated 3,962 people currently undiagnosed in Lincolnshire, the cost of delayed diagnosis is projected to be between £36 million and £178 million, again including unpaid care (Source: Alzheimer’s Society). Together, these figures underline the significant value of early identification and intervention. 

The NHS England Well Pathway describes the route for people living with dementia and their carers. It also provides a clear framework for a person-centred approach throughout every stage of the individual’s dementia journey and to support improvement in health, social care and communities and encourage joined up care. Our Joint Lincolnshire Dementia Strategy 2025-30 aims to incorporate an innovative, personalised, and adaptable approach to the dementia care which will meet the needs of all communities in Lincolnshire, using the Well Pathway.

The Dementia Home Treatment Team provide a hospital at home approach to prevent people living with dementia from having to go into hospital when their needs are escalating. This short-term additional, intensive support is provided to people in their own home or place they live, supporting as much autonomy and independence as possible.

Lincolnshire Memory Assessment and Management Service (MAMS) is part of Lincolnshire Partnership NHS Foundation Trust’s (LPFT) community services. Currently available for people over 18 years of age who are having problems with their memory and/or other cognitive difficulties such as with language or attention and/or personality/behaviour changes, its core aim is to help get a diagnosis in order to have an effective plan in place to get the support needed to help people live as independently as possible.

In partnership with Alzheimer’s Society, Lincolnshire Partnership NHS Foundation Trust (LPFT) are piloting a new Young-Onset Dementia Support Service for people living in Boston. The service is for anyone in Boston aged under 65 who has received a diagnosis of dementia (also known as young-onset dementia) and offers one-to-one support. The service is also available to friends and family members.

Wider mental health services also seek to support people with dementia. The Mental Health Liaison Service, working across acute hospitals in Lincolnshire, aims to assist in the identification and management of mental health and dementia related needs, identify and support people with dementia related needs as well as supervise acute hospital staff in the recognition and management of dementia.

Older Adult Community Mental Health Teams provide individualised assessment and recovery-based interventions and support. This support includes people experiencing dementia. The teams include mental health intermediate workers, supporting older adults with dementia for a period of physical health rehabilitation.

Health and wellbeing outcomes are greatly improved when people with dementia and their carers, are supported to access activities that bring enjoyment and provide social contact. Many independent activity and support groups across Lincolnshire are detailed on the Connect to Support website.

Lincolnshire ICB also seek to tackle dementia through their wider population work. In particular, the ICB’s Ageing Well approach is a frailty‑focused, whole‑system, preventive and community‑based model which doesn’t regard dementia as a standalone issue, but as an issue that requires an approach that is integrated across diagnosis, daily living, carer support, crisis response and end‑of‑life pathways.

Alzheimer’s UK offer a range of support including raising awareness and support through their Dementia Friendly Resources. These resources encourage shared responsibility for ensuring people with dementia feel understood, valued, and able to contribute to their community through individuals, organisations, and communities.

A carer is anyone, including children and adults who looks after a family member, partner, or friend who needs help because of their illness, frailty, disability, mental health problem, or addiction and cannot cope without their support. The care they give is unpaid. Lincolnshire Carers Service provide support and guidance to unpaid carers across the county including those who care for people affected by dementia.

Dementia carers regularly and often report “wandering” – when loved ones suddenly up and leave, unbeknownst to their carer. The Herbert Protocol, provides a record of vital information to support a timely response if someone is missing.

During the development of the JSNA a workshop was undertaken with key local stakeholders from across the health, social care and voluntary sectors. 

Workshop Feedback
In general, workshop participants highlighted significant and persistent inequalities affecting people living with dementia, their families, and carers in Lincolnshire. These inequalities arise from gaps in post diagnostic support, structural challenges linked to geography and service configuration, and variations in digital access, data quality, and workforce capacity. 

Limited Post Diagnostic Support and System Fragmentation
A consistent message from the workshop was that post diagnostic support for people with dementia remains extremely limited.  

Geographical and Population Based Inequalities
Lincolnshire’s geography contributes heavily to inequalities. Large rural areas, limited transport infrastructure, and dispersed populations make it harder for people to access memory assessment pathways and ongoing support.

The Role of Carers and Associated Inequalities
Carers carry a substantial burden, with many providing over 100 hours of unpaid care per week. Carer strain is compounded by limited specialist carer support, inconsistent training for staff in care homes, and the absence of coordinated post diagnostic provision. 

Digital Exclusion and Unequal Access to Technology
The system’s shift towards a digital first approach – particularly in memory assessment services – has created further disparities.  

Variation in Service Provision and Short-Term Funding
Provision across the county was described as patchy, reliant in part on variable local voluntary sector capacity and short term, inconsistent funding.  

Workforce Education and Capability
Training and understanding of dementia vary widely across settings. Staff in A&E, GP practices, call centres, and care homes are not always equipped to recognise dementia related needs. 

Data Quality, Recording, and Intelligence Gaps
Stakeholders highlighted gaps in the completeness and accuracy of dementia registers, inconsistent recording of ethnicity, and variation in primary care coding.  

Growing Demand and Rising Cost Pressures
Participants emphasised the significant and growing scale of need. Local forecasts predict a sustained growth in the numbers of people living with dementia, alongside rising financial implications for health and care services.  

Prevention: Essential but Not Sufficient
There is broad support for a stronger prevention approach aligned with national ambitions. However, this should complement, not replace, support for those with an existing diagnosis of dementia. 

Need for Strategic Prioritisation and Investment
A strong theme from the workshop was that dementia requires clear systemwide prioritisation. Participants expressed concern that without dedicated investment, coordination and leadership, the county risks shifting unmet need into the community without the capacity to respond.  

Importance of Lived Experience in Service Design
Finally, participants emphasised the critical importance of incorporating the voices of people living with dementia and their carers. 

Patient and Carer Survey
In early 2026 NHS Lincolnshire ICB also undertook engagement work, in the form of a survey with people living with dementia and their carers. The survey asked about people’s experience with dementia care in Lincolnshire, from diagnosis and support to prevention, community resources, and overall wellbeing. 

Key findings from the survey, broken down by theme were as follows:  

Challenging diagnosis experience 

• Only 37% of respondents found it easy to get a diagnosis.
• Long waits for a diagnosis were common, with more than half of respondents (51%) waiting 6 months or longer for a diagnosis. 8% of respondents waited for 2 years or more. 
• Delays throughout the diagnostic process, in terms of referrals, assessments, scans, and follow-ups, caused individuals to experience anxiety and left families feeling unsupported. 
• Referrals were reported as getting lost or being unprocessed, with communication between services being inconsistent. 
• Individuals felt there could be a lack of clarity about timelines and responsibilities. Knowing what to expect next or how long processes will take was not always clear. 
• Many respondents did however report that when they received information this was easy to understand and useful. 
• Diagnosis was sometimes delivered abruptly, impersonally, or without adequate explanation. Communication was not directed at the patient and lacked empathy. 
• Concerns were not always taken seriously early on. This ultimately led to delayed diagnosis, and reduced access to timely support, treatment, and planning.

Post diagnosis support lacking 

• Only 48% of respondents reported receiving any professional support after diagnosis, with 44% reporting receiving none. 
• Carers and families were sometimes left to find out about services and support independently. 
• Respondents reported having no structured opportunities to ask questions as the condition changed, leaving some families feeling abandoned, unsupported, and unsure where to seek help. 
• Overall, most respondents (69%) did not feel supported in Lincolnshire as a carer or a person living with dementia. 
• Respondents wanted to have a single point of contact/navigator, receive practical information (support available, financial help, planning), and ideally experience more face-to-face support.

Lack of local services 

• Whilst 45% of respondents attended dementia-friendly groups/cafés, only 35% of respondents found their community supportive. 
• For those who did feel supported, most helpful were Carer support groups, Dementia cafés, Admiral Nurses, and Respite services.

Prevention awareness poor 

• 57% of respondents had not been offered information about dementia risk reduction historically, and 42% had never had opportunities to undertake risk-reduction activities (exercise, social connection etc.). 
• Respondents valued social connection groups (choirs, cafés, coffee mornings), Carer-inclusive activities, exercise/dance/walking sessions, and cognitive stimulation activities (games, puzzles). 
• Messaging on early signs, how to access help when symptoms appear, and provision of an MOT style check to discuss memory and cognition were all seen as beneficial. 
• Better transport and the offer of buddy schemes would remove barriers to accessing existing services. 

Dementia risk, prevalence, diagnosis, and outcomes are shaped by multiple inequalities. People in lower socioeconomic groups and those with a learning disability are three times more likely to develop dementia earlier in life.

Dementia incidence is over 20% higher among Black adults than the national average, while South Asian communities are projected to experience the steepest increase in dementia prevalence. Barriers to early diagnosis and access to culturally appropriate support persist across many minoritised ethnic groups.

Women account for 65% of people living with dementia, reflecting both longer life expectancy and potential biological factors.

In Lincolnshire, current service models often concentrate resources in large population centres such as Lincoln, leaving those in the east and south of the county – particularly within coastal communities – facing greater barriers. 

Pilot initiatives often begin in urban or better resourced areas, reinforcing existing inequalities. Small community groups may develop effective activities, but a lack of sustainable funding makes it difficult to scale successful models or ensure equitable access across the county.

A number of population groups are considered at especially high risk with regards to unmet need:

• Farming and rural communities: Older average working age, limited digital access, and cultural hesitancy in help seeking mean symptoms are often missed. Although local organisations undertake health checks in rural areas, these insights are not consistently integrated into wider system planning at present. 
• Older coastal residents and those experiencing deprivation: Areas such as East Lindsey have disproportionately older populations and higher levels of disadvantage, increasing both risk of dementia and difficulty accessing services. 
• Ethnic minority and migrant communities: Diagnostic rates are notably low among Eastern European and other ethnic minority groups. Contributing factors include language barriers, cultural differences in understanding dementia, unfamiliarity with the UK primary care model, and potential recording issues. 
• Learning disabilities and autism: Late or missed diagnoses are attributed to a lack of formalised pathways and inconsistent recognition of symptoms by supported living staff. 
• People living alone: Older adults without carers or advocates are less likely to notice early symptoms, pursue diagnosis or access available support.

To understand these populations, the use of data is vital. Work undertaken recently to identify people missing from GP dementia registers demonstrates both the large scale of missed need and equally the value of targeted data work. Better use of data is key to identifying at risk populations, understanding crisis patterns, and targeting resources proportionately.

The existing data demonstrates that dementia needs will continue to grow over the coming years. However, dementia is still not consistently treated as a strategic system priority, and the recent removal of national mandated targets is a risk to sustained focus. Embedding dementia as a strategic priority across local authority, ICB and partner organisations, and of recognising the scale and complexity of current unmet need, is of paramount importance.

Prevention is key to managing this need in the medium to long term. Opportunities exist to embed health promotion, through work in schools, colleges, and workplaces. However, prevention will not address current unmet need. A large number of people already living with dementia require significant support now, meaning prevention messaging should be accompanied by investment in post diagnostic and community-based care.

How the future dementia offer looks locally should be informed by input from those with lived experience. Sources of lived experience insight include ongoing survey work, dementia groups and peer led activities. These should inform future JSNA development and subsequent commissioning decisions.

A diagnosis of dementia is the gateway to help, information and advice, yet many people with dementia still do not have a diagnosis. Implementing revised diagnosis pathways will greatly improve population health outcomes. 

Locally, for those with a diagnosis, many receive only initial information at diagnosis – often in the form of a leaflet from their GP – and may then have no further contact with formal health services until their annual review. This absence of structured follow up creates a “barren landscape” for people with dementia and their carers, who often feel left to manage complex needs alone. As a result, crises escalate and lead to preventable use of emergency and acute services. The lack of a specialist dementia crisis response is a significant system gap, with A&E frequently acting as the default option during periods of distress or behavioural change. Individuals with dementia, and those who care for them, require practical, human support, not solely signposting or leaflets.

Many older adults in the County either lack the confidence to use digital tools or do not have access to devices, broadband or data. Digital exclusion contributes to longer waits for assessment and less equitable access to early intervention. Digital poverty is not only about skills, but also affordability of equipment and connectivity.

Variations in staffing resourcing, training and provision currently lead to inappropriate responses or missed opportunities for early support. Enhanced training – particularly in care homes – is essential. 

Lincolnshire Joint Dementia Strategy 2025-30 
This strategy sets out priorities and goals about how health and social care will continue to improve the lives of people affected by dementia, their carers, and families from the point of diagnosis to the end of life, including people most at risk of developing dementia. It also sets out a plan that will identify key actions which will be undertaken to help us achieve our goals and to realise our vision. 

It lays out the importance of increasing investment in prevention in Lincolnshire, aimed at raising awareness of the importance of good brain health across all ages and reducing the risk of dementia. Coupled with this is the need to ensure inequalities are equitably addressed to give everyone who needs it the chance to access support to be active, eat well, continue to learn, and to stay connected.

Delivery of the strategy priorities, goals and outcomes is a crucial next step for work to support people at risk of and affected by dementia. 

Dementia Partnership Board 
The Dementia Partnership Board for Lincolnshire has recently undertaken a self-assessment. Taking account of the latest legislation, policy and guidance, the assessment provides a wide-ranging view of strengths and areas for development in order to support high-quality, person-centred, and integrated care. 

The outputs from this have highlighted strong foundations with some areas of excellence, but inconsistent system‑wide delivery with significant variation between PCNs, providers, and localities. This has helped the board to identify some key priority areas of focus covering our four workstreams of preventing well, diagnosing well, living well, and dying well.  

Delivery of these priorities will achieve short-term improvements and impact on longer term outcomes as set out in the strategy, referenced above. 

ICB Commissioning Plans 
As part of the Derby & Derbyshire, Lincolnshire, and Nottingham & Nottinghamshire ICB cluster, Lincolnshire residents will see system wide commissioning priorities more closely aligned with tackling dementia from 2026/27 onwards.

Plans are now in place to introduce a greater focus on prevention activities around reducing smoking prevalence and increasing weight management uptake. Residents in the Core20PLUS5 population groups will be of highest priority.

Improved diagnostics and earlier detection are also key priorities, with a focus on Right Test, Right Time and nearer home diagnostics. Integrated Neighbourhood Teams will undertake proactive case-management and case-finding, with enhanced personal support for individuals and their carers also in place, underpinned by improved carer identification.

In secondary care, a drive to reduce emergency admissions will be facilitated by a same-day community response approach.

Choice and personalisation will be actively enabled, including digital access so that people can choose how, where and by whom they receive care wherever clinically appropriate. 

Evidence-based Approaches 
Based on feedback from the stakeholder workshop and patient and carer survey, some key themes which emerge are as follows: 

Prioritise a coordinated, life-course approach 
Growing evidence emphasises the potential for prevention throughout the life course. The Lancet Commission (2024) expanded the number of modifiable dementia risk factors from 12 to 14, adding vision loss and high cholesterol to the list of established risks such as hypertension, diabetes, smoking, physical inactivity, hearing loss, and air pollution.

A life course public health approach is therefore critical, recognising that many risk factors are socially patterned and linked to deprivation, early life disadvantage, and environmental conditions. Policy levers such as tobacco control, active travel infrastructure, safe green spaces, improved air quality, and accessible health and education services can be used to help reduce risk and narrow inequalities in the long term. Local systems should focus on midlife interventions and population wide prevention. 

Focus on training staff 
The CQC has found that health and social care staff do not always understand the specific, personal care needs of people with dementia, and that care environments, like hospital wards and care homes, do not always support people’s wellbeing.

NICE guideline NG97s provides practical recommendations on staff training and helping carers to support people living with dementia. 

Incorporate Lived Experience 
The importance of incorporating the voices of people living with dementia and their carers into service planning and delivery cannot be understated. Existing mechanisms for gathering lived experiences should be formally incorporated into Lincolnshire’s dementia approach going forward.