Table of contents

Approximate read time: 15 minutes

The House of Lords is scheduled to consider the following question for short debate on 9 July 2026:

Lord Weir of Ballyholme (DUP) 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.

1. About dementia and frailty

1.1 Dementia

Dementia is an umbrella term for a range of conditions associated with an ongoing decline of brain functioning. Alzheimer’s disease and vascular dementia are commonly known forms of dementia.[1]

Symptoms of dementia can include problems with:

  • memory loss
  • mental sharpness and quickness
  • language and understanding
  • mood
  • movement
  • doing daily activities

There is currently no cure for dementia, but there are medicines that can help with some symptoms and related problems.

In addition, people may need increasing support from family, friends and carers due to difficulties caused by living with dementia. This can lead to issues with the cost and complexity of funding ongoing care.[2]

Concerns have also been raised about the diagnosis of dementia in the UK. For example, the Alzheimer’s Society charity has stressed there are regional variations in dementia diagnosis and support:

Diagnosis rates vary significantly from place to place, with dementia prevalence also nearly twice as high for those living in the most deprived areas compared to the least deprived areas.

[…] a lack of guidance around post-diagnostic support is leading to a “postcode lottery of access to effective care and support,” leading many people living with dementia and their families struggling to access the help they need.[3]

Statistics published by NHS England indicate that as at 31 March 2026:[4]

  • 513,135 patients had a recorded diagnosis of dementia, an increase of 2,796 patients since 28 February 2026
  • 66.3% of patients aged 65 or over who were estimated to have dementia had a recorded diagnosis of dementia[5]
  • 388,628 (75.7%) of those with a recorded diagnosis of dementia had received a care plan or care plan review in the preceding 12 months
  • 301,136 (58.7%) of those with a recorded diagnosis of dementia who had received a dementia care plan or care plan review in the preceding 12 months have received a medication review since 1 April 2025
  • 34,639 (6.8%) of those with a recorded diagnosis of dementia received their diagnosis before the age of 65

The research charity Alzheimer’s Research UK estimates that 982,000 people across the UK are living with dementia.[6] The NHS has also cited estimates that one in 11 people over the age of 65 have dementia in the UK.[7]

Further details on dementia and support for the condition can be found in the following:

1.2 Frailty

NHS England defines frailty as:

A clinical state that is more common with increasing age. It is characterised by decreased physiological reserve, an increased vulnerability to stressors, and an increased risk of adverse outcomes such as falls, delirium, loss of function or independence, hospitalisation, long-term care needs and premature mortality.

[Frailty describes] a medical condition where people lose their in-built reserves and become increasingly susceptible to illness. Although more common with increasing age, it can occur in younger age groups.[8]

The NHS considers frailty to be a more effective way (compared with age alone) of identifying people who may be at greater risk of “sudden deterioration in health and wellbeing, falls, confusion, disability, hospital admission, the need for long-term care, and mortality”.[9] It says early identification may enable steps to be taken to mitigate and plan for potential issues.

A report published by the National Audit Office (NAO) estimated that, as at March 2025, 1.06 million people aged 65 or over had been diagnosed by an NHS England GP as living with moderate frailty and a further 450,000 had been diagnosed with severe frailty.[10] However, it noted difficulties estimating the number of people who may be living with frailty and stated these totals were likely underestimates as not all people aged 65 or over have been assessed for frailty. It also said there was “significant and unexplained local variation in the proportion of patients who were assessed for frailty […] this may be due to local capacity, local prioritisation or data issues”.[11]

The report then considered the growing issue of frailty (particularly in light of an ageing population) and the government and NHS approach to supporting people living with it. Among its findings, the NAO said there was limited national level data on the outcomes of frailty-related services, there was not a single clear and joined-up NHS England and departmental strategy for dealing with frailty, and GPs were not providing the required support and follow-up for people diagnosed with severe frailty.[12] NHS England has since published a best practice guide which sets out priorities and related key actions to help ensure people living with frailty receive the right support.[13]

Further information on frailty, including on diagnosis and support, can be found in the following:

2. Modern service framework for dementia and frailty

2.1 Announcement and scope

The government committed to develop a modern service framework for dementia and frailty as part of its 10 year health plan published in July 2025.[14] It announced this in the context of providing clearer accountability and stronger incentives for high quality care.

Giving details on its plans for modern service frameworks, the plan stated:

The National Quality Board [which is tasked with driving high quality care] will, working with clinicians and patients, oversee the development of a new series of service frameworks to accelerate progress in conditions where there is potential for rapid and significant improvements in quality of care and productivity. Between 1997 and 2010, national service frameworks were a clinically led and authoritative tool that supported sustained improvement in major condition outcomes, including by narrowing inequality and reducing unwarranted variation.

We will reintroduce and modernise this approach, publishing a first wave of ‘modern service frameworks’ in 2026, which are accessible and transparent to all. Early priorities will include cardiovascular disease, mental health (including severe and enduring mental illness), and—informed by phase one of the independent commission into adult social care led by Baroness Casey[15]—the first ever service framework for frailty and dementia. These modern service frameworks will:

  • define an aspirational, long-term outcome goal
  • 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
  • set standards on how those interventions should be used, alongside a clear strategy to support and oversee uptake by clinicians and providers
  • 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
  • alongside a plan to partner with the wider ecosystem, support the creation, adoption and spread of novel new ideas.[16]

2.2 Further statements and reaction

As part of her ongoing review of adult social care, Baroness Casey of Blackstock (Crossbench) wrote a letter to then Health Secretary Wes Streeting in March 2026 urging the government to take more urgent action on dementia, as well as on adult safeguarding and motor neurone disease.[17] She argued there was a lack of drive to address the issue of dementia:

I have not found a system set up to tackle this problem with the same energy we have seen in the face of other conditions.

Preparation needs to be made for future clinical breakthroughs. Dementia is currently viewed as an inevitable part of aging or something which should be tackled through prevention only. People with dementia are too often treated as “bed blockers” rather than patients with neurological, health conditions. There is a lack of collective drive on this issue.[18]

As part of her recommendations, she called for the government to make faster progress on setting the modern service framework for frailty and dementia and for it to publish this in 2026. She continued:

It should be developed in partnership with local government as well as the NHS and look at how dementia can be put on a level playing field with other conditions, for example by setting national standards for dementia diagnosis, including an 18‑week referral‑to‑treatment target.[19]

Her other recommendations for the government on dementia were:

  • Giving immediate backing to scale up investment in dementia trials. Starting with using funding from the dementia goals programme to trial new dementia drugs, beginning with pilots of 100 people across two sites, with an ambition to scale up to 2,000 people across 20 sites within five years.
  • Appointing a new, full-time dementia tsar who has national responsibility for driving forward the prevention, treatment and care of dementia, including fulfilling the government’s manifesto commitment to put Britain at the forefront of transforming treatment for dementia.[20]

James Murray, Mr Streeting’s successor as health secretary, responded to Baroness Casey’s letter on 22 June 2026. He agreed with the need to be more ambitious on dementia care and treatment, stating that the government would be “pulling all the levers available to us, and […] harnessing a full range of innovation”.[21]

Mr Murray said the government would publish the modern service framework for dementia and frailty by the end of the year. In addition, a government blog post by Minister of State for Care Stephen Kinnock detailed plans to publish an “interim product in September this year [2026] to feed into NHS and local government planning cycles”.[22]

Giving more details on the framework in his letter, Mr Murray said:

This will be an outcome-led blueprint for how we deliver a once in a generation shift for people living with dementia. It will cover faster access to care, including diagnosis and treatment and ensure the right access to support that allows them to live well in their own neighbourhoods. It will also outline how we will accelerate and prepare for the innovations that will transform care in the future.[23]

He also confirmed the government would be appointing a dementia tsar and increasing support for dementia trials. In addition, he said it would be reviewing how the Department of Health and Social Care and its arm’s length bodies approach dementia, to ensure there is one coherent strategy.

The government has also stated it intends for the modern service framework to set national standards for dementia care and address local and regional variations for diagnosis and support.[24] In response to a recent parliamentary question, the government said it was currently working with stakeholders on the plans:

We will set an aspirational, long-term outcome goal for frailty and dementia over the next 10 years. This is currently being refined based on feedback from stakeholders across the health and care sector and will address our three key ambitions for timely and proactive support, coordinated and well-organised care, and fair and consistent outcomes.

We are engaging with a wide group of partners to understand what should be included to ensure the best outcomes for people living with frailty and dementia, and as part of this exercise, we will develop a list of best evidenced interventions following analysis of the evidence gathering exercise submissions and wider research.[25]

The dementia nursing charity Dementia UK responded positively to the announcement of the modern service framework, stating that “if delivered well, this could be an opportunity for real progress in joining up and improving dementia care”.[26] The organisation said it was committed to feeding expert insights and experiences from specialist nurses and people living with dementia into the framework’s development.

Alzheimer’s Research UK has also said it is working with the government on the framework’s development. It said the framework was a chance to address the issues of “too many people [facing] long waits, fragmented pathways, and unequal access to diagnosis and innovation”.[27] It called for the framework to deliver on three key changes:

  • A clear, fair diagnosis pathway—wherever you live: People affected by dementia deserve an early and accurate diagnosis wherever they live. There should be one national pathway which would reduce unfair variation, support earlier diagnosis, and provide clarity for people living with dementia and their families.
  • Better data, to drive better care: Improving care depends on understanding what’s happening on the ground. Consistent data collection would support improved services, expose inequalities, strengthen accountability, and speed up research and innovation.
  • National leadership on innovation: With major advances in diagnostics and treatments on the horizon, the NHS needs to be ready to deliver. National support and investment would help services build capacity, spread best practice, and ensure access to innovation for everyone.[28]

Dementia UK, Alzheimer’s Research UK and the Alzheimer’s Society sent a joint letter (cosigned by other stakeholders) to Health Secretary James Murray on 21 May 2026 setting out their views on dementia services in the UK and what they believed the modern service framework needed to address.[29] In addition to the matters set out above, their letter stressed the need for a coherent national approach and strengthened workforce capacity (including access to specialist dementia nursing) to ensure any advances in diagnosis and treatment led to better longer-term outcomes.

3. Read more

Image by freepik

References

  1. NHS, ‘What is dementia’, accessed 29 June 2026; and Dementia UK, ‘What is dementia?’, March 2026. Return to text
  2. House of Lords Library, ‘Dementia care’, 11 January 2024. Return to text
  3. Alzheimer’s Society, ‘What we think about dementia diagnosis’, accessed 1 July 2026. Return to text
  4. NHS England, ‘Primary care dementia data, March 2026’, 30 April 2026. Return to text
  5. NHS England notes that many people with dementia will not have been diagnosed, so this statistic compares the number of people aged 65+ thought to have dementia with the number of people diagnosed with dementia. Return to text
  6. Alzheimer’s Research UK, ‘Statistics about dementia’, accessed 29 June 2026. Return to text
  7. NHS, ‘What is dementia’, accessed 29 June 2026. Return to text
  8. NHS England, ‘Supporting people living with frailty’, accessed 29 June 2026. Return to text
  9. As above. Return to text
  10. National Audit Office, ‘Primary and community healthcare support for people living with frailty’, 27 November 2025, p 14. Return to text
  11. As above, p 31. Return to text
  12. As above, pp 6–12. Return to text
  13. NHS England, ‘Best practice guide for NHS frailty pathways’, 14 May 2026. Return to text
  14. Department of Health and Social Care, ‘Fit for the future: 10 year health plan for England’, 30 July 2025, CP 1350. Return to text
  15. Independent Commission on Adult Social Care, accessed 1 July 2026. Return to text
  16. Department of Health and Social Care, ‘Fit for the future: 10 year health plan for England’, 30 July 2025, CP 1350. Return to text
  17. Casey Commission, ‘Letter from Baroness Casey of Blackstock to Wes Streeting’, 3 March 2026. Return to text
  18. As above, p 2. Return to text
  19. As above, p 5. Return to text
  20. As above, p 2. Return to text
  21. Department of Health and Social Care, ‘Letter to Baroness Casey: Progress on adult social care reform recommendations’, 22 June 2026. Minister of State for Care Stephen Kinnock cosigned the letter. Return to text
  22. Department of Health and Social Care, ‘Creating hope: Improving dementia care and research’, 22 May 2026. Return to text
  23. Department of Health and Social Care, ‘Letter to Baroness Casey: Progress on adult social care reform recommendations’, 22 June 2026.. Return to text
  24. House of Commons, ‘Written question: Dementia: Diagnosis (1627)’, 26 May 2026; and ‘Written question: Dementia: Health Services (7291)’, 15 June 2026. Return to text
  25. House of Commons, ‘Written question: Dementia: Health Services (7291)’, 15 June 2026. Return to text
  26. Dementia UK, ‘Progress for dementia care in the NHS 10-year health plan’, 11 July 2025. Return to text
  27. Alzheimer’s Research UK, ‘Modern service framework’, accessed 30 June 2026. Return to text
  28. As above. Return to text
  29. Dementia UK et al, ‘Joint letter to Health Secretary James Murray’, 21 May 2026. Return to text