1. Common Standards of Care for Dementia
1.1 One of the strongest messages repeatedly coming out of the development of the strategy was a demand and need for a greater common understanding of what constitutes a good quality of care and support - through all stages of the illness and in all care settings. The nature of the illness means that people quite often have difficulty in asserting their rights in demanding quality; and they and their families and carers can be subject to discrimination which means that they can be treated with less dignity and respect than other members of society.
1.2 The final strategy reflected this key message in committing to the development and implementation of common standards of care for dementia. In doing so, the strategy adopted the principles of the Scottish Parliament's Cross-Party Group on Alzheimer's Charter of Rights for People with Dementia and their Carers in Scotland, which stated that, in line with their human rights as enshrined by law, people have the right to be empowered to participate fully in the design and delivery of care to live as independently as possible, and be free from any discrimination.
1.3 The Scottish Government commissioned The Mental Welfare Commission to lead in developing the standards, with a multi-representative steering group Chaired by the former Director of the Dementia Services Development Centre, Professor Mary Marshall and including people with dementia and carers. The steering group met regularly over almost a year to guide the preparation of the final document. Its content, as it was developed, was also consulted on in a series events held throughout Scotland.
1.4 The final document is designed to help people with dementia and their carers understand and assert their rights in obtaining and participating in care and treatment which they need. It is designed as a key resource for those statutory and voluntary agencies providing services in giving detailed information on what is expected from them in terms of the content and quality of services; and for NHS Boards and local authorities in assessing the services commissioned or managed. For scrutiny and improvement organisations, it will inform the assessment of care in individual cases and in programmes of inspections.
1.5 The standards explicitly assert that people have a right to a diagnosis; the right to be treated as a unique individual and to be treated with dignity and respect; the right to access the range of care and treatment; the right to live as independently as possible and be included in the community; the right to have carers who are well supported and educated about dementia; and the right to end of life care that respects their wishes. For each of these, the standards describe what should happen in individual's care and treatment in order for this right to be promoted, recognised and protected - and the role to be played by agencies in order to ensure that the standards are implemented every time.
1.6 The standards articulate a national consensus on what level of quality those with dementia should expect in local services. While we will expect services to use the standards in an early assessment of local provision - to identify areas of strength but also areas where changes and improvements need to be made - we will simultaneously, over the best part of the next year, engage in national and regional consultation on their contents and how they translate into practice.