England's former national cancer director backs an 18-week referral-to-treatment target for dementia care, intensifying pressure on Greater Manchester mayor Andy Burnham to establish concrete waiting-time benchmarks for the region.
The push mirrors successful models from cancer treatment pathways, where defined timelines have become standard across the NHS. The 18-week standard emerged from cancer care frameworks, where delays directly impact prognosis and patient outcomes. Dementia diagnoses operate differently, but experts argue that similarly urgent timelines serve the patient interest, particularly given the neurodegenerative nature of the disease and the value of early intervention in slowing cognitive decline.
Burnham, who oversees health policy across Greater Manchester's 2.8 million residents, currently operates without region-specific dementia waiting-time targets. The absence creates inconsistency across trusts and puts Greater Manchester behind some other English regions where such frameworks exist. NHS England has not mandated a national dementia target, leaving local integrated care boards to set their own priorities.
The former cancer director's endorsement carries weight within NHS circles. Cancer waiting-time targets, introduced in 1997 and refined repeatedly since, forced healthcare systems to allocate resources strategically and measure performance transparently. Two-week urgent referrals for suspected cancer became non-negotiable policy. By analogy, an 18-week pathway for dementia referral-to-diagnosis could establish similar accountability.
Current dementia diagnostics in England average 12 to 20 weeks from GP referral to specialist assessment, depending on regional capacity. Memory clinics remain understaffed in many areas, and staffing shortages in neurology and old-age psychiatry mean backlogs persist. Greater Manchester faces particular strain given its aging population and competing demands on mental health services.
Burnham has positioned himself as a health-system reformer and devolution advocate. He negotiated the Greater Manchester Health and Social Care Partnership devolution deal in 2021, which granted the region greater autonomy over NHS spending and strategy. A public backing of the 18-week target could signal his commitment to measurable outcomes and equity across the system.
Campaign groups focusing on dementia care have voiced frustration with variable waiting times. Patients and families navigating diagnostic uncertainty face prolonged limbo, during which disease progression continues unchecked. An explicit target would clarify expectations and force resource planning around capacity.
NHS England leadership has not blocked regional targets, but national resources remain constrained. Implementing an 18-week target would require additional funding for memory clinics, recruitment of geriatricians and neuropsychologists, and operational redesign. Burnham would need to justify the spend against competing priorities like emergency department wait times and planned surgery backlogs.
The former cancer director's intervention suggests growing consensus that dementia diagnostics deserves parity with other pathways in terms of urgency and measurement. Whether Burnham adopts the target will test whether regional devolution translates into faster, better dementia care or simply new bureaucratic targets without resources to match them.