The 18-Week Dementia Target Is Almost the Median Wait

England’s memory clinics already take a median 137 days to diagnose dementia, 11 days past the 18-week target now being urged on Prime Minister Andy Burnham. Alzheimer’s Society, with The King’s Fund, used last week’s London conference to demand a cancer-style clock, and Social Care Minister Alison McGovern called that report “spot on.”

The number sounds like a leap. Against the clinic data it is a trim. The longer wait still sits at home, before a GP referral starts the clock, and the only licensed drugs that need an early diagnosis are still blocked for NHS use.

Memory Clinics Already Wait 19.6 Weeks

The National Audit of Dementia’s 2025 mapping of memory assessment services, published by HQIP on 11 June 2026, put the median wait from referral to diagnosis at 137 days, or 19.6 weeks. That is five days longer than the 132 days in the 2023 spotlight audit, even though clinics reported low staff vacancies.

THE CLOCKS ALREADY RUNNING

Professor Sir Mike Richards, the former national cancer director who introduced cancer waiting targets in 2000, says an 18-week dementia target is achievable if ministers put money behind it. “All of that is going to cost more money but remember the toll that this condition is taking at the moment, both on the people affected by dementia themselves and their relatives,” he said.

About one million people live with dementia in the UK, a figure Alzheimer’s Society expects to reach 1.4 million by 2040. There is still no national waiting-time target for the condition in England.

A Six-Week Pathway Was Written in 2018

Memory clinics were already told to move faster. The 2018 Dementia Care Pathway from the National Collaborating Centre for Mental Health said most people should get a diagnosis within six weeks of referral. In May 2025, NHS mental-health data showed 16.8% of people in England met that mark.

An 18-week target would be three times that older guidance and only 11 days inside today’s median. The audit also found 23% of services did not offer cognitive stimulation therapy after diagnosis, the group treatment NICE already backs.

On 31 December 2025, NHS England Digital counted 512,466 people with a recorded diagnosis. That was 66.3% of people aged 65 and over estimated to have dementia, a shade under the old two-thirds goal of 66.7%. That rate target later dropped out of NHS operational planning, which is why charities now want a time target they can hold local systems to.

Michelle Dyson, chief executive of Alzheimer’s Society, has put the demand in writing. “People living with dementia should receive an accurate diagnosis and, crucially, a care plan and access to appropriate treatment, within 18 weeks of referral,” she said. “This would bring dementia in line with all other major health conditions and is not only achievable, it is the very least that people with dementia and their families deserve.”

Sir Mike Richards Built Clocks the NHS Still Misses

The political model is cancer. Richards was national cancer director when maximum waits for diagnosis and treatment arrived in 2000, with a national director and later a web of standards. Charities now want the same kit for dementia: a tsar, a plan, and a public clock.

Cancer has not cleared its own bars. Health Foundation analysis of the March 2026 interim tests found 65.3% of elective waits within 18 weeks, which met a lowered 65% goal rather than the old 92% constitutional standard. The 28-day faster diagnosis standard for cancer sat at 79.4% against an 80% target. The 62-day wait from urgent referral to first cancer treatment sat at 72.8% against 75%. The older 85% version of that 62-day rule has been missed nationally since 2014.

Copying cancer’s brand copies a system that still runs late. It also copies the wrong cancer number. The NHS aims to tell people whether they have cancer within 28 days. Eighteen weeks is 126 days, more than four times that diagnosis standard. Dr Richard Oakley of Alzheimer’s Society has already said he can see no reason not to be as ambitious as 28 days, and has described 18 weeks as a starting point.

What an 18-Week Target Would Require

A clinic clock only moves if the tests behind it move. Dementia diagnosis is slower than a biopsy because it is a stack of interviews, scans and, for drug eligibility, biomarker proof. Baroness Louise Casey, who chairs the Independent Commission on Adult Social Care, told ministers in March to put dementia “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.”

She later said the NHS had “stuck our heads in the sand about it.” An 18-week stamp does not, on its own, buy a PET slot or a lumbar-puncture list. A target without that kit becomes a waiting list that gets managed on paper.

WHAT AN 18-WEEK PATH WOULD NEED

• Memory clinic capacity: Referral, interview and cognitive testing already consume a median 57 days before the diagnostic work even starts.
• Brain imaging: MRI, and CT where MRI is not possible, to rule out other causes and to screen for bleeding risk if antibody drugs are in play.
• Amyloid proof: A PET scan or a cerebrospinal fluid test, still the gate for licensed antibody treatment, with blood tests only in trials such as READ-OUT and ADAPT.
• Genetic counselling: APOE4 testing for lecanemab-style drugs, because homozygous carriers face higher swelling and bleed risk.
• A care plan on the day: Charities want treatment advice and social-care signposting inside the same 18 weeks, not a letter and a leaflet.

McGovern said the government has put £5 million into a Dementia Patient Flow Challenge because the average lag from evidence to practice is 17 years. That money is a study of the bottleneck, not a national scan network.

NICE Still Blocks the Only Licensed Drugs

Lecanemab and donanemab are licensed in the UK for early Alzheimer’s. In June 2025 NICE said they should not be routinely funded, because slowing from mild to moderate disease by 4-6 months was too small to justify the additional cost of infusions and safety MRI. In March 2026 appeal panels sent both appraisals back. They are not on the NHS in the meantime.

The committee concluded the small benefits of donanemab and lecanemab shown in the clinical trials and the lack of long-term evidence of effectiveness, together with the substantial resources the NHS would need to commit to the treatments means if they were approved they could displace other essential treatments and services that deliver significant benefits to patients.

Helen Knight, director of medicines evaluation, NICE

Those drugs only work in a narrow window: mild cognitive impairment or mild dementia, proven amyloid, and a brain that has not already moved past the eligible stage. A long wait can push someone out of that window. Speeding diagnosis without a funded drug still helps people plan, claim support and join trials. It does not slow the biology.

McGovern told the conference that 158 dementia drugs are now in trials, up from 24 a decade ago. That pipeline is the hope. It is also why a clinic clock is being sold as a cancer moment: the next drugs will need the same early, typed diagnosis cancer already demands, and England does not yet run that machine at scale.

Unpaid Families Carry Half the Cost

The 137-day clinic wait is not the wait families describe. Alzheimer’s Society says people wait 3.5 years from first symptoms to a diagnosis. A survey of more than 1,000 carers found 45% waited more than six months after they first sought help, a stretch that includes the GP queue before the memory-clinic clock starts.

Michael Fethon’s father, Jim, was 69 when he was diagnosed with Alzheimer’s in 2022. The family waited 18 months from the first GP visit. When the result came, it came by phone, with leaflets in the post and no follow-up. “I have family members who have had cancer and they had so much more support than we did for Dad’s dementia,” Fethon said.

WHO PAYS WHILE PEOPLE WAIT

• The bill: Dementia costs the UK £42 billion a year, 63% of it borne by people with the condition and their families, rising to £90 billion by 2040 if nothing changes.
• The lifetime hit: A person with dementia spends about £100,000 on care over their life under the current means-tested system.
• The hidden workforce: About 1.8 million people in England already provide some care for someone with dementia.
• The breaking point: 43% of dementia carers say they have been unable to cope, and Carers UK polling cited by McGovern puts job exits to unpaid care at about 1,500 people a day in Britain.

A faster clinic letter does not staff a night rota. It can stop families spending a year in limbo without a name for what they are seeing, which is why the 18-week ask still has force even when it barely beats the median. The larger gap is the years before that letter, and the social care bill after it.

It’s too often a trauma, and as a result it’s been neglected for far too long. But that is all the more reason it must be a priority right now.

Alison McGovern, Minister of State for Social Care and Mental Health, Alzheimer’s Society Conference, 17 September 2026

In the same neglected for far too long address, McGovern said working-class women still hold up paid and unpaid care, and that economics treated that labour as free. She pointed to a Fair Pay Agreement backed by half a billion pounds for the first deal, and to Skills England’s estimate of 200,000 extra adult social care workers by 2035. Those are workforce pledges, not a diagnosis standard.

Burnham’s Dementia Plan Is Due by December

Burnham cancelled engagements after the death of his father, Roy, who had Alzheimer’s. Returning, he said his father would have wanted him “back out there” to bring forward “the changes that he always pushed me to make.” In July he had already tied that illness to his push on adult social care. McGovern opened the conference by sending the hall’s thoughts to the family.

Personal grief is being read as political weather. It does not decide the target. Burnham has said he will wait for Casey’s recommendations before he sets the shape and the funding of social care reform.

HOW THE TARGET REACHED NO 10

1. 2000: Richards introduces national cancer waiting targets and a national cancer director.
2. 2018: Pathway guidance tells memory clinics to diagnose most people within six weeks.
3. June 2025: NICE rejects routine NHS use of lecanemab and donanemab.
4. 3 March 2026: Casey writes to the health secretary urging an 18-week dementia standard and faster trials.
5. March 2026: NICE appeal panels send both drug appraisals back for another look.
6. 11 June 2026: The National Audit of Dementia publishes the 137-day median wait.
7. 17 September 2026: McGovern backs the Alzheimer’s Society report and confirms a dementia tsar and a modern service framework by the end of the year.
8. Summer 2027: Casey’s wider social care recommendations are due, after Burnham asked for the work to be brought forward from 2028.

The framework can still put 18 weeks on paper. It can also repeat the 2018 six-week line and leave it unenforced. McGovern promised to “appoint a dementia tsar, backed with real expertise,” and said families are “too often left to navigate a shattered system at the most difficult time in their lives.”

An 18-week target would make that system countable. It would not, by itself, shorten the 3.5 years before a referral, staff the scans, or put the licensed drugs on a hospital chair. Those are the decisions still sitting with Burnham, Casey and NICE after the conference banners come down.

Disclaimer: This article is news reporting on NHS dementia policy, waiting times and drug appraisals, and is for information only. It is not medical advice, a diagnosis, or a recommendation to start, stop or seek any treatment, and it is not advice on social care funding or legal rights. Readers with memory symptoms, a possible dementia diagnosis, or questions about care should speak to their GP or another qualified clinician, and may also need independent advice from a social worker or solicitor on care charges. Figures and policy positions reflect the official data and statements cited here as of the dates on those sources and may change as the modern service framework, the Casey commission and NICE appraisals move on.