Younger people with dementia and their carers frequently fall through the net of the health and social care services. During the 1990s an increasing number of these patients were referred to old age psychiatry services. In response to this new pattern, in 2000 the Royal College of Psychiatrists’ Faculty of Old Age Psychiatry, in conjunction with the Alzheimer's Society, published a policy paper outlining the configuration of services for younger patients with dementia. The document was well received. In 2002 a review showed that a start had been made in implementing its recommendations but that no health area had put all its recommendations into practice.

The authors of the present report are encouraged by what has been achieved and remain convinced of the importance of the original document's two key recommendations. An incremental approach is advocated, with the appointment of two key players: at the commissioning level (primary care trusts or their equivalent), a named person responsible for planning, and a consultant clinician to act as a focus for referrals, initially with two programmed activities or sessional equivalents. An old age psychiatrist is well-placed to undertake the clinical role.

After these appointments have been made, the rudiments of the local service are created. At all stages, coordination and networking with people already involved with younger people with dementia is important; the composition and evolution of the new service will depend on existing local services and facilities.

Both organisations remain committed to these principles and consider that it is timely to publish this second edition of the policy paper so that the momentum will be maintained. In this way this disadvantaged group of patients will have a modern dedicated service to meet their special needs.