It urges the Department of Health to demonstrate that its dementia strategy, published last year, is not just words.

The plans include action to boost early diagnosis and better patient and carer support. The NAO praises the ambition but asks whether they can be delivered.

Care services minister Phil Hope welcomed the report but insisted the implementation plan was on track.

'Very patchy'

"We are in the first year of our ambitious five year National Dementia Strategy - change will not happen immediately," he said.

"There is still much more to be done and we are working hard to put the plans outlined in the strategy into place."

The NAO report describes the dementia strategy as "comprehensive and ambitious". However, it says achieving the planned "transformation" in services will be very challenging.

In particular it criticises a failure to make dementia a national priority in the NHS Operating Framework - which sets out the key areas for the NHS in the year ahead.

NAO director of health value for money Karen Taylor said trusts would concentrate on other issues if they were not made to focus on dementia.

"They won't be giving it the priority or the urgency that both ourselves and the Public Accounts Committee were led to expect dementia would get when we reported on it in 2007," she said.

The strategy is expected to cost nearly £2bn over 10 years, funded largely through efficiency savings. But the NAO says the eventual cost will be more than that.

Announcing the plans last February the government said trusts would receive an extra £150m over two years to support the strategy.

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