This section provides briefings on English legislation and policy initiatives that are relevant to addressing loneliness and isolation. It draws out specific implications that can be used to guide the practice of commissioners of loneliness interventions.
The Care Act and Loneliness
The Care Act 2014 creates a clear imperative for a range of key local actors to take action to address loneliness and isolation. This includes meeting the new prevention duties, and to meet care and support needs identified during assessments. The Statutory Guidance (the Guidance) which accompanies the Care Act elaborates how authorities should meet their new obligations.
The Act also establishes the “wellbeing principle” – making promoting wellbeing the core purpose of local authorities’ exercise of their care and support functions. It will create more opportunities to identify people whose wellbeing is at risk due to loneliness and social isolation. It will also create more opportunities to intervene early through the new requirement to offer assessment to any individual who appears to have a need for care and support, and to all carers – whether eligible for services or not.
Better Care Fund and Loneliness
Areas that incorporate action to prevent and reduce loneliness and isolation into their plans under the Better Care Fund are likely to reap rewards across a range of key metrics, including reduced A&E admissions:
• Given the strong evidence from the UK and overseas linking loneliness and isolation to increased admissions to A&E, local areas should ensure that their Better Care Plans drive forward work to address these issues.
• Tackling loneliness has also been endorsed as a key form of primary prevention, and was recognised by the Kings Fund as a way of making best use of the Better Care Fund.
Adult Social Care, Public Health and NHS Outcomes Frameworks
There is good evidence that action to reduce loneliness is likely to drive improvements across a wide range of domains of the key outcomes frameworks for health and wellbeing – the NHS, Public Health and Adult Social Care Outcomes Frameworks. This includes, but is not limited to, outcomes which explicitly relate to social contact.
Public Health England – Ending Loneliness in the North West
Transforming Primary Care
The Transforming Primary Care paper includes explicit reference to loneliness as one of the wider determinants of health, making clear that the issue needs to be considered by GPs and care coordinators as they determine an appropriate programme of care for vulnerable patients.
Integrated Personal Commissioning
Integrated Personal Commissioning (IPC) is another part of the reform of health and social care which is likely to urge the provision of services and supports designed to tackle loneliness. The Prospectus for the scheme was launched in September 2014 and highlights the likelihood that action to prevent or address social isolation will be part of packages commissioned under IPC. This point is further expanded under guidance launched by Think Local, Act Personal on the scheme, which includes the Rotherham Social Prescribing Scheme (featured in Promising Approaches) as a case study.
NHS Five Year Forward View and New Models of Care Vanguards
The shift towards preventing ill-health and promoting wellbeing should encourage action to address loneliness, as this has been recognised as a key form of primary prevention.
The Five Year Forward View and Planning Guidance set out three main new models of care that are being promoted in addition to changes that are already underway. Across the new “Vanguard Sites” for the New Care Models Programme, the need to address loneliness and isolation has already been recognised by a number of the sites. For example, in the area of Integrated Primary and Acute Care Systems (joining up GP, hospital, community and mental health services), plans from Salford Together state: “working with the voluntary sector [we] will build supportive networks for individuals who are at risk of becoming socially isolated.”