Alex Fox writes about loneliness, social isolation and prevention, and explains how you can help shape the Government’s reform of social care law.

‘Caring for Our Future’ is the government’s ‘engagement exercise’, which is giving anyone with an interest the opportunity to contribute to the ideas going into next Spring’s social care White Paper, which will be followed by completely new legislation for social care.

This will replace all the cobbled-together social care law we’ve been accumulating since 1948 with a brand new – and hopefully clearer – legal basis for care and support. There are six strands to the exercise, including prevention which asks the question: how do we create a system in which I have more opportunity to share responsibility for planning a sustainable life now, rather than waiting until I’m in a crisis for a limited choice of services?

Some of the most passionate debates we’ve had around the theme of prevention have been about how we should measure the success of preventative services. Is this all about achieving savings to the NHS, in which case you risk dividing people into the ‘fixable’ and the not fixable? Or should preventative and early intervention services focus on softer outcomes such as tackling isolation and loneliness?

There is a consensus that isolation and loneliness have impacts which stretch across people’s health and well-being. There is awareness that, if people remain isolated, they may be more likely to lose their independence and to use expensive services. But there is less of a consensus about the best approaches to take to tackle the issue, and idea of measuring the success of those interventions and the savings they might generate, is still regarded by many as unrealistic.

Resolving these questions is important. It’s easy to point to a number of reasons why commissioning for reactive and crisis services takes precedence over commissioning for universal and early intervention services. But it is the weak evidence base for the achievement of outcomes, let alone savings, which appears to be an important reason.

Services which tackle isolation are often seen as the nice things that commissioners fund if they’ve got any money left over after funding the ‘essentials’.

There is some evidence that ‘little bit of help’ services help people stay independent, but also evidence that some speed people’s journey into ‘service land’ by reducing their sense of self-reliance or the input of families and communities.

Arguably, genuinely reduced isolation isn’t something a service is best placed to provide. A befriender may have a very positive impact, but there is a difference between a volunteer and a friend, or a network of friends. You can’t specify love or a sense of belonging in a contract.

The answer appears to lie in those interventions which recognise that they are most effective when working alongside unpaid and informal relationships, not a replacement for them. Interventions such as Local Area Coordination, Asset Based Community Development, KeyRing, Shared Lives (my day job) and neighbourhood networks all attempt to bring professionals, volunteers, friends and neighbours together in productive ways.

You may agree or disagree – please do! There’s still time to feed into the engagement exercise. You can see the latest thinking of the six reference groups on the official website.

Alex Fox is CEO of Shared Lives Plus and ‘Action Group Partner’ with the Campaign to End Loneliness. He is a board member of Think Local, Act Personal and co-leads on the prevention strand of Caring for Our Future.

For more information on what you could include in a consultation response to highlight the importance of addressing loneliness, visit the Campaign to End Loneliness page ‘Respond to the Caring for Our Future Consultation’ here.