Reconnections - the UK’s first Social Impact Bond targeting loneliness
Loneliness can affect everyone, and the suffering it causes is something which we can all understand… Reconnections provides personalised support to older people… It is not about distraction for a couple of hours a week – it is tailored support to build confidence, develop mutually supportive relationships and helps people to enjoy life once again.
John Kingston, Chair (2015–2022), Reconnections
The problem Reconnections was trying to solve
One in ten older people find chronic loneliness to be a significant challenge to their wellbeing and are likely to make high use of health care services.
Compared to well-connected people, they are on average 1.9 times more likely to visit a GP, 1.6 times more likely to go to A&E, and 3.5 times more likely to enter local authority-funded residential care.
This so-called ‘epidemic of loneliness’ was something local authorities and NHS services across the UK were starting to recognise as a significant issue when the Care and Wellbeing Fund was launched in 2015.
How the Reconnections Social Impact Bond was set up
Reconnections was commissioned as an Social Impact Bond by Worcestershire County Council and the three NHS Clinical Commissioning Groups (CCGs) that cover the county, with payments dependent on reductions in loneliness, as reported by people receiving support.
Upfront funding for development and delivery was provided by a group of socially motivated investors and grant makers, including Macmillan Cancer Support and Better Society Capital (formerly Big Society Capital) whose investment was channelled via the Care and Wellbeing Fund, overseen by Social Finance.
As well as the investment to set up and run the service, Social Finance and Age UK secured grants from a range of funders to support innovation, learning and evaluation.
The project was delivered by Age UK Hereford and Worcestershire in partnership with three local voluntary sector partners – Onside Advocacy, Simply Limitless and Worcester Community Trust – and with support from Social Finance.
Outcomes
Between 2015 and 2020 Reconnections received 3,000 referrals from 150 different agencies and teams, and worked with over 1,500 lonely / socially isolated older people.
The Reconnections service was supported in each pilot by a service manager and delivered by a team of case workers, a volunteer coordinator, a service administrator and a wider network of around 150 volunteers.
On referral to Reconnections, the older person worked with a case worker to discuss their hopes and aspirations and develop a personal plan to pursue the things that matter to them. If required, the person were then be matched with a volunteer, who provided practical and emotional support to take the first steps in this plan, whether joining a dog walking group or community choir or a more unusual activity such as motorcycling.
From these first steps, people were supported and encouraged to do more and to grow in confidence and independence, with support generally provided for six to nine months. Volunteer matches were overseen by a paid coordinator who also monitors progress. The team also included a caseworker, to support people whose situation were too complex for a volunteer, and to make referrals to other professional services as needed.
In 2020, the Reconnections brand and intellectual property was transferred to Independent Age, a leading national older people’s charity, and seconded two members of staff to support the replication and roll-out of the Reconnections model.
When it took over Reconnections in 2020, Independent Age made a financial contribution to cover some of the initial investment in service development.
A range of funding models may be considered in the future, including direct local authority commissioning (as in Worcestershire), grant funding, outcome-based contracts, or hybrid models.
Handing over the Reconnections model allowed Social Finance and the social investors to ‘exit’ responsibly, confident that the approach will continue to grow under Independent Age. In our framework, this is an example of ‘using new vehicles’ to achieve impact at scale.
Independent Age’s first Reconnections service in the east London boroughs of Barking & Dagenham and Havering, ran from January 2020 to December 2021. The second was in Guildford and Waverley, and was adapted to include a small cohort of dementia patients at the local NHS Integrated Care Partnership’s request, in November 2020.
Though primarily working with people aged 65 and over, these services are open to anyone aged 18 or over, in recognition of the high levels of deprivation and health inequalities in the London boroughs.
Using the learning generated from Reconnections, particularly in terms of recruiting, engaging, training and supporting volunteers, Worcestershire County Council and the CCGs co-commissioned a new loneliness service.
People Like Us (PLUS) started in March 2020, and used a similar model of delivery to Reconnections. Reflecting the evidence that loneliness and isolation happens at all ages, particularly at the start of the Covid-19 pandemic, the service was offered to anyone over the age of 18 registered with a GP service, and it accepted self-referrals.
Onside delivered the service with Worcester Community Trust and Simply Limitless, with more than 900 individuals seen over the 18 months to November 2021.
The length of support varied to reflect individual needs, but in most cases was up to six months. It included mentoring and coaching to build confidence, sourcing information, accompanying them to activities, exploring opportunities such as training or volunteering, and provision of opportunities for mutual and peer support.
During the pandemic, many of the local activities were curtailed and replaced with online options, including support groups, virtual coffee mornings and cooking demos. In an initiative called ‘Techtober’, electronic devices were loaned to those who needed them.
Key learnings
We have identified four key learnings from Reconnections for those seeking to tackle complex issues such as loneliness. These learnings provide reflections for other organisations seeking to develop their own interventions; be it another loneliness service or for wider community-led approaches.
An outcomes-based model enabled the service to innovate and adapt to achieve outcomes and impact.
Both the potential of service user to invest in themselves and volunteers to gain access to wider community networks.
Developing a strong relationship across cross-sector partners requires investment.
An outcome metric needs to be tested to understand its strengths and limitations.