Loneliness is a universal public health issue that impacts health and wellbeing (Nyqvist et al., 2016) and generates more demand for social care and health services. The problem that this project seeks to address is a lack of understanding of how and where our council should deploy interventions.
Within Cambridgeshire there are numerous initiatives for combating loneliness; some are directly by the council and others are community-led. We have found that commissioned initiatives, such as Day Centres, are under-utilised despite the statistical likelihood that a high percentage of our target group would be at risk of suffering from loneliness. We need to understand where there are gaps in provision, why certain services are underutilised and whether we are providing best value for money. It is not clear that existing local initiatives are based on robust user research or are effectively meeting user needs. Therefore as opposed to undertaking an project from the outset, it is vital for our councils to obtain a thorough understanding of our users before launching any pilots.
Therefore this project has the following core objectives:
- Carry out qualitative and quantitative research locally. Discover the scale of need, gaps, user needs and create personas
- Hold an event with local organisations and partners at which we present our research and agree on a product or service to test
- Carry out rapid prototypes of the ideas generated at the hack
Events and milestones
- User research within the community. Organise the Design Hack including inviting citizens and organisations to attend the design hack event
- Draft a research report to circulate around attendees before the Hack event
December/ Early Jan
- Hack week with partners, organisations within the sector and service users. Present desktop research and user and expert stories.
January – March
- Rapid prototype idea(s) generated at hack event
- Write-up of alpha project brief
The work will be jointly resourced by the Cambridgeshire County Council Transformation Team and Public Health team, Peterborough City Council, Huntingdonshire District Council and LGSS Digital (external partner ).
Measuring achievement of our objectives
|Quantitative research||Data report setting out the scale of need and gaps in provision|
Direct quotes, user stories and case studies
Understanding of underutilisation
|Carry out a hack||Ideas from citizens
Co-produced design of alpha project
|Rapid prototypes||User feedback|
The key benefit that initiatives to combat loneliness can bring to local authorities is enabling citizens to stay healthier and independent for longer and less reliant on our public . Individuals suffering from loneliness are more likely to have early admission to residential or nursing care. Estimates of the cost of loneliness to health and social care services for a cohort of people aged over 65, over a ten year period are £1,700 per person or (McDaid, Park and Fernandez, 2016). Costs for older people who are most severely lonely would be in excess of £6,000 per year to adult social care.
The 6-13% estimates in the Campaign to End Loneliness toolkit suggested that in Cambridgeshire, between 7,100 and 15,400 over 65s are lonely so loneliness could be costing ASC in CCC between £12.07m and £26.18m per year. More analysis work is needed to understand how effective our current initiatives are in tackling loneliness of service users, and to what extent further savings are possible through more effective interventions.
These outcomes give rise to preventative savings and more efficient use of Council finances. With the high cost for social care where loneliness is not addressed, there is a strong case for investment in this area, particularly given the relatively low cost of many effective interventions. Gloucestershire Village and Community Agents, a scheme to identify the most lonely and isolated resulted in £1.2m savings to Gloucestershire health and social care services, with every £1 that the scheme cost, the return on investment was calculated to be £3.10.
Other anticipated benefits are as follows:
- Reduction in loneliness for citizens suffering from loneliness but not engaging with initiatives
- Greater community cohesiveness
- Improved community resilience
- Access to ideas from new sources by engaging with local citizens
- Greater buy-in from local citizens and stronger likelihood of higher participation and more efficient use of resources
The prevalence of loneliness nationwide and the impact that loneliness has on social care costs is well-documented. Therefore due to the universal nature of the topic, the findings from this Discovery Project as well as any findings about the return on investment from the Alpha project are likely to be useful for other local authorities across the country to support business cases for implementing similar interventions.
We plan to work in partnership with Huntingdonshire District Council and Peterborough City Council to carry out user research with citizens (within key risk groups) and hold a hack event in collaboration with external organisations.
As the research will be gathered from areas with very different demographic and socio-economic profiles (Fenland – rural and greater deprivation, and Cambridge City – urban and comparatively affluent with pockets of deprivation) we believe that the findings of the project could be useful for a variety of local authorities.
Given the high cost of the health and social care services required by lonely individuals if their circumstances are not addressed, there is a strong case for development of evidence-based interventions within this area, particularly given the relatively low cost of many effective . This project aims to bring about preventative savings by reducing the demand for social care, ensuring better targeting of existing resources and harnessing community capacity by reconnecting individuals to their communities.
The funding would allow our councils to carry out valuable user research to inform the council about what kinds of interventions are needed locally as well as how and where we should deploy interventions.
Moreover the user research carried out within the discovery project will initiate engagement with citizens and organisations that we could work with collaboratively on an ongoing basis. The unique opportunity offered by a dedicated user researcher is that this role will allow for more robust engagement with a more representative sample of citizens that do not typically engage with existing interventions. This will enable the council to avoid the common pitfall of solely engaging with ‘usual suspects’ because there is limited staff capacity or time to devote to research.
Our key project outputs are as follows:
- a business case that explains the cost of the problem and the potential for savings – both to the councils involved and the nation
- user engagement with citizens from key ‘at risk’ groups
- a co-production group comprised of citizens, representatives of local organisations, community groups and others within the sector to work with on an ongoing basis to co-design and drive forward the work
- a user research report setting out the project’s conclusions
- a conclusion proposing what product or service we may develop in an ‘alpha’ project to solve the problem
Who are your users?
Users are local citizens meeting one or more of the following criteria that correlates with risk of loneliness:
- Living alone
- New parent
- Experiencing transitions such as moving home, moving job, leaving care, losing a job, retirement
- Being a refugee
- Non-paid carer
- Have a head of household aged 65+
- Older people 65+, particularly aged 80+
- Victims of trauma such as bullying, domestic violence, crime or discrimination
- Poor health such as a physical disability, mental illness, hearing and sight loss
- Living in rural/ geographically isolated areas
- No car/ never using public transport
- Low income or on benefits as main income
- Individuals with English as a second language
- No access to a telephone
- Speak to their neighbours less than once a month or never
- Express dissatisfaction with their social life
How we will engage with them:
The user research methods that we plan to use are: contextual interviewing and observation of key groups at sites across the county and surveys using the Campaign to End Loneliness tool questions, gathering responses through the contact centres and social media. Moreover we will work with the CCC Adult Early Help team, our partner organisations, the CCG and local GPs to recruit citizens for feedback.
Proposed user research objectives are as follows:
- Engagement with a variety of citizens from each ‘at risk’ group
- Carrying out contextual interviews and observation
- Refining data gathered into a comprehensive list of user needs
- Constructing personas for individuals that do not engage with any Council services or commissioned services based on the responses that we receive
- Gathering ideas for combating loneliness including stories about initiatives that have been successful in alleviating feelings of loneliness and helping people suffering from loneliness to form meaningful connections
- Ongoing co-production with citizens and community organisations
We have not received any funding for this project in the past. To date, work to establish relationships with relevant organisations in order engage their participation in the Ageing Well Board, and Loneliness Working group has been supported by the Cambridgeshire County Council Public Health team. No costs have been incurred for this project to date.