This case study looked at the outcomes of a social impact bond to reduce social isolation and improve long-term condition self-management, based on a study by Social Finance and Age UK (Hereford and Worcestershire). The case study shows that to achieve “long term improvements in health and wellbeing and establish a health and care system that is financially sustainable in the medium term, the causes of health deterioration in the older population must be addressed earlier.”

The analysis looked at how an intervention to reduce social isolation in the over 65s can lead to financial and carbon savings from reduced service use, based on reductions in the risks of dementia, depression and inactivity-related conditions (stroke, CHD, diabetes). The original case study analysis was extended to look at the additional expected carbon savings over the first five years. The expectation of reduced use of healthcare services as a result of reduced social isolation implies a secondary assumption that the unused healthcare services are not redirected to treat other patients. Although it is quite likely that services would be redirected, this would lead to a different set of positive outcomes that could not be quantified in the analysis.

Case study source:

Intervention in Worcestershire

Healthy Returns – Production Reports

Financial Calculations

Costs

The total costs associated with the intervention described in the case study were £618,000, there were 3,000 participants targeted by the intervention so the cost per person was £206. It is estimated that the Total number targeted would be 28,520, therefore the Total cost scaled would be approximately £5,875,120. The lifespan of the intervention has been estimated as 15 years therefore the annual costs are approximately £391,675.

Savings

The cost saved over a 15-year period is estimated to be £12,615,347, therefore the annual savings have been estimated as £841,023.

Carbon

The total carbon savings have been calculated as:

• Carbon savings from GP appointments avoided is 1,364,682 kgCO₂e
• Carbon savings from A+E visits reduced is 48,978 kg CO₂e
• Carbon savings from emergency admissions avoided is 651,129 kgCO₂e
• So the Total Carbon Savings are the sum of these values is 2,065 tCO₂e
• And the Total 15 year Carbon Savings (NPV – assume service usage reduced consistently across 5 years) is 1,865tCO₂

Spreading this Carbon saving across the 15-year life span of the intervention the annual Carbon saving has been calculated as 124 tCO₂e, taking into account a 50% uptake rate, carbon savings for the MACC are estimated as 62 tCO₂e per annum.

Additional Benefits

There are a number of additional benefits accrued to the rest of society from reducing social isolation in older people. Inter-generational connections help children and young people develop a sense of place and context. Societal benefits to children from knowing old people include increased sense of belonging, hope, feelings of security and a source of inspiration.
The elderly are a valuable resource. The perspective and wisdom built-up over a lifetime can mentor and influence younger generations and result in increased social resilience. Equally, older generations have a sense of history that can be transmitted helping younger generations feel more grounded in a chaotic world.   

Assumptions

Healthcare services not used are not filled by someone else’s use

Carbon savings only for first five years

Model uses loneliness rather than social isolation as its primary measure