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This also applies to patchy and unreliable services.• Many schemes cannot yet be proven to be successful, even though it has been assumed that they have.• People who have enjoyed friendship and companionship are more likely to be lonely than those who have never had close ties.• The loss of a service which has had success at alleviating loneliness is worse than never having had the service at all.

• Identifying people at risk of loneliness can be difficult, but targeting those disproportionately affected by loneliness – lower socio-economic groups, the widowed, the physically isolated, people who have recently stopped driving, those with sensory impairment and the very old – has proven most effective.

The vision was expanded in the Department of Health Local Authority Circular Transforming Social Care (January 2008),2 which located the focus on independence and inclusion in the context of the White Paper Our Health, Our Care, Our Say (January 2006).

The White Paper set out the role adult social care services should play in increasing people’s independence and promoting inclusion in communities through preventive approaches and the promotion of well-being, rather than intervention at the point of crisis.

Citizens live independently but are not independent; they are interdependent on family members, work colleagues, friends and social networks.

Putting People First (December 2007) 1 Putting People First is a concordat signed by six central Government departments, the NHS, local government, professional bodies and regulators, and adult social care and health providers across all sectors.

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To meet this goal, the system will need to undergo significant reform and redesign to ensure people have access to early interventions and to exercise choice and control over the services and support they need.3 5 Loneliness and Isolation Evidence Review This emphasis in the White Paper was itself a response to views expressed in the public consultation which preceded it: ‘There was a strong desire for more help to support people to maintain their independence and feel part of society, with more emphasis on tackling loneliness and isolation, especially for older people, vulnerable people and those caring for others.4 The same theme was picked up in the Commissioning Framework for Health and Well-being (March 2007).

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