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1. ‘Bristol did it anyway’ – delivering LinkAge without DWP pilot funding
Terms of reference for study visit and summary report
It was agreed that a Director and Senior Researcher from the Centre for Social Justice (CSJ)
would undertake a short study visit of two days in order to make a thorough assessment of
the LinkAge Bristol model, to be followed by this summary report. Both the study visit
and summary report were to be particularly concerned with whether or not the
‘model’ has transfer value and can be duplicated elsewhere. It was agreed that the
study would be carried out more generally with a view to determining whether
or not the CSJ is happy to endorse and showcase LinkAge in a further report.
This subsequent report would focus on local and national policy implications of our research
and the University of the West of England (UWE) findings and help establish the case for the
effectiveness of LinkAge Bristol and its potential for ‘roll out’ nationally.
The short report below details our findings from primary research (a preliminary meeting at
LinkAge headquarters in Bristol and two-day study visit on the 14th
and 15th
May 2013) and
secondary data (publicity and other documentation provided by LinkAge Bristol).
We have concluded that this model does indeed have transfer value and we would be very
interested in working with LinkAge Bristol going forward to disseminate good practice to a
range of other geographical/local authority areas through:
a dedicated report that lays out a full range of evidence for why we endorse the
approach and examples of where it is working well (in Bristol and beyond)
a detailed strategy for influencing and persuading national and local decision-makers.
The last section of this report provides some examples of what might be included in
such a strategy.
Setting the scene for the study visit
The CSJ was approached to assess LinkAge Bristol because it is considered a thought leader
in older age policy following its major Older Age Review which resulted in the publication of
two groundbreaking reports, The Forgotten Age and Age of Opportunity. In the latter, final
report, we outlined how the Government, communities and older people can work
together to ensure that later life is an age of opportunity for all.
We stated that the first priority for any strategy to achieve this must be to re-engage the
most lonely and isolated older people and build dynamic communities. Despite social
2. 2
isolation receiving widespread media and policy attention we are as a society largely failing
to tackle this complex problem, which has many negative consequences, especially for the
most vulnerable. The extent of loneliness in later life for those aged 65 and over has barely
shifted over the last six decades. Over a million people over 65 report feeling lonely often
or always and a similar number feel trapped in their homes.
Many of the reforms we proposed to tackle social isolation in the Age of Opportunity report
are rooted in the outstanding work we encountered both in the UK and abroad. One of our
key recommendations was that every local authority should have a coordinated, systematic
approach to supporting older people in the community, by bringing together service
providers of all kinds to map and establish networks of local provision. Given the cross-
cutting policy agendas of health and wellbeing, financial and social inclusion, housing and
community cohesion, such an approach would need to be championed at Chief Executive
Office level, and draw in public, private and third sector players.
The example cited in the Age of Opportunity report was the Valuing Older People (VOP)
team situated at Manchester City Council, which has pioneered a way to coordinate local
groups and services for older people at a neighbourhood level. Established in 2003, it was
tasked with improving the quality of life of older residents in Manchester. Since then the
progress made by the dynamic seven-person team is reflected in the World Health
Organisation’s designation of Manchester as an ‘Age-Friendly City’ – the first city in the UK
to receive this accolade.
A key way the VOP team set about making Manchester age-friendly was to establish at the
most local level possible, networks bringing together every kind of agency, charity and
community group focussed on older people. At present VOP networks cover 17 of
Manchester’s 32 wards. After conducting a two-day visit to LinkAge Bristol, we consider
that this is another excellent example of such a coordinated, systemic approach (although
there are obviously some differences).
Brief description of LinkAge Bristol
LinkAge Bristol works with people aged 55+ and local communities to facilitate
inspiring social activities that enrich lives, reduce isolation and promote active
participation.
LinkAge has existed in Bristol since 2007 and is a partnership between Bristol City Council,
the NHS/Public Health and two charitable trusts (the Anchor Society and St Monica Trust).
It catalyses the development of new activities, pulls together many of the existing projects in
Bristol and gives both new and existing programmes a trusted brand identity. It aims to
perform a complementary role to existing and emerging local initiatives: to work in
partnership with and enhance them but not to ‘take them over’.
As described in the recent University of Western England (UWE) evaluation:
The vehicle for driving the programme is ‘beneficiary’ led Hubs. By beneficiary we
mean a service user who has attended a LinkAge meeting or activity more than once.
Hubs are supported by a paid Community Development Worker (CDW) who
develops activities, primarily through encouraging and promoting beneficiary
3. 3
engagement. This often involves outreach work. Through hubs LinkAge seek to
empower older people to fulfil their ambitions to enable them to influence local
developments or to support them to design and set up new groups or activities that
meet the interests and/or aspirations of local older people. Since its inception
LinkAge has developed four active hubs and has a long term aim of developing more
hubs across Bristol: one for each of Bristol’s fourteen Neighbourhood Partnership
Areas...
...Their approach includes fostering social awareness and encouraging older people
to share their skills with volunteers, young people and others within their
community. LinkAge aims to inspire older people and others to share their time and
experiences with other older people who for one reason or another have become
isolated. (p6)
University of Western England (UWE) evaluation report on LinkAge Bristol
Assessing the Impact of the LinkAge hub in Whitehall and St George, Bristol: Briefing Report
Richard Kimberlee and Robin Means – November 2012
Key points:
The outreach work around the hub is bringing in beneficiaries that feel very isolated
in their local communities
There was a statistically significant increase in beneficiaries’ socially connectedness
scores from baseline
LinkAge beneficiaries reported that they are experiencing improved well-being on all
four national indicators of the ONS ‘Happiness Index’
There is clear evidence for an increase in beneficiaries’ physical activity
Based on project costings, added value and assumptions around deadweight,
displacement and attribution we calculate that for every £1 invested in the
Whitehall and St. George hub there is a social return on investment (SROI) of
£1.20. This is a considerable return and in our view it is probably an
underestimation of the potential return in the medium term.
The impact of hub engagement on beneficiary health is probably underestimated in
our calculations.
LinkAge Bristol rationale and modus operandi
LinkAge Bristol is not a membership organisation but a partnership between funders and
providers of activities and services for older people which:
advertises a diverse range of high-quality and ‘safe’ provision
catalyses the user-led generation of further activities;
facilitates their ongoing sustainability and
creates connectedness between individuals and between organisations - within
localities and across a whole city.
4. 4
There are many strong similarities with recent government initiatives such as the
Partnerships for Older People Programmes (POPPs) and LinkAge Plus pilots (and therefore
opportunities for learning). Bristol City Council was one of the local authorities who put in
an unsuccessful bid to the Department of Work and Pensions (DWP) to become a LinkAge
Plus pilot area.
As a result, a consortium was formed between Bristol City Council, Guinness Care and
Support, St Monica Trust and the Anchor Society to create and finance LinkAge Bristol.
They went ahead with the project without funds from central government, as will be the
case for many areas going forward, and have developed it in a highly sustainable, professional
and inspirational way. They have also done so in a way that is consistent with the core
principles of the LinkAge Plus pilots (see box below) as this short report makes clear,
although the creation and development of LinkAge Bristol has been completely separate
from the national initiatives.
The DWP’s LinkAge Plus pilot programme
The Department for Work and Pensions (DWP) began piloting the Sure Start for older
people approach in rural and urban areas in Spring 2006. Referred to as the ‘Link-Age Plus’
programme, this model was evaluated in its different expressions around the country. A
significant body of useful data and learning is now available which would help to refine the
LinkAge Bristol approach with the aim of aiding other local partnerships to establish similar
approaches in their areas. The 6 core principles of LinkAge Plus were to:
engage and consult: older people should be involved in the design and
development of how services and relevant information are provided, and their
opinions sought in the quality of delivery;
reflect the needs and aspirations of current and future generations of
older people: the diversity of the local older peoples’ population should directly
inform services provided for them and anticipate their changing requirements over
time;
enable access by an increasing range of customers: a “no wrong door”
approach should provide information and access to services from an initial or single
point of contact. Signposting or referral processes should ensure all relevant
services are made available;
ensure that isolated or ‘difficult to reach’ older people are enabled to
access information and services: positive steps should be taken through
outreach to identify and engage with isolated older people. Joined-up customer
contact facilities should be flexible to meet different needs and include face-to-face,
visiting, telephone and electronic media;
ensure that services promote independence, well-being and active
ageing: services should focus on early intervention and a preventative approach
which goes beyond traditional health and social care functions; encouraging respect
and social inclusion for older people as citizens should be a primary consideration;
maximise opportunities for efficiency and capacity building: efficiencies
should be sought through joint working with partner organisations and improving
outputs through capacity building.
5. 5
LinkAge Plus pilots were set up before the fiscal consolidation of 2010 which profoundly
changed the financial settlement to local authorities (LAs) – what we heard in Bristol about
the changing face of the LA confirmed what we have heard from many other sources, which
is that the ‘capacity to meet social need has been decimated.’
The last Government made it clear that the way forward for older age provision was for
local authorities ‘to work closely together with their partners in health and the voluntary
and community sector to find innovative ways to break down traditional organisational and
financial barriers and to join up services.’ Such an approach has become even more
necessary in the current climate of austerity and with the heightened awareness that
isolation in older age is a far larger and more prevalent problem than previously realised.
We heard in Bristol that more people are retiring on their own ie relationships have broken
down. Also, we were told that ‘while many don’t seem high on the social isolation index
they are actually quite lonely and concerned about going forward.’
Furthermore, many local authorities are undergoing a profound shift in the perceived ways,
means and goals of commissioning. We heard that in Bristol, as elsewhere, ‘the local
authority is used to commissioning against outcomes rather than against user-led outcomes.
Going forward, it should be older people who are in the driving seat rather than local
authority commissioning.’
Networking/partnership-working
Partnership working operates at different levels. There is funding and strategic input from all
the partners mentioned above. Current LA funding commitment is a grant of around £65k
per annum. The Strategy Board comprising key players from all these organisations oversees
and coordinates the work of the various hubs and their staff who also work semi-
autonomously under the guidance of local advisory groups.
We heard that working in partnership in this way enables a far higher degree of buy-in from
those it is intended to benefit and draw in both as users and as volunteers. It ‘Creates more
resilience in community [as] it’s not just “the local authority doing this”’ and ‘“People joined
in [to an activity] because Bob did it’ rather than ‘the Council have put this on”.’
In the initial stages, getting activities off the ground was made possible through having a
champion in the local council and some very active and interested older people. The
energetic and enthusiastic approach of a Chief Operating Officer, brought in to post some
time into the project, and a willingness to charge for some activities have both been vital for
sustaining the momentum.
The next level of partnership involves LinkAge Bristol, as an overarching organisation,
looking for what’s on the ground already and working with groups and individuals who are
bringing people together and making activities happen.
For example:
Contact the Elderly – helping them find host venues for their activities
Including Church’s coffee mornings in LinkAge Bristol advertising
6. 6
Partnering with Bristol City Football Club’s community sports activities
LinkAge Bristol donates to get things off the ground eg to start up a regular bingo
session in a care home (paying for the books and initial prize money)
For older people not knowing how to cook, one leisure centre’s healthy living
programme includes ‘intergenerational cooking sessions’ run by school-leaver
apprentices, coordinated by a LinkAge Bristol Community Development Worker
and facilitated by highly portable equipment provided by LinkAge Bristol.
Their main aims are to combat isolation and make active life in older age attractive and
attainable – not to duplicate or compete with other organisations but cooperate to achieve
these shared goals.
LinkAge is a saviour. I gave up work six months ago and it was incredibly important in
helping me make the transition.
Quietly enthusiastic participant in LinkAge-organised Tai Chi class
There are clear advantages to having a consistent approach in neighbourhoods and to having
a strong and trusted brand. We heard that when older people are considering taking up new
activities they like the association with LinkAge Bristol and the perceived security that it
brings. LinkAge’s desire to form associations coexists with a willingness to see the
progression of an activity or programme towards a ‘declaration of independence’: an
eventual ‘cutting loose’ from the administrative and other assistance provided to LinkAge-
advertised activities.
‘Some of the people have taken over their activities, which we have set up saying “this is not
LinkAge anymore”.’
Claire Miller, COO
They provide free, high-quality advertising for many existing community-based activities
although visiting prior to signposting is considered to be essential. There is poster
advertising in sports centres, lunch clubs, sheltered-housing schemes and other venues for
older people’s activities and glossy booklets providing information specific to each local area
in Bristol covered by a hub.
Strengths to the LinkAge Bristol model
The very existence of an overarching organisation that coordinates and validates a range of
older age activities is a significant strength – having an institutional anchor is a key ingredient
for sustainable and successful projects.
7. 7
Hubs, Advisory Groups, Community Development Workers and Volunteers
It’s not the bricks and mortar in themselves but having a space in the community that
provides a focal point for the organisation of activities as well as a venue where people can
come together that enables isolation and loneliness to be tackled: ‘It’s relationships that
matter, rather than the hubs.’ Moreover, older people appreciate the security that being
signposted by a trusted brand to places and activities provides. Knowing that they will
receive a warm and safe welcome is very important particularly when they have become
unaccustomed to going out and meeting new people or trying new things. Lack of transport
and fear of crime can present barriers to older people’s inclusion and make travelling any
distance to activities a problem. We were told that a ‘five minute walk to all activities [and
presumably to the nearest hub] is the goal’.
A self-moderating advisory group (AG) provides ‘the cornerstone to each hub...they are
action-focused groups making decisions on what will be developed in the local community.’
Comprised of up to 25 volunteers, they meet once per month and determine what activities
will be funded based on the level of relative popularity and participant feedback. Taster
sessions are provided to gauge interest before deciding what courses or activities a hub will
provide.
‘We put forward ideas; you can try different things; tasting rather than paying for a
whole course.’
Some but not all AG members are retired/ready for retirement. The calibre of these
volunteers is often very high. The majority are former school governors/councillors who are
keen to ‘regain a sense of purpose’. One volunteer, newly retired from a Public Health
background told us, ‘I wanted to give something back.’ A senior representative of statutory
health services – which are involved in LinkAge Bristol, for example in the various Walking
Groups – commented that ‘it is good to have health people to fall back on’.
‘LinkAge was a godsend – I could be not only active, I could be doing and helping’
Advisory group member and volunteer
Some members of advisory groups are there because they want to grow their own existing
groups. For example, one Bowls Club’s membership had dropped off and its Chairman
joined LinkAge Bristol to grow the club: LinkAge supported an open day to gain new
members (six potential new members were identified).
Community Development Workers are vital for:
finding existing groups/activities to draw under the LinkAge Bristol umbrella or
signpost older people to (and boosting their planning capabilities where
appropriate);
setting up new groups/activites from scratch, encouraging participants to contribute
as volunteers and being sufficiently familiar with the local people and culture to
know when and how to challenge them to take up responsibilities;
progress chasing to ensure good ideas are followed through, then moving on to help
develop other groups/activities – to some extent making themselves redundant at an
individual project level so that their capacity can be maximised.
8. 8
‘Community district workers are cheerleaders. Encouraging people and working with them
to find out who can do what. I have to ensure things continue in my absence. Once we get
healthy walks up and running my work is really with walk leaders [rather than those who
participate in them].’
‘With intergenerational work there is a whole community element – my work is getting
activities up and running and handing over to the community.’
Community Development Workers perception of their role
It became clear that some older people were involved in activities simply to fill their time
and had no intention of volunteering or any desire to help make things happen and thereby
‘give back to society’. LinkAge Bristol were aware that this was the case but took the view
that if people were ‘plugged in’ and engaged in some way, their involvement would act as a
protective factor against severe loneliness and/or isolation when they went through a bad
life event, such as a bereavement, the onset of a chronic illness or a sudden and severe
health shock. Furthermore, a key aim of community development workers and volunteer
leaders is to encourage greater involvement in a wider range of activities, thereby improving
individuals’ connectedness to other people and activities within society.
Enthusiasm, energy and vision of senior staff/members of LinkAge Bristol
The leadership and belief provided by members of the Strategy Board and by the Chief
Operating Officer are inspirational to others involved in delivering the LinkAge Bristol
approach on a daily basis. There was a clear local authority champion (in the Director of
Adult Services, Kay Russell) who was indispensable in ensuring the tranche of LA money
remained available and that older age issues remained salient regardless of fiscal contraction.
As we state below, strong and effective leadership and a highly motivated senior team are
essential ingredients to the replicability of the model.
Weaknesses, opportunities and threats for replication/adoption elsewhere
We were concerned that a lack of willingness to pay for activities (we heard that ‘people
won’t pay for walks’) could compromise the sustainability of LinkAge Bristol in the long-
term, if LA funding were appreciably reduced. Also, without the strengths of the personnel
identified in the last section, particularly the Chief Operating Officer, it is unlikely that the
success of LinkAge Bristol would be replicated elsewhere.
A full analysis of the weaknesses identified in the LinkAge Plus pilot evaluations would also
be advisable for inclusion in a subsequent report.
Opportunities include the important synergies between what LinkAge Bristol is trying to
achieve and many aspects of the public health agenda and the work of Health and Well-
being Boards. Their intergenerational work ties in with other youth-focused agendas (for
example, re-engaging young people who are not in employment, education or training and
the reduction of teenage pregnancy).
9. 9
Finally, in terms of threats, whilst allowing organisers of successful activities to ‘declare their
independence’ is laudable in that it enables greater autonomy, there is a danger that the
LinkAge brand could be diluted if it happened too frequently. If activities that had become
nominally independent subsequently become exclusive but were still associated in local
people’s minds with LinkAge, this could damage their brand.
Threats to adoption in other towns and cities include a reluctance to be guided by another
model (‘not invented here’ syndrome) and protectionism of other charities, many of whom
will get some funding from the local authority, who may feel threatened by the existence of
an overseeing body and fail to grasp the aims and advantages of partnership.
Without careful implementation elsewhere, that partnership and enabling ethos could be
compromised especially if undue weight is given to better coordination of statutory services
and low regard to VCS activities that build social capital. Similarly, a public health emphasis
that is solely focused on preventing physical ill-health and overly medicalises the issues of
older age may skew a LinkAge-type programme too far towards a ‘healthier older age’
approach.
Scaling up – West of England, rest of England, rest of UK – if appropriate (we
would need to look closely at devolved nations’ older people and localism policy)
What follows is not a fully worked-up strategy, but some ideas that can be expanded upon
in further discussion with LinkAge Bristol. As stated earlier, a key starting point would be
the production of a further report which showcases the project, sets its replication in the
context of learning from a range of other programmes, most notably the DWP LinkAge Plus
pilots and lays out how LinkAge Bristol plans to engage with partners elsewhere in the
country, drawing on the ideas below.
These ideas assume the completion of the LinkAge Bristol franchise manual currently being
planned, as this will be a vital toolkit and something we recommended be produced by a
local authority or consortium of organisations in a local area which had been successful in
stimulating and coordinating local provision for older people.
Although Anchor’s aim is that the idea will become self-replicating in time, as it is taken up
across the country, in the medium term they would need to allow capacity within the Trust
and pioneering LinkAges (primarily LinkAge Bristol) for advising other localities on how to
set up a LinkAge. This might involve speaking at regional and national events to spread good
practice etc., notwithstanding the planned development of a franchise manual. There is the
danger that this manual will sit on a shelf unless it is very actively promoted. Setting up a
social enterprise as a separate wing of LinkAge Bristol, which performs a paid-for
consultancy service to local authorities and their partners who want to replicate this
approach is one option to consider.
Find champions at national and local level
The CSJ is currently conducting an evaluation of the Silver Line advice and
befriending phoneline started by Esther Rantzen CBE. The association of her name
with the service has made a huge difference to people taking up the offer.
Someone with media presence of the right age could be incredibly helpful eg. Sir
10. 10
Michael Parkinson was Dignity Ambassador for the year recently as part of the
Dignity in Care campaign.
[There are clear synergies between the principles behind the Dignity in Care
campaign and the LinkAge Bristol approach – high quality care services that respect
people’s dignity should:
o Enable people to maintain the maximum possible level of independence,
choice and control;
o Listen and support people to express their needs and wants;
o Assist people to maintain confidence and a positive self-esteem.]
Also at a national level, consider inviting individuals with national reach onto the
Strategy Board or onto a separate Advisory Board specifically tasked with spreading
the word about LinkAge and scaling up.
Local champions would need to be at a fairly senior level eg Chief Executives of
Councils, Mayors, MPs to help build a ‘top down’ movement (who would need to be
fully aware that there are votes and savings to be made in a LinkAge Bristol
approach) but, equally, LinkAge Bristol might have experience in stimulating a
grassroots movement within an area that could start to call for it – and be willing to
help make it happen.
o Influencing and persuading needs to happen in senior executives’/champions’
offices as well as in local events attended by them and the people who would
be key to implementation and who could identify at an early stage where
resistance might lie.
Build strong links and maximise the potential of synergies with other
‘rising’ organisations who offer a complementary approach most notably the
Silver Line advice and befriending line for older people. In evaluating the pilots for
this service the CSJ has learned that older people want to go beyond a regular phone
call and have opportunities to meet people face-to-face in trusted settings. The
endorsement of activities and locations (particularly hubs) that LinkAge Bristol
provides is particularly important to older people who feel vulnerable and who may
be struggling to have the courage to break the cycle of loneliness and isolation in
their lives because of fear of meeting new people or crime.
Hold formal event(s) such as an expert roundtable with key players in the
field from politics, policy and practice complemented by:
Informal consultation exercise with a range of experienced ‘advisors’ obtained
through CSJ’s extensive connections including:
o former senior members of the Cabinet Office;
o current DWP and DH officials;
o ministerial special advisors;
o senior members of Labour Party Policy Review and older age policy desk
officers in Conservative, Lib Dem and Labour parties (with the intention to
raise awareness);
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o Baroness Newlove, Victims Commissioner in Department for Communities
and Local Government and community reformer;
o Senior researchers in other thinktanks who have looked at related areas of
older age policy eg RSA (Sam Maclean), Young Foundation (Yvonne Roberts)
and IPPR (Dr Dalia ben Galim);
o Local government officials and their partners in private and third sectors who
have pioneered a similar approach to LinkAge Bristol (eg. Paul McGarry from
Manchester – the case study in Age of Opportunity – and Richard Elphick in
Camden who runs a ‘community-facing team’);
o Campaign to End Loneliness.
Learning from ways other projects have gone to scale eg. Diana Barran
(CEO of Coordinated Action against Domestic Abuse – Caada) has successfully
proliferated the Multi-Agency Risk Assessment Conference method and structures
around the country.
Approach large consultancy and other organisations with a view to
getting pro bono consultancy on how to scale up. Many of the big firms have a
strong CSR ethos and routinely release employees to volunteer creative and
technical assistance to innovative third sector organisations. The CSJ has a strong
relationship with Impetus-The Private Equity Foundation who provide advice and
strategic resources to scale up effective interventions and have indicated they would
be willing to consider hosting a capacity-building ‘workshop’/meeting.
Learning from Leeds (Leeds Neighbourhood Partnership) to help develop
strategic vision (already planned before our evaluation).
o How partners from three sectors can work together
o How to obtain political support
o Getting strategic buy-in e.g. from Health and Wellbeing Boards
Summary of recommendations and next steps
One of the key recommendations in the CSJ’s Age of Opportunity report was that every local
authority should have a coordinated, systematic approach to supporting older people in the
community, by bringing together service providers of all kinds to map and establish
networks of local provision. After visiting LinkAge Bristol we have concluded that this is an
excellent example of such an approach from which many other local authorities could learn.
It could be replicated elsewhere with the aid of the franchise manual currently planned and
by taking a strategic approach. This summary report advises LinkAge Bristol to consider:
Commissioning a further report which showcases the project, set its replication in
the context of learning from a range of other programmes and lays out how LinkAge
Bristol plans to engage with partners elsewhere in the country, drawing on the ideas
below.
Setting up a social enterprise as a separate wing of the project which would perform
a paid-for consultancy service to local authorities and their partners who want to
replicate this approach.
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Agreeing a detailed strategy for influencing and persuading national and local
decision-makers which would include:
o Finding champions at national and local level.
o Building strong links and maximising the potential of synergies with other ‘rising’
organisations who offer a complementary approach.
o Consulting extensively through formal event(s) such as an expert roundtable and
informally with a range of experienced ‘advisors’ obtained through CSJ’s
extensive connections.
o Learning from other projects which have gone to scale and other local
neighbourhood partnerships.
o Approaching large consultancies and other organisations with a view to getting
pro bono consultancy on how to scale up.
The Centre for Social Justice would be delighted to meet in the near future to discuss how
we could work in partnership to take our recommendations forward.