The other day I told a member of the BHT Board of Management that we hand out £25,000 in cash to men and women with a history of alcohol and drug misuse. To say he was perturbed is an understatement.
Of course we are not doing anything quite as reckless as that might appear. The men and women I was referring to are residents of our Addiction Services and the money is used to buy food for communal meals, cleaning equipment and so on. Part of the philosophy of that service is to ensure that the residents are giving responsibility for the running of their community.
One of the first decisions I took, way back in 1987 when I first became the manager of Recovery Project, was to remove staff from the project in the evening and at weekends. Responsibility for safety and support ‘out of hours’ was devolved to the residents themselves. It is always easy for staff to ‘police’ a service such as this, but to involve clients in the most important aspect of the service is more beneficial for them. In those days we may have called it a ‘self-help’ model. Today it is more than just self-help, it is the Co-delivery of services.
Increasingly at BHT clients are being asked to take on tasks traditionally undertaken by members of staff. This isn’t a cost cutting measure but it is part of our commitment to the Co-delivery of services. The devolving of budgets, not just in influencing how resources are spent, but handing out actual cash, means that BHT is putting its reputation and money where its mouth is!
Yes, there are risks involved but they are often overstated. We have lost money from time to time but I would be very surprised if we lose more than £100 or £150 a year. The real payback is the change in clients. It breaks a ‘them and us’ mentality. It embeds responsibilities, not just rights. The consequence of the choices made by clients are immediate and obvious. Every time the cash and receipts are returned and accounted for, clients receive positive validation and contributes to the development of skills and other qualities required for normal living.
Co-delivery isn’t new, although the name might be. There are many examples of clients being involved in service delivery. Emmaus, and its Companions, is an obvious example. There are many other examples of Co-delivery. I know that there are some exciting ideas emerging from Brighton and Hove City Council on Co-delivery, with discussions taking place regarding maintenance and other services.
At BHT there is Co-delivery at all levels. In recruitment we aim to have a client representative on interview panels. When we made the last appointment to my management team, a client was a member of the selection panel. At our Phase 1 Project, where clients are at an earlier stage of their progression than the Recovery Project, shared Training Flats are provided where residents take a major part in the running of the service and in decision making.
But it isn’t all plain sailing. In our Sackville Gardens Project a clients wish to become involved in the running of one of our satelite houses, on this occasion by helping with gardening, his enthusiasm was frustrated by red tape and the time it took to deal with CRB requirements. There was little, if any, risk posed by his involvement. The Project, itself, had assessed risk and the CRB disclosure told us nothing we didn’t already know. He is now actively part of our Co-delivery approach thanks to his patience and perseverance and that of the staff at the Sackville Gardens Project.
Last week I put up a post that looked at Intelligent Commissioning (IC) and the Co-design and Co-production of services. The value of an IC approach is that service provision is improved and the problems faced by a community or neighbourhood are more likely to be solved. It is a bottom up approach, facilitated by, for example, a local authority. It ensures that services are more relevant to a locality which isn’t always the case with services driven by centrally driven targets.
Co-delivery takes IC a step further and introduces real opportunities and community-led accountability.