In mid-summer I received a phone call from Lucy Stewart, a researcher working with Ossian Communications www.ossiancommunications.co.uk. Ossian is an Edinburgh based agency commissioned by the Substance Use Network Edinburgh (SUNE) to undertake research into UK-wide developments in cross-sector (public and third sector) partnerships developing new approaches to service design, partnership working and service user involvement within the field of substance misuse recovery.
This initial conversation led to a longer and wide-ranging interview where I shared with Lucy, some of the experience I had gained as Lead Recovery Community Organiser within the Whole Person Recovery (WPR) project in west Kent. As some of you will already know, the RSA’s WPR project is part of a consortium that includes CRI and Sussex Partnership NHS Foundation Trust. Our project is a working example of the type of partnership that SUNE, was looking to draw learning and insight from in preparation for imminent reforms within the Scottish public and third sector social welfare communities.
Following the interview with Lucy, I was invited to attend the SUNE event, Getting Ready for Better Services: Learning Day. This whole day event in Edinburgh organised by SUNE, provided an opportunity for Edinburgh-based third sector organisations to participate in a knowledge exchange regarding cross-sector partnership working and service user involvement in service design and delivery. As a guest presenter / facilitator, I offered an overview of the genesis of the Whole Person Recovery model within the RSA’s work, which began in 2007 with the publication of the report Drugs - facing facts, The report of the RSA Commission on Illegal Drugs, Communities and Public Policy. I drew attention to the different contexts in which the WPR model has been developed, first in west Sussex during (2008-2010), as an independent project run with partners form across the public, third and voluntary sectors including GPs, criminal justice system and drug rehabilitation professionals, substance users and individuals in recovery from substance misuse. A further report: Whole Person Recovery: A user-centred systems approach to problem drug use was published offering an account of this work, to the current context of the WPR project. Presently (2012-2014), the WPR project is operating ‘within the system’ i.e. as part of a consortium working within the Payment by Results (PbR) mechanism. The WPR project is one of eight national pilot projects delivering social welfare programmes under the PbR model. In the PbR context there are rigorous governance and reporting frameworks that service delivery partnerships must comply with. These relate to the clinical elements of programme delivery where service users draw on the expertise of specialist nurses, doctors and psychiatrists as they move towards abstinence on their journeys of recovery, and to programme completion rates for service users under the care and supervision of service providers.
I made an effort to foreground the realities of the challenging dynamics and realpolitik expediencies that one has to exercise in partnership working, especially in the dual-contexts of working with relatively unstable user groups and rigorously prescribed reporting obligations. I also made a particular effort to open up our experience of working to engage service users in the co-design and co-production of the RSA elements of the WPR programme. These are challenging and iterative approaches to service provision and are not necessarily straightforward in their development or implementation. This kind of fluidity and the contingent nature of the work can sometimes be at odds with conventional organisational processes and cultures. The business of partnership working and service user involvement is sometimes gritty not pretty; it requires a particular resilience and steadfastness on the part of professional partners.
The event was deemed a success by the SUNE members and I had the opportunity to visit Edinburgh’s first Recovery café – The Serenity Café www.serenitycafe.co.uk, which is an initiative of community development charity COMAS www.comas.org.uk. I was given a tour of the space and a summary account of the genesis of the project from John Arthur, who chaired the SUNE event and is also the Recovery Coaching Development Manager at COMAS. It was interesting to see the way that the cafe was used as an ‘ordinary’ community resource by a range of people from the general public. It was inspiring to see the way that former service users make use of the cafe as community members seeking a social space and a creative and learning space for a range of activities that take place over the course of each week. The grassroots take-up of the recovery model as a real, achievable and desirable path back into the wider community is clearly alive and kicking. There is much that commissioners and others involved in policy level decision making could learn from these projects, particularly the ways in which service users are determining the speed and trajectories of their personal development and reintegration into society as proactive citizens with hard-won experience and inspiring stories to share.