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Case Study: Commissioning by communities

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Name of project: Essex Recovery Foundation

Led By: Essex County Council

Summary: Essex County Council developed a model for service design which radically shifted commissioning power to people with lived experience of addiction.

The situation: Traditionally, drug and alcohol services were commissioned by the county council with the aim to deliver and create a balanced drug and alcohol treatment system that fulfilled national requirements. Efforts were made to involve the community, but it “always felt a bit tokenistic” because the outcomes against which the services were evaluated were not meaningfully defined by the community.

The approach: The council created an arms-length body owned by the community with overall control over commissioning. This was done in the belief that those best placed to understand what was needed to make services work effectively were the people at the receiving end of those same services. This involved handing over responsibility for the allocation and spend of more than £9.5-10 million a year, and empowering service users to create their own strategy, define their own outcomes and reshape how the services functioned for them.

The detail: Staff within the public health team worked collaboratively with the legal department, the commercial department, elected members and senior managers to agree a model that was detached from the council. Together they formed an independent, community-led charity.

Now in its sixth year, the charity’s governance structure has two parallel and equal boards. One is the Recovery Advisory Committee made up of people in recovery who represent the views of the recovery community in their area or social group. The other is the Trustee Board, 50% of whom are graduates from the treatment system in Essex, people in recovery or relatives of people in recovery. These boards make collaborative decisions and are jointly responsible for the charity’s social outcomes. The charity has been formally identified as the chair of the Essex Joint Commissioning Group, with support from the public health team, and has been agreed as the community/lived experience lead of the Southend, Essex and Thurrock Drug and Alcohol Partnership.

The council’s role has shifted and it now acts as the Commissioning Support Unit, offering external support and holding funds and contracts on behalf of the charity.

Challenges: As the model was an unconventional one (a charity set up to take delegated responsibility for a function usually carried out by a statutory organisation) there were several bureaucratic and legal hurdles to overcome. There were protracted conversations to persuade partners and other stakeholders how this differed from business-as-usual, and why it was necessary. For example, registering with the Charity Commission took approximately a year and involved extensive engagement with the commission to define the role and aims of the charity. The eventual form of the relationship between the council and the charity also needed to be iterated once a CEO was in place.

Top lessons:

  • Build on everyone’s experience of the past: The idea for this approach arose out of extensive experience in the team and in the recovery community of past activities. The resulting radical approach was built from a collaborative relationship and an awareness that business-as-usual wasn’t delivering the outcomes everyone wanted.
  • Consider risk positively: The team worked very hard to consider the risks if the charity didn’t work as planned. It was an important principle to remember that if it didn’t work, it would always be possible to go back to the old way of doing things. The lessons learned along the way have been invaluable to understanding of how to enable the community to influence this agenda.

Name of project: Essex Recovery Foundation

Led By: Essex County Council

Summary: Essex County Council developed a model for service design which radically shifted commissioning power to people with lived experience of addiction.

The situation: Traditionally, drug and alcohol services were commissioned by the county council with the aim to deliver and create a balanced drug and alcohol treatment system that fulfilled national requirements. Efforts were made to involve the community, but it “always felt a bit tokenistic” because the outcomes against which the services were evaluated were not meaningfully defined by the community.

The approach: The council created an arms-length body owned by the community with overall control over commissioning. This was done in the belief that those best placed to understand what was needed to make services work effectively were the people at the receiving end of those same services. This involved handing over responsibility for the allocation and spend of more than £9.5-10 million a year, and empowering service users to create their own strategy, define their own outcomes and reshape how the services functioned for them.

The detail: Staff within the public health team worked collaboratively with the legal department, the commercial department, elected members and senior managers to agree a model that was detached from the council. Together they formed an independent, community-led charity.

Now in its sixth year, the charity’s governance structure has two parallel and equal boards. One is the Recovery Advisory Committee made up of people in recovery who represent the views of the recovery community in their area or social group. The other is the Trustee Board, 50% of whom are graduates from the treatment system in Essex, people in recovery or relatives of people in recovery. These boards make collaborative decisions and are jointly responsible for the charity’s social outcomes. The charity has been formally identified as the chair of the Essex Joint Commissioning Group, with support from the public health team, and has been agreed as the community/lived experience lead of the Southend, Essex and Thurrock Drug and Alcohol Partnership.

The council’s role has shifted and it now acts as the Commissioning Support Unit, offering external support and holding funds and contracts on behalf of the charity.

Challenges: As the model was an unconventional one (a charity set up to take delegated responsibility for a function usually carried out by a statutory organisation) there were several bureaucratic and legal hurdles to overcome. There were protracted conversations to persuade partners and other stakeholders how this differed from business-as-usual, and why it was necessary. For example, registering with the Charity Commission took approximately a year and involved extensive engagement with the commission to define the role and aims of the charity. The eventual form of the relationship between the council and the charity also needed to be iterated once a CEO was in place.

Top lessons:

  • Build on everyone’s experience of the past: The idea for this approach arose out of extensive experience in the team and in the recovery community of past activities. The resulting radical approach was built from a collaborative relationship and an awareness that business-as-usual wasn’t delivering the outcomes everyone wanted.
  • Consider risk positively: The team worked very hard to consider the risks if the charity didn’t work as planned. It was an important principle to remember that if it didn’t work, it would always be possible to go back to the old way of doing things. The lessons learned along the way have been invaluable to understanding of how to enable the community to influence this agenda.
Page published: 22 Nov 2023, 12:14 PM