Out For The Count

Adrian Barton is a senior lecturer in criminal justice
studies at the University of Plymouth, with a background in
researching and publishing on drug policy.

Richard Teagle is a research assistant working on issues concerning
young people and drug use at the University of
Plymouth.

Voluntary sector work is increasingly being audited.(1) This has
created a need to ensure that outputs are identifiable, measurable,
produced in a manner that ensures information is shared, achieve
value for money and demonstrate that outputs comply with key
performance indicators.

The government has produced many documents urging improved data
collection especially for services for drug users.(2) In the main,
voluntary sector drug agencies can comply with this need but there
is one type of intervention where there appears to be some concern:
outreach work.

Outreach work is often ad hoc, based on the need to build trust
with hard-to-reach groups, often over a series of fleeting contacts
with the client. Moreover, outreach workers often operate in a
twilight world that falls between the agency and the street, making
detailed information gathering, research and evaluation difficult.
But outreach work also has a key place in services for drug users
because of the flexibility provided by its “closeness” to
hard-to-reach groups and its distance from officialdom. The dilemma
facing outreach work is how to retain its essence while at the same
time fitting into the evaluation culture demanded by the National
Treatment Agency (NTA).

Our research examined the impact of the evaluation culture on
front-line drug workers in the voluntary sector. We carried out 14
semi-structured interviews with workers from three voluntary sector
agencies, who provide tier two and moving into tier three services.
Three key themes emerged from the interviews: the impact of data
collection on creating trust, the focus on treatment at the expense
of “softer” forms of intervention and the rigidity of the NTA
system.

All agreed that the need to collect information affected their
ability to build confidence and trust with fleeting contacts.

The following quote summarises the feelings: “I had a call from a
lady who was worried about her son’s drug use. I’m supposed to ask
her name, date of birth, partial postcode and so on. All she needed
was some quick advice. I guessed her age, made up a name and put
down a postcode. If I’d asked all that she’d have hung up and we’d
have lost the chance to help.”

The second theme was the NTA focus on treatment at the expense of
“softer” forms of intervention. This was a key concern as these
agencies are asked to be both a conduit for clients into treatment
but also provide a set of other services that are the client’s
primary reason for contact.

One worker said: “For some, structured day care plans are great.
They need it, they need the discipline treatment brings in order to
prevent relapse. But I’ve been here a while, and we used to offer
something else to people who can’t or won’t respond to structure
and treatment. We were like a comfort blanket – they could come up,
have some tea, read the paper, talk. Not any more; it is all
treatment, plans, structure, measure and output. There seems to be
no room for alternatives to treatment any more, it’s like take it
or leave it.
“I deal with people and outcomes and that can take much longer than
some structured programme. Trouble is, I can’t see the space being
made for that approach for much longer.”

The third theme revolved around what was seen as a rigid approach
by “the system” and a lack of understanding about the philosophy
inherent in the nature of front-line work.

Another interviewee said: “In a recent survey of our databases, I
discovered that only 0.04 per cent of our records are linked to NTA
data collection systems. Or, putting it another way, the NTA has no
idea about 99.96 per cent of the work we do yet its need for
information dominates our approach.

“The roots of this agency lie in a few committed people wanting to
help drug users and making that help client-centred. I can see a
time soon when the NTA system stops that. In five years’ time
there’ll be a network of small voluntary groups working outside the
NTA to meet a need that the NTA won’t or can’t accommodate.”

The research is specific to drug work but this type of pressure is
felt by those working with marginalised and hard to reach groups in
all forms of intervention. There are concerns about the tensions
created by the need to monitor work with the skills needed to
master the “difficult art of reaching the very fringes of
society”.(3)

Front-line workers are caught in a dilemma. On the one hand they
recognise the need to have a professional management structure and
the mechanisms that allow them to “prove” success. On the other,
implementing those structures places a huge strain on their ability
to work with a problematic and often difficult client group. At
present, front-line drug workers feel that the balance has gone too
far towards the needs of management. They are concerned that those
clients who do not want or are not ready for treatment are being
marginalised, as are the workers who concentrate on servicing their
needs. The problem for the policymakers in the NTA is to recognise
the fact that drug services and drug workers are more than conduits
into treatment. 

ABSTRACT
Management and evaluation are a fact of organisational
life. But for some workers “doing evaluation” affects their ability
to undertake
their job. This article looks at front-line drug workers’ concerns
about the need to monitor and evaluate their day-to-day work and
client contacts. The issues raised here will be pertinent to
voluntary workers in a number of sectors.

REFERENCES
(1) M Power, The Audit Explosion, Demos, 1994
(2) Home Office, Guidance for Local Partnerships on Alcohol-related
Crime and Disorder, 2003, and Department of Health, Models of Care,
2003
(3) A Coppel, “The outreach method and the difficult art of
reaching the very fringes of society”, in Peut-on Civilises Les
Drogues?, Syros La Decouverte, 2002

CONTACT THE AUTHOR
E-mail A.Barton@plymouth.ac.uk