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

    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

    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

    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. 

    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.

    (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,
    (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

    E-mail A.Barton@plymouth.ac.uk


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