COMMISSIONING
that LEROs want to deliver ,’ adds executive director of new business at With You , Sarah Allen , whose organisation has long-standing partnerships with LEROs such as Double Impact in Lincolnshire . The role of LEROs is ‘ very specialist and the value they bring is really important ’, she says . ‘ I think one of the things we can do better is make sure there ’ s a requirement within service specifications for contracts that LEROs are an active part of .’
One of the challenges is around funding and allocation , she states . ‘ If there are always going to be sub-contracted organisations to a large provider then there needs to be a commitment that it ’ s a long-term relationship , and we absolutely make that commitment with our LEROs . They need that stability and investment in their own infrastructures . A lot of the conversations we have with LEROs are around “ if you ’ re taking on this additional work , what is it you need to support you to do this ?” I would welcome it if commissioners ring-fenced money for LEROs in contracts . We also work with LEROs where they have a specific contract in their own right – not every area has a LERO , and as large organisations I think we have a responsibility to not step into that and say “ we ’ ll do everything ”.’
Rather they should be looking at how they can support the community to develop their own LEROs so they can retain an independent function away from larger providers , she says .
BOX TICKING It ’ s also important to avoid any situations where simply including a LERO in a contract potentially risks being reduced to its own form of box ticking . ‘ What I worry about is things coming out of the centre like “ you need to have a LERO in your area ”,’ says Hager .
‘ I ’ m always worried by single organisations , because how inclusive and representative are they ? The challenge is true representation and inclusivity – how far can you stretch that ? Are women adequately represented ? People with multiple vulnerabilities ? That ’ s the challenge – how meaningful is it , how inclusive is it , and how far are you prepared to cede power .’
Making partnerships meaningful means actually supporting people to participate effectively , not just inviting them to meetings , she says . ‘ I used to train service user groups across the south west , which included things like what commissioning is and the structures and processes that many of us take for granted .
‘ As a minimum , it ’ s really important to equip them to understand the environment they ’ re working in , as it can be so alien . Even better , move and change your structures and processes , and involve people with lived experience in making them more effective and inclusive . It ’ s not enough to say it , it ’ s about what you put in place to make it happen , and the skills that the people need to be able to do that . Most importantly , what we learn through that process , together .’ It ’ s clear from the CLERO membership that a lot of people and organisations are ‘ desperate for somebody to help them to build up that expertise and grow their experience ’, agrees Smith – ‘ help them position themselves where they can then be commissioned to do the work that generally they ’ re already doing , but to be paid fairly and equitably .’
Part of the imbalance is that national organisations clearly have much more ‘ collateral ’ when it comes to bidding for tenders , she says . ‘ They just have such a huge infrastructure compared to a local LERO ’, while the mechanics of a bidding process can appear impenetrable to anyone with little experience of them .
WHAT ELSE CAN WE DO ? So what else can commissioners be doing to improve the situation ? ‘ In terms of support to aid development they can ensure that when they ’ re commissioning LEROs the funding available is enough to provide equitable salaries , because the staff they have are as qualified if not more qualified than staff in some of the larger organisations ,’ says Smith . ‘ Some of our staff are qualified to masters level – it ’ s fundamentally wrong to pay minimum wage for a recovery worker . And where there isn ’ t a LERO visible , the commissioners and larger commissioned organisations
Back in 2018 , chief executive of Build on Belief Tim Sampey told DDN that peer-led organisations with strong track records were often excluded from tendering unless they subcontracted their services to a large provider , or else were levered in as ‘ added value ’ with specifications ‘ so fuzzy as to become meaningless ’. www . drinkanddrugsnews . com / the-right-focus /
need to be looking out to see where there ’ s one emerging and help them mobilise and grow so that at some point they ’ re able to have some equity in terms of the commissioning .’
‘ I ’ ve worked in a couple of areas where we partner with wellestablished service user groups , which now you ’ d call LEROs ,’ says Middleton . ‘ On the provider side it ’ s really about trying to get the balance right between nurturing and being able to share power , being open and embracing it . That ’ s where it ’ s happened well . I can see developing more elements of coassessment in the future – getting people in as part of inspections and audits to tell us how they ’ re experiencing services and what could be done better .’
‘ I think there ’ s a lot more we can do as providers to support service users , because it ’ s invaluable that they ’ re part of this process ,’ agrees Sarah Allen . ‘ Without them we won ’ t get the same quality . In terms of the commissioning standards themselves , we have lots of volunteers within services and peer mentors , and we ’ ve also developed specific paid lived experience roles within the organisation . I think that ’ s a really good step in terms of working towards those standards and starting to embed them . Yes the commissioning standards are there at the point of the contract , but they need to be there through the life of the contract . That ’ s how we ’ re going to know if we ’ re achieving this – by having that continual review .’
‘ I think we ’ re on the right path for lived experience , and the commissioning framework will help ,’ says Smith . But for this to work a lot of it comes back to ‘ building trust and brokering relationships ’, she says . ‘ Trust really is a key word – we ’ ve got to trust people and trust small organisations . The work that we ’ re doing as CLERO is just trying to help LEROs build in a way that ’ s going to position them to be able to get a piece of this pie , because what I ’ d hate is if they were overlooked because they don ’ t tick the boxes . That would be an absolute shame .’
But ultimately , when it comes to genuinely involving people with lived experience , ‘ you have to be honest about the limits of your ambition – how far you ’ re willing to give up power or have it taken ,’ states Hager . ‘ In Cornwall , our ambition for co-production is high . I ’ ll know I ’ ve succeeded when they take my job .’
See next month ’ s DDN for the final part of the series
This series has been produced with support from an educational grant provided by Camurus , which has not influenced the content in any way .
14 • DRINK AND DRUGS NEWS • NOVEMBER 2022 WWW . DRINKANDDRUGSNEWS . COM