When Trust Is Not Enough

Graham Duncan and Pritpal S Tamber

August 21, 2019

One of the assumptions that’s starting to take hold is that community-based organisations (CBOs) are better able to reach and influence local citizens than health care. While this is often true, how many CBO leaders really understand why their work is effective? And how many are actively trying to uncover it through self-analysis? 

Today’s interviewee is doing just that. Graham Duncan is the Director of St Mary’s Community Centre in inner city Sheffield, UK. I first met Graham through my Beyond Systems project and I caught up with him on where he’s got to in trying to understand the core of what it is that makes the Centre successful. 

Pritpal S Tamber: Hi Graham. Let’s start with what you used to do and what happened off the back of the austerity agenda that started around the end of 2009.

Graham Duncan: St Mary’s opened as a community centre in 2001. Our building is impressive and we use it to generate income through a conference and catering business. Until austerity, we had a very profitable enterprise that enabled us to employ a team of community and youth workers with very little reliance on grant or contract funding. When austerity started we knew that our business model would be battered. And it was. We lost about 60% of our income in the space of two months. We were suddenly pitched into survival mode and had to close all our community work. 

Pritpal: Wow, that must have been challenging. So, how did you respond? 

Graham: We knew we needed to better understand what residents wanted. To achieve that we needed to have conversations with them so we hired an empty shop and opened a pop-up project called the Pie Experiment. We gave apple pie and coffee to anyone who came in to talk to us. We learned a lot, particularly that people wanted to contribute their time and make a difference, but they didn’t find traditional volunteering accessible. It got us thinking about the value that already exists in a community – its assets, to use the jargon – and how we might activate them. Our new strategy was to be the best friend to any person or grassroots group that wanted to do something. Then we looked for a mechanism to help them participate.

Pritpal: What do you mean by “a mechanism”?  

Graham: It’s one thing to see that there are assets within a community, it’s another to get them working to the benefit of the community. That requires a mechanism. 

Pritpal: OK, understood. So, what did you find? 

'Sharrow Foodcycle’: Volunteers cooking meals from waste food; each week more than 200 meals are served
‘Sharrow Foodcycle’: Volunteers cooking meals from waste food; each week more than 200 meals are served

Graham: We looked around to see who was doing something with ‘assets’ and discovered two organisations who became really important to us: Spice (now called Tempo) who had developed a track record of using ‘time credits’ in Wales, and FoodCycle who were using waste food to build friendships and communities. They were both generous with their knowledge and we learned enough from them to start our own programme called TimeBuilders.

Pritpal: I want to hear about TimeBuilders but explain what ‘time credits’ are. 

Graham: People earn a ‘time credit’ for each hour that they work on a community project and they can ‘spend’ the credit on rewards. Our rewards include tickets for sports games, gigs, leisure centres, or theatres. The tickets are donated from the surplus capacity of leisure organisations in the city. We also run a community café where you can buy meals with your credits. 

Pritpal: OK, got it. So, back to TimeBuilders…

Graham: TimeBuilders uses time credits to help marginalised people develop purpose and relationships. We ask people to help us work on projects that tackle loneliness and poverty, such as cooking a community meal from surplus food, running a wood workshop using recycled materials, or running a group in art, sewing, writing, or crafts. That earns them time credits, which they can use for themselves. It effectively creates a parallel economy where people get the opportunity to do something purposeful, be rewarded for it, and develop supportive relationships.

Pritpal: Sounds simple but does it work? 

Graham: It is simple and it does work. In the last 12 months we had 484 active members earn 17,190 time credits. People tell us that being a member of TimeBuilders changes their lives. And the really interesting thing is that most of the benefit occurs at a peer level through the informal connections created by the TimeBuilders ecosystem.

Pritpal: So, if the benefit is happening at the peer level, does this parallel economy just run itself?

Graham: In the long-term people do become leaders and projects do become sustainable. But it takes time because so many marginalised people have been living for decades in toxic environments that have eroded their confidence and motivation. Many have responded, quite reasonably, by deciding not to engage with those who claim to help them. For these reasons an asset-based solution isn’t necessarily quick or cheap. People don’t fulfil their potential just because others proclaim them to have or be assets. They need to experience a whole new ecosystem and understand how it can work for them. That takes investment, which is what TimeBuilders offers.

Pritpal: So, what does that “investment” look like? 

Graham: For us, the investment is a staff team of six people, mostly part time, working in different communities in Sheffield and Rotherham. Their job is to do practical things with local people to build confidence and hope. Once ideas and motivation start to flow it’s about structuring the experience so that people do things that are successful.

Pritpal: OK, but how do you build confidence and hope? 

Graham: First we listen to people and work with them to design projects that are important to them. The projects enable them to do something meaningful and form positive relationships. Secondly people earn time credits for their work. This is incredibly important: it means they are able to provide for themselves and their families, and do things they could not otherwise afford. The dynamic of earning and spending is at the heart of the project.

Pritpal: Purposeful, meaningful projects. Positive, supportive relationships. And reward. 

Graham: Right.

'Woodstar’: In a community workshop people share skills and make beautiful items from waste wood
‘Woodstar’: In a community workshop people share skills and make beautiful items from waste wood

Pritpal: So, those are the ingredients for confidence and hope? 

Graham: We think so but we’ve tried to understand it more rigorously. We could see right from the start that TimeBuilders was having an impact but we wanted to understand the psychological processes underlying it. What was happening to influence the way that people were thinking? 

Pritpal: So, how did you go about doing that?  

Graham: Over the last three years, we’ve been working with the School of Health and Related Research (ScHARR) at Sheffield University. We’ve analysed structured conversations with over 100 members of TimeBuilders and tried to make connections with theories in behaviour science. We came across the COM-B framework which proposes that behaviour (B) is influenced and/or determined by a combination of capability (C), opportunity (O) and motivation (M). This resonated with us because it allowed for behaviour to be a response to environment. It makes clear that some of the response is conscious and some is unconscious. If behaviour is unconscious then rational and cognitive arguments don’t help – people need to experience something. 

Pritpal: OK, so how do the experiences of members of TimeBuilders relate to the framework? 

Graham: Firstly, through participating in projects people experience some success, whether it’s learning something, contributing something, or belonging to something. Most people aren’t used to success and this increases their sense of capability (C). Through participation, they have the opportunity (O) to experience positive, supportive relationships. And because the work they are doing is important to them and they are rewarded with time credits, they feel motivated (M). Members tell us that through their experiences with TimeBuilders they change their behaviour (B) – they come out of isolation, they make relationships, and they achieve new goals. The framework has helped us make sense of what we’re seeing. 

Pritpal: That’s an impressive analysis of what you’re seeing and how it might relate to a theoretical framework. 

Graham: Thanks. 

Pritpal: So, now that you’ve worked it all out, are you franchising your approach? 

Graham: I think we have a model that can be replicated but that’s not the same as being franchised. Franchising implies rigid adherence to a set of processes which will make you a profit in return for a fee. That’s not our idea of replication. The work with ScHARR has helped us to make the underlying psychological mechanisms visible: It’s given us a tool box of practical ways to help people experience success, form relationships, and do rewarding activity. This analysis makes it easier for other people and organisations to adapt our model to their contexts.

Pritpal: So, is that what you’re doing now? 

Graham: Our next step is to create a network of organisations who use and adapt TimeBuilders to their local contexts. What we’ve done is pilot the approach and tease out the underlying psychological mechanisms at play. We want others to build on that with us so that we can create something of sufficient scale to be noticed by the mainstream health and social care systems.

Pritpal: That’s ambitious. 

Graham: Yes, and we’ve started. Over the last few months we’ve been in discussions with a whole range of partners and potential partners in Sheffield and Rotherham. We’ve started working with primary schools and a GP practice (primary care), and have had interesting conversations with leaders of drug and alcohol services who believe that people leaving rehab need to return to new, more supportive environments. Being able to articulate the kernel of the work is making it much easier for these organisations to see how it could help them achieve outcomes with the people they work with. 

Pritpal: It’s pretty exciting but let me ask the killer question: how might you fund this if there is no money out there? 

Graham: Not sure yet! But this is the world we live in. I get the sense that funders are looking for new approaches to complex issues and I’m hoping that, having backed us to generate the insights that we have, they’ll continue to help us spread the approach so it has a wider impact. In the longer term we’re all waiting for health money to move towards preventative work and we need to keep building the case that we all know so well.

Pritpal: Well, hope is not a strategy, as they say, but I sense more than hope in what you’re doing. I’m impressed with the intentionality and wish you well for the road ahead. Thank you for sharing your journey with me. 

Graham: It’s been good talking with you. Good luck with your project: it matters. 

All too often I have heard leaders of community-based organisations market their work solely on the basis of the trust community residents have in them. I’m not denying this is important – indeed, I’m of the view that it’s crucial – but I’m clear that it’s not enough. For formal systems like health and social care to truly partner with CBOs, their leaders need some kind of understanding of why the work of a CBO is likely to have impact. Whether it’s called a theory of change, a conceptual framework or a value proposition, this understanding is, I believe, crucial to partnerships between health care and CBOs. To my mind, Graham’s analysis goes beyond surface-level rhetoric of ‘trust’ to truly understand what it is about their work that matters and hence how to go about it more intentionally. It’s plain impressive. 

Graham Duncan

Graham Duncan spent 30 years running small voluntary organisations that try to find new ways to make things better. After starting his career in drug rehabilitation, he had the opportunity to build up three organisations from scratch: in youth homelessness, community development, and mental health. He has been running St Mary’s Community Centre for nearly 20 years, as a charity and social enterprise. Graham believes that TimeBuilders is the best thing they’ve ever done.

Pritpal S Tamber

Independent Writer, Researcher & Consultant | pritpal@pstamber.com

I'm an independent writer, researcher and consultant focussing on community health and medical information. I'm a former physician, medical editor and medical publisher, and also the former Physician Editor of TEDMED. I began my career at The BMJ. For more information, see the About page.

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