Using their initiative

Driving through the Bentilee housing estate in Stoke-on-Trent it would be easy for a passer-by not to spot the true extent of the deprivation afflicting its 15,000 residents.

Compared with some inner city areas the estate, which also takes in Berryhill and Eaton Park and was among the biggest in Europe when it was built, does not appear obviously run-down or particularly menacing.

Row upon row of look-alike houses and flats may not be very attractive, but at a glance many of the 5,000 homes appear well maintained and the streets relatively clean and tidy.

But as one observer comments, the problems are behind the walls and in the alleyways. Bentilee has a high unemployment rate - 8.8 per cent, 44 per cent higher than the average for Staffordshire - and a high level of, and fear of, crime.

There are few recreational facilities, the educational achievements of the residents are low, and their health status poor.

Health workers and others know that if real improvements are to be made, the range of deprivation factors must be tackled.

A multi-agency project, the Villages Initiative, aims to do just that. While not unique, it has many of the features being promoted by the government as part of its health action zone initiative.

Staff involved in the scheme - they include personnel from North Staffordshire health authority, North Staffordshire Combined Healthcare trust, Stoke- on-Trent city council, the police and voluntary agencies - believe prospective HAZs have much to learn from their experience.

The HA itself is among the 30-40 applicants expected to have submitted a bid seeking zone status by tomorrow's deadline.

HA chief executive Richard Priestley says the authority would use the Villages Initiative, as well as the three others within its boundaries (with a fourth proposed) funded through the single regeneration budget (SRB), as part of the basis for that bid.

He says: 'The HA is involved in all the SRB projects. We put a lot of emphasis on partnership arrangements and believe this is the sensible way forward. We now want to strengthen this approach by going for HAZ status.'

Working in partnership with others is difficult, Mr Priestley admits, but it has been easier than he expected because there is a huge willingness on the part of all agencies to do it.

But Mr Priestley is adamant that, even if there is good joint working, this type of project cannot succeed without community involvement and ownership. 'It is not a question of doing it for people. That is passe... A lot of it is about empowerment of individuals and communities.'

The Villages project, which has attracted pounds20.5m SRB funding over seven years, has recruited many of the estate's residents.

Among the 50-odd sub-projects currently running under the initiative is 'Working Together for Better Services', which has at its heart the idea of involving local people in helping to decide the shape of services.

Malcolm McClean of MJM Healthcare Solutions consultancy, which has been hired to take forward that sub-project, says the aim is eventually to get residents taking part in commissioning services across the agencies.

But he does not underestimate the size of the task. The first phase of the initiative - 'going out onto the streets' and finding those people - was very time-consuming: 'If you give people a choice between sex, drugs and rock and roll or the chance to get involved in a commissioning model, what do you think they are going to opt for?'

Mr McClean thinks the trick is to seek out the 'informal consultants' in the area, the people to whom everyone runs with a problem, and use these 'power houses' of energy to recruit others.

One such 'consultant' Mr McClean has found is ex-wrestler Jayne Porter, who was already active in the community.

Ms Porter welcomes the chance to help improve the lot of fellow residents on the estate, and says it is right that local people should know how money is spent.

Another resident, John Davis, a member of the Villages Initiative partnership board who has lived on the estate for 40 years, agrees: 'This is a good way of empowering local people and ensuring you get best value for money from available finances.

Mr Davis adds that he would not shy away from making 'rationing decisions' should it be necessary.

North Staffordshire Combined Healthcare trust is enthusiastic about the initiative. Chief executive Glenn Warren sees the integrated approach as the way forward and praises the residents' contribution.

There have been many suggestions about service changes even though the project is in its early stages (the first full year of implementation began in the summer).

Among changes residents have proposed is having more police on the streets, and improving road services, which would cut down on the number of falls, particularly in winter, so saving money spent on hospital care.

Lesley Walker, community development co-ordinator based in the chief executive's department of Stoke-on-Trent city council, says the council is very serious about community development.

'The whole ethos from which the project sprang is great, what people want and need, giving them a voice and determining whether what they want will fit in with the rest of the city.'

If the 16,000 responses the project team has received about changes residents wish to see overall on the estate is anything to go by, people certainly intend to use that voice.

David Gibson, project director of the Villages Initiative, says that as well as plans to create 1,000 jobs, renovate homes and improve recreational and shopping areas, there would be a range of community development initiatives, with a role for 'developing the capacity of people'.

The problem with urban regeneration in the past, he says, has been a tendency to concentrate on improving physical environment while ignoring their expectations and aspirations.

'You have to look at the whole picture. If you're talking about achieving dramatic improvements in health, you have to tackle all factors.'