Co-production Week 2019

Co-production Week 2019

Wednesday, 19 June 2019

Co-production and Quality Improvement – Camden & Islington Recovery College

By Ksenija Kadic & Anne Prouse

All Camden & Islington (C&I) Recovery College courses are co-produced and co-delivered by a peer tutor (expert by experience) and a C&I Trust staff professional tutor (expert by profession).  We have trained psychologists, social workers, nurses, researchers, and managers to co-produce with us as professional tutors. 

Fewer Trust staff teach with us, relatively speaking, than other UK Recovery Colleges.  Unfortunately, we struggle to have C&I staff released to co-produce with us, especially for longer courses. Over the last five years, the College has grown significantly but we can’t offer all the courses we would like to, as we do not have enough staff tutors. 

C&I staff who co-produce and teach with us tell us they do find it valuable. ‘[It] has taught me a lot and encouraged me to reflect on how I work with people’ and ‘[I now] approach work in a more collaborative way.’

In February 2019, we set up a Quality Improvement (QI) project to explore ways to encourage more C&I staff to co-produce recovery and wellbeing courses with us.

Our aims

  • Promote co-production & teaching for personal & professional development
  • Transform C&I Trust culture through co-production and recovery model
  • Invest in staff skills & knowledge

Our SMART goal

To increase the number of C&I staff teaching at the Recovery College by 20% by October 2019.

Our team

We invited students and C&I staff tutors to join our QI team to co-produce  ideas.   Our team was two students, three C&I tutors and a research manager, led by the College Deputy Manager/Senior Tutor and with a C&I QI Hub member.

We shared our own stories, and discussed why the Recovery College is a place where C&I staff would want to co-produce and teach. We collected stories from C&I staff tutors and student stories on how our co-produced recovery courses had helped them.  We presented our project to C&I leaders and it was well-received.

What happens now

As senior C&I leaders have shown support for our project, we feel confident we will soon be welcoming more C&I Trust staff to co-produce with us.

Thursday, 13 June 2019

Working well Together at National Collaborating Centre for Mental Health

By Steph de la Haye, National Advisor at NCCMH and Co-production Working Group

NCCMH have taken on the mantle of developing co-production in all its facets, and their genuine commitment to make it real has driven Working Well Together, the paper on co-production and mental health commissioning, which was published on 10th May.

The first thing to state is that the team was made up of more people with personal experience of mental health distress and using services than there were professionals, although many had both hats.

One area of discussion during the development of this paper was around establishing key principles for co-production, which came down to:

Click on the image for a larger version

Another central conversation in the development of this paper was about ensuring that we acknowledge the range of involvement and engagement - as well as acknowledging that co-production may not fix everything! Co-production should, however, run through all work streams as a ‘golden thread’, from the start.

Recognising power is fundamental and something that everyone within teams, services and organisations needs to do, and support the equalisation of. Accessibility is another key factor that can create a level playing field for all people, while recognising the equalities and inequities that people experience.

NCCMH already models what we want commissioners to do. By being open to improvements and individual requests, they have made the process of co-production more inclusive while being aware that more can be done. This is the mindset we hope others will take on. 

A member of the co-production working group said:
“I couldn’t have got to the meetings at all without taxis and 2 nights in a hotel, for a 2-hour meeting. This commitment of resource meant someone who would otherwise not have been at the table at all was able to attend.”

Another person reflected on the support they were given so that they could continue to access benefits while being involved in co-production
“Being on Employment and Support Allowance was also a barrier to being able to take part. While I worked hard and earned my payments, the flexibility of expectations, the low frequency of meetings and the level of support I needed to engage with the process couldn't really be reproduced in a job. Involvement in work like this shouldn't be used to assess capacity to work. Even though they had no experience doing this before, NCCMH agreed to write a supporting letter to be sent in with my permitted work form.

"This flexible approach of listening to what I needed is a vital part of working well together, inclusively.”

Monday, 10 June 2019

Creating the space for effective co-production based, power sharing

By Richard Field and Clive Miller – Independent consultants

Co-production is more than a practice innovation. It’s a total shift in the way the world is understood to work. This is the bedrock on which the new set of working relationships, with power-sharing at its centre, will be built.

Co-production understands that services do not produce outcomes. Instead it is what people and communities do alongside organisations that together produce outcomes. This has always been the case but has either not been recognised or taken into account in conventional practice. Hence the opportunity for people and community to be effective co-producers with practitioners continues to be missed. The result has been both the ineffective and inefficient use of the collective assets of people, communities and organisations.

What is now needed is large scale change that uses the learning from the many examples of innovative co-productive practices to completely transform all conventional practice to being co-production based. This is not a theoretical musing. Wholesale ‘re-imagining of social care’ is already starting to happen in places as diverse as Somerset, Thurrock and Wigan.

It works by devolving power:

·       A new relationship - ‘re-defining the relationship between councils and residents. For example, the Wigan Deal.
·       Community anchored support - ‘A clear sighted commitment to foster development of services and support, often small-scale, which is anchored in the community’.
·       Permission - ‘Senior managers creating a permissive framework that creates the expectation and provides support for practitioners to work in imaginative person and community-centred ways’.
At whatever scale co-production is being introduced, if power sharing is to become a reality it will also require a new ways of exercising power, including a new model of leadership with its own unique set of terms and conditions. SCIE trustee Alex Fox identifies some of them:
·       What. Stop believing in ‘heroic leadership’ the ‘inspirational leader who turns around a troubled organisation’. This is the opposite of the power sharing culture that underpins co-production.
·       Who. No diversity, no power sharing
·       What. ‘Co-production can only work where there are people with lived experience in a position to co-produce’.

The context within which power sharing takes place has a major impact on its outcomes. Hence the commissioning process also requires wholesale change. The many different individual innovations that comprise asset-based commissioning show what is needed.
Now is the time to bring them together as a connected set to deliver the new model of power sharing, at scale.  

Three key shifts will be:

Focus and how outcomes are perceived to be produced
Collaborate with people and communities as equal decision makers.
A fundamental shift in the relationship between commissioners, people, communities and suppliers.  

None of the above will happen unless there is system-wide change in both practice and commissioning. True co-production.

Wednesday, 5 June 2019

Sharing Power through Sharing Stories

By Flexible Films, a video production group working with SCIE

Sharing the power in filming creates interesting and captivating content. We would highly recommend it!

When we first started filmmaking in 2002, we were a bit nervous about doing this as we thought that things had to be exact and technical. There was an element of us wanting to take full control to make sure that the filming sessions were focussed and thorough. We learnt a lot through our mental health filmmaking group, which was a collective made up of people using mental health services. They helped us realise that it's better to include all those involved and to give them as much control as feasible.

We have since learnt that:

  • Those being filmed should hold the power as it is their story.
  • By sharing the power, this makes for honest and open footage.
  • Taking ideas from others makes the films richer and more interesting.
  • A collective process means that people have more ownership.
  • The completed films are more real and engaging as a result.

We are learning all the time and at the start of each project, we leave ourselves open to new possibilities. Because of changing technologies, this can make sharing of power in film easier to achieve. For example, in this year's SCIE co-production festival, there are five volunteers who will be filming interviews with their Smart phones. We will train them how to do this as it is important that technical needs are met. Having co-production members interview delegates will give the interviews a new look and feel. It will also mean that the content is different because members are asking the questions. We are excited at this new prospect and look forward to the festival.

Thursday, 23 May 2019

Co-production power-cut

By Michael Turner, Policy and Strategy Manager, Merton Centre for Independent Living

It’s old cliché but time does fly and it's almost a year since I left my co-production job at SCIE to join Merton Centre for Independent Living.

Most of my career has been about supporting the development of user involvement. It's a simple idea that when the people who use a service play a meaningful role in how it is run, it’s probably going to improve the service and make it more likely that it will give people what they want and need.

I've worked on spreading this message all over the country over the past 25 years. Literally from the depths of Devon to the Highlands of Scotland. I even worked briefly with Disabled people and services in Russia.

Not just a new word

During my eight years at SCIE, the word co-production came into fashion as a way to talk about this way of working. I thought it was a bit of a jargon word and I wasn’t that keen when SCIE first wanted to talk about co-production rather than user involvement.

But I was persuaded by the idea wasn’t just sticking a new name on the same old thing. For a jargon word to have meaning, it has to be linked to doing things differently, and that's where co-production comes in if it's done properly.

Real co-production is about services sharing power with Disabled people and professionals working together on a more equal basis. It has become a well-established way of working in organisations like SCIE and local authorities like Oxfordshire County Council and Hammersmith and Fulham - it's even in National Institute for Health and Care Excellence (NICE) guidance and the Care Act, so it's almost part of the establishment.

Reality check

One of my first projects with Merton CIL was a review of adult social care in the borough. It was a real dose of reality about how social care works on the ground but there was real hope for it to be the first step towards improving the situation and the development of a co-production approach.

We're still waiting on this. Since we published the report the Council has stopped funding our Advice and Advocacy service. It's not been the great start to co-production we were hoping for, but we're now working on a review of housing and Disabled People in the borough. Co-production will be part of the message again so hopefully we'll have more luck this time.

Wednesday, 22 May 2019

Co-production in Action

Patrick Wood reflects on his experience as a member of the Integrated Personal Commissioning Evaluation Co-production Panel

In August 2016, the Department of Health commissioned an independent evaluation of Integrated Personal Commissioning (IPC), which is a new approach to joining up health and social care and other services. The evaluation was undertaken by a consortium led by SQW in partnership with SCIE, leading on the co-production side, and others.

A co-production panel ensured that the views of the public, particularly those that share characteristics with IPC users, could contribute to shaping the evaluation and test findings. The panel consisted of around 10 people who used services and carers working alongside researchers and co-production team members from SCIE and SQW.

The role of the panel included:

Receiving and commenting on reports on the progress of the project
Involvement in the development of research tools
Identifying research themes from service user and carer perspectives
Involvement in research team debrief meetings

One of the concerns of panel members was making the group accessible without oversimplifying the issues. When a person with learning difficulties commented that she had problems with the language used at one of the meetings, this was addressed by inviting her to lead a workshop on accessibility at the next one.

Sometimes, panel members were concerned with commenting on IPC in general rather than on the process of the evaluation in particular. For example, IPC struck panel members as a top down approach (which does not align with co-production principles) and it was hard to know what difference IPC had made to people who use services.

This illustrates that you might be surprised when working in a co-productive way. A key consideration for people aiming to work inclusively is how to bridge the gap between the different backgrounds and experiences of the people involved and a key question to ask is what is necessary to make working together meaningful for everyone.

Overall, the panel worked well. It was a pleasant group to be involved in (this might seem like a superficial observation but it illustrates that people were respectful of each other’s contributions). It was productive and made a difference. Most importantly, everyone acquired some new learning that can be used in other contexts.

Tuesday, 21 May 2019

Sharing power and decision making as part of a team

By Niccola Hutchinson-Pascal

We are the first to admit we don’t get everything right and some things don’t work – but that it is the beauty of a new project. Everything is learning, everything is adding to the Centre that we will launch as a collective in mid-2020. 

The UCL Centre for Co-production in Health Research has, since October 2017, been working hard to co-produce the Centre from scratch with a mixed group (open to anyone to join at any time) that includes members of the local community, patients, carers, researchers, healthcare practitioners and students. 

The sharing of power and decision-making is something that the Centre for Co-production feels very passionate about and is one of the key principles that we live by!

As part of the Centre development work that has taken place to date, we have tried extremely hard to share power and decision-making. This isn’t always straightforward but one thing in particular that helps us to achieving this sharing is that we are all open and honest about the challenges and work through them together. We are ONE team, no member of the group is more or less important than another member, we just bring different skills and experience to the table.

Taking time to build relationships first before embarking on any work is fundamental to us being able to operate in this way; it helps build trust between members of the group and enables more straightforward decision-making. We have also found that it means that sharing of power is easier to achieve, as people are more likely to be open and honest.

Photo credit: Beth Ingram, UCL Centre for Co-production collaborator

As part of the development of the Centre for Co-production, and in order to further test and refine our approach we are looking for collaborators (organisations or groups of individuals) who are interested in delivering a co-production innovation, piece of research or intervention project. We have recently opened a call for funding applications. The deadline for applications is 14 June.

To find out more about how to apply have a read of our latest Centre blog. We look forward to hearing from you very soon!