Co-production Week 2019

Co-production Week 2019

Friday, 15 February 2019

Co-producing Research: How do we share power?

By Dr Gary Hickey, Senior Public Involvement Manager, INVOLVE (INVOLVE supports service user and carer involvement research) 

Gary Hickey 
Co-production, as an approach to research, is gaining traction.  At INVOLVE, in an effort to move toward clarity on what co-production means to research, we led on the development of some guidance (See here - pdf file) identifying some key principles and features involved in co-producing research.  The key principle is the ‘sharing of power’.  

The idea is that ‘the research is jointly owned and people work together to achieve a joint understanding.’  Easily said - but how do we achieve this in practice?  Research teams are often, and with all best intentions, hierarchical; with a chief investigator leading a team made up of researchers of various grades.  And how do we ensure that public members truly have a voice in decision making?  How do we also ensure that the knowledge of public members is respected and valued?

We will explore these issues in our second #How2CoPro event, Co-producing Research:  How do we share power? on 12th March. Last year the same event was such a success that we are back again with a bigger event and looking forward to learning together once more!  

Our key aim for the event is that we all share experiences, and provide practical examples, of how power can be shared in a co-produced project. We will also update you on various co-production initiatives and opportunities that we know of.  

At the event we have a range of quality speakers including Simon Denegri (National Director for Patients, Carers and the Public, National Institute for Health Research), who will update on co-production in the National Institute for Health Research; as well as a range of speakers (public members and researchers) who will share their experiences of, and techniques for, sharing power.  The event will end with a panel discussion on sharing power and will include SCIE’s Head of Co-production, Pete Fleischmann.

This event is sponsored by: Centre for Public Engagement, Kingston University and St George’s, University of London; INVOLVE; University College London Centre for Co-production in Health Research.

You can register for the event and see the agenda here. Twitter Hash Tag: #howtocopro   

Tuesday, 5 February 2019

Making it Real – something wonderful this way comes?

By Caroline Speirs - discussing power, which is the theme of Co-production Week 2019. Caroline is Head of Think Local Act Personal (TLAP). A longer version of this blog is on the TLAP website

‘Don’t shift power. Share it’. This sums up the thoughts of Halima Khan, from the innovation foundation Nesta. Halima believes that sharing power can open up new solutions. That’s TLAP’s intention with Making it Real. It’s our new approach to what good citizen-focused care and support should look like. It’s a framework that creates space for a different model of power – a shared power.

By virtue of a great partnership, TLAP holds a privileged position that provides us with a multi-dimensional perspective. We get to speak to national leaders and decision makers. We meet regularly with practitioners and we work up close and personal with people with lived experience via our work with the National Co-production Advisory Group. Viewed through that lens, we get to see up close the gap between the rhetoric of what ought to be supportive policy and legislation and the reality of what’s happening on the ground.
The view isn’t always a good one. We see an exhausted colleague who accesses care and support questioning what he needs to do to live his life. We see a parent who worries about a system that cannot see what her grown up daughter has to offer society, only how much she costs.

What does any of this have to do with power?

Quite a bit I think. Clearly the impact of unprecedented cuts has some role in creating a harsh gate keeping system but it would be wrong to apportion all blame at the door of austerity. We have, after all, lived through financially healthier times but processes were no less harsh and stifling when we had a bit more money in the back pocket.
The beauty and the power of Making it Real is that, applied properly, it gently encourages a shift in relations. It generates a change in focus and supports a new outlook, one that is far more about relationships than transactions. An approach focused on a conversation, on what matters, on a life not a service.
Making it Real in Manchester
I began to see what a turbo charged version of this could look like in Manchester TLAP ran a session on Making it Real at the annual conference for Directors of Adult and Children’s Social Services. Something interesting happened Some barriers were dismantled and a few roadblocks removed. Not only did the world continue to spin on its axis but it did so with gusto. The challenge now is to harness that energy and that optimism to go further and deeper and create the transformational system change we’ve spoken about for so long. I am hopeful that with the arrival of the long-awaited social care green paper, we will see a clear commitment to working in this way.
Think Local Act Personal will do everything it can to support that.

Monday, 9 July 2018

Searching for the Aha! moment. Co-production in care

By Sophie Chester-Glyn, Managing Director, Manor Community

When I mention the phase ‘co-production in care’, I often get a confused look or blank stare back. It doesn’t quite roll off the tongue and takes some explaining before you get that ‘Aha!’ moment. Over the past two years we have strived to get that ‘Aha!’ moment throughout our organisation. Coming up to co-production week, we’ve reflected on how we’ve embedding it into our care.

Our journey started in early 2016 when I was asked by a manager what colour I wanted to have one of our care homes painted. My response was ‘I don’t know, I don’t live there’. Even though we knew about co-production we obviously weren’t yet living and breathing it. So, we began to change the culture of developing services from a bottom up rather than top down approach.

Using technology has been crucial. We collaborated with a software development company which helped us adapt an internet Cloud based product into an accessible staff and client intranet site. We are now integrating real-time feedback systems such as Survey Monkey into our intranet site. This enables clients to connect efficiently with senior management. They can now individually and quickly vote on everything from their care experience to activities, staff practice and service design. This also enables clients, families and staff to have a direct input into strategic decisions-making. Feedback on this new system has been fantastic. Both staff and clients enjoy using the system and it has proved to be a great way for co-production to be fun and interactive.

Getting feedback from people is crucial, but co-production is more than that. In fact, we have found some people misunderstanding co-production as simply engagement. Some local authorities might let people know about their plans after the decisions have been made or without providing accessible means whereby people can have an input. TLAPs ‘co-production’ ladder has been helpful in explaining the ‘co-designing’ aspect of co-production. Involving people in writing policies has helped us. 

We support people with mental health, learning disabilities and autism. Within this client group we have an enormous amount of talent. Over the past few weeks we have been hiring people who we support to help edit and design our operational policies, this has been especially exciting for those who have a particular skill in accuracy and attention to detail. We have also consulted with the people we support on our easier read documents on voting, staying safe in the heat and internet security.

When deciding how to implement our social values policy, one of the people we support found out about a local charity that helps feed the homeless. He expressed an interest in supporting the charity. Now one of our care homes and its residents help prepare and service meals to homeless people in Bristol. This gives everyone a feeling of achievement and self-worth and contributes to our community involvement.

Co-production has brought great benefits to our culture and quality of care. Events like Co-production week help to share good practice and spread the word. So hopefully more people can understand what co-production is, how to do it and to get that ‘Aha!’ moment.

Promoting co-production in the care sector

By Penny Holden, with Martin Symons, Members of the Making it Real Norfolk Board - and Mary Fisher (Making it Real Norfolk)

With special thanks to Christine Futter and Sarah Steele from Norfolk and Suffolk Care Support, for their contribution.

The recent CQC Report “Better Care in My Hands” found that people with long-term health and care needs are least likely to report feeling involved in their care and in making choices about their daily life. Making it Real Norfolk believes the best way to improve services is to ask the people who use those services what they need and how best to provide it. If co-production is taken seriously then, as Martin Symons says, “Co-production works for everyone, people feel they have choice and are in control ”.

Martin Symons and his Boma

We want to use our skills and lived experience to improve service user involvement and promote co-production in the adult care sector. We began this work at the Norfolk Care Conference in Nov 2017. Two of our members, Penny and Martin, developed an idea and have taken the lead role in promoting it. Penny says, “we are the people who currently use services, we are people who will using the services in the future and we are the people who will use services that are currently not available. We have lived experience of our own conditions, we are the experts who can help care providers to get it right. Co-production ticks all the boxes and it is the future.”

A bit about us – We are a group of people with lived experience of disability and unpaid carers. We have links to community groups, user led organisations and strategic partnerships. We work in partnership with Norfolk Adult Social Care and Norfolk County Martin Symons and his Boma Penny and Martin talking to care providers Making it Real Norfolk board meeting Council – councillors are also co-opted onto our board - so that service design reflects the voice of service users and carers.

We have teamed up with Norfolk and Suffolk Care Support (N&SCS). N&SCS support the health and social care market to deliver health and social care excellence; they do this by supporting the care market to develop skills, knowledge and values of the paid and unpaid workforce. We have worked with Norfolk & Suffolk Care Support in the past and they have a proven track record in their commitment to seeing co-production in practice. We will soon be starting work with N&SCS to coproduce a set of resources for care providers to use. The resources will highlight good practice and provide a guide to improving service user involvement for those groups identified in the CQC report who report feeling less involved in their care than other groups. 

The project also includes an event to showcase the resources to care providers. We will co-host the event with N&SCS. This will give us a chance to network with care providers and talk about ongoing involvement. Mary says, “When people are involved in shaping their care, people feel that they are part of the solution and not the problem”. Work begins on our project with care providers on 11 July 2018 and we are really excited. Wish us luck! 





Thursday, 5 July 2018

On the board in Oxfordshire

By Ben McCay,  Team-Up Board member and member of My Life My Choice, Oxfordshire

My Life My Choice asked me if I wanted to visit a co-production board meeting in Oxfordshire, which was on the 3rd April 2018 and I said I would like to attend.

At the meeting it was explained to me by the board members that they wanted people with experience of using services within Oxfordshire to come and visit to see if they would like to become a permanent member of the co-production board.  Danie who is the co-production lead at Oxfordshire County Council explained to me and the other people visiting about the co-production aims and plans. I was thanked for visiting.

My Life My Choice asked me if I would like to become a permanent member of the co-production board and explained if I did Danie and some of the other board members would interview me about why I wanted to become a board member and what my motivation for joining was and what did I think I could contribute to the table. 

I thought I could use my experiences of using services to help lead the way in designing good quality co-produced services. I had an interview.

I then attended my second meeting as a full board member. At the meeting we had to review the Oxfordshire co-production champions training. The board did one day of the training and were asked to give our feedback.

I gave positive and constructive criticism to help shape the training for the champions. I really enjoyed working in small groups at the training discussing how to put literature into plain English. We then wrote down our plain English and fed back to the other groups.

After the training I felt I had a better understanding of what co-production is.

I attended the co-production festival in Camden which is part of co-production week and enjoyed being part of group discussions and feeding my ideas back to the other people. I learnt more about SCIE and enjoyed the music and seeing The Lost Voice Guy perform.

I am looking forward to being on the co-production interview panel to help employ a new member of the co-production team. 

I am very pleased to be part of the work the co-production board are doing in working towards promoting co-production and shaping services to improve them in the future.

Co-production and the NHS

Kath Sutherland, FRSA – Founder of START Ability Services and SCIE Co-production Steering Group member

The NHS is 70 and there is no doubt that we have made some phenomenal achievements in that time, not least in the discovery of DNA!  However, with much focus on medical advancements, few have mentioned the importance that co-production plays in supporting an individual’s physical and emotional wellbeing, as well as in reducing the ever-increasing costs facing the NHS.   

The contribution of lived experience 

Individuals, their families and day-to-day supporters have valuable knowledge to share with health and social care staff that can meaningfully impact upon their recovery and their successful and timely discharge from hospital.  And yet, this expertise is often ignored, even though access to information and full participation in all aspects of decision making is essential to ensure the emotional and physical wellbeing of our population.  

As a result, many people with impairments have very negative experiences when using health and social care services.  Our support is then requested as people are trapped in hospital unable to return home, as they cannot secure appropriate community support.   

Too many people face unnecessary barriers

One such person was Elizabeth, who after fracturing her hip, faced a catalogue of errors and omissions with medicine management, physiotherapy and rehabilitation services.  Her pre-existing impairments and mobility difficulties were ignored, and she encountered significant isolation from her family and friends causing barriers to her discharge, due to a lack of consideration for her speech impairment and hearing loss.  This situation was intolerable and entirely inappropriate.  

Elizabeth’s story in her own words

 “My experience as an inpatient was one of isolation, lack of control and subsequent depression.  However, this was not as a result of the fracture I sustained, or indeed the attitude of staff towards my impairment.  It was purely as a result of a lack of consideration of my needs and a significant lack of planning and co-ordination of my discharge.  This resulted in an unnecessarily lengthy hospital stay, where I was significantly isolated from all of my family and friends.

Upon receiving my complaint, I was contacted and asked if I could meet with senior managers to look at the issues I had raised.  This was very positive as I then worked with the managers to ensure that staff were reminded of policies and practices, in relation to the issues I had raised, but with a particular focus on the implementation of person-centred support that meets accessibility requirements.   This has resulted in a significant benefit for the community as a whole, as the hospital now have a 99% satisfaction score from patients and family, whereas this was previously registering in the region of 60%.”

Co-production is the way forward! 

The striking thing is that, as the principles and practices of co-production are spreading, the responses people receive to complaints are becoming more appropriate and effective.   Indeed, the actions taken since Elizabeth’s complaint (and since complaints from many others) have enabled Board members, staff, patients, carers and visitors alike to significantly benefit from the more accessible, person centred environments that have now been created.  Perhaps it is time that we all realised the amount of money and distress that could be saved if co-production was applied to all areas of health and social care? 

Wednesday, 4 July 2018

Why the England penalties were all about co-production

By Steve Palmer, SCIE communications manager 

I’m not sure if Gareth Southgate’s ever heard of co-production but I’d like to suggest that what he did last night was immersed in co-production. In 1996 Southgate missed a penalty in the semi-final of the Euros and we went out against Germany. This man has lived experience. When he became England manager, one of the things he did was to start talking about penalties and what happens when we take them. And he got the team to practice penalties at the end of training, when they were tired. In other words, he replicated some of the conditions that exist when you’ve played 120 minutes of football and as the nation holds its breath. Last night wasn’t a fluke. It was the result of a strategy. But, essentially, Gareth worked with his players so that they took control. He led them but they were centrally involved in the design of the strategy, drawn from Gareth’s lived experience. 

That sounds like co-production to me. And no doubt there was some luck and we might lose the next shoot-out, despite that strategy. But the point is that Gareth Southgate has drawn on lived experience and co-produced a stunning England victory. Something that no ‘traditional’ England manager has done. Every day in every way, people who have care and support needs are available to shape services so that everyone is in a better position: the people themselves and their carers, but also commissioners and service providers. People with lived experience have stood on the penalty spot and missed but they’ve learnt from it and they’re helping the shape the way that care and support is designed. Perhaps we should tell Gareth Southgate about co-production. I think he’d like it.