Co-production – the Wiltshire perspective

By Clare Evans MBE, first director of Wiltshire Users Network, 1991-1997

Co-production! It is a comparatively new word in common use in social care – 25 years ago it is what we called user- controlled user involvement - it stood at the top of the ladder of user involvement for those of us who used services and valued involvement.

Why did we value it then and what similarity is there with co-production?

There were one or two important factors we valued and fought for as we set up Wiltshire Users Network (WUN), a generic user - controlled network of long term users of Health and Social Care, in November 1991 in response to the new NHS and Community Care Act which first enshrined the terms “user” and “carer”. Although these terms later came to restrict people, they helped us then, define a new identity for ourselves to gain a voice and move beyond “professionals know best” to involvement on equal terms.

We learnt that by building our own organisational culture and values, we could gain  confidence and negotiate involvement from the start on our terms. As well as agenda-setting, we could prepare adequately and collectively to take forward the views of many “service users”. Of course, funding for WUN was crucial to establish good practice in paying fees and travelling expenses to service users, to sit alongside professionals to plan and monitor services. A negotiated service agreement with the local authority gave us the flexibility we needed and we began our involvement! Once, I counted 64 different ways we were involved in health and social care!

So was it all worthwhile?

We recognised we were there for the long term - to change the culture of social care as well as direct service provision. Ultimately the growth in Independent Living, and the legalisation of Direct Payments gave the flexibility many sought. Undoubtedly the shared understanding of co-production good practice has brought equity but how much happens at local level? Sadly, austerity has changed the landscape in recent years but whatever the financial climate, undoubtedly best practice comes from co-produced social care.