How Early is Early?

By Kevin Minier. Independent carer.

Cost-effective co-production must ensure that we do the right things in the right way.

This means that the end-user of services must drive the need for change. We can no longer acquiesce and relinquish our responsibility to health and care managers.  Currently those managers can often determine what needs to change; and this might have to be based on the premise of short term finances. Under these circumstances, real change can be just too difficult. 

I believe this is because the authorities have limited influence and are only able to impact the services that they are directly responsible for. This means they are limited to dealing with symptoms and not the root problem.  What I also believe is that the end users and their carers are in a key position to highlight the root cause of the problems that they face. And we call this co-production.

Using co-production to contain costs

My proposal is that service user and carer groups are proactive in defining the root cause of system issues regarding integrated health and social care. Of course there is a need to contain costs and one way to do this is to work up proposals from lay people. This reduces the need to engage more expensive professionals, and it can also take them away from performing their desperately-needed duties. This is especially so if it means taking staff and clinicians from their front-line activities.

So, local patient and user groups can do things like: be proactive; get trained up in co-production facilitation; and create proposals for new integrated models of care. They can then get professionals, clinicians and other frontline staff to critique the proposals that they have come up with. These proposals, can, in turn, be presented to those ‘decision-makers’ and the proposals can be revised and given timescales so that they can be implemented.

It’s also important to create a co-production steering group of professionals and experts-by-experience to develop those things that can be delivered- and for them to monitor progress. Barriers and bottlenecks can be reviewed by all concerned.

Revolutionising models of care

I believe this process will facilitate programmes for change to address those root issues, thereby providing solutions that can revolutionise models of care rather than merely patching over symptoms. The latter adds cost to a process and rarely results in quality of care and customer satisfaction.

This process can surely be more cost-effective as it more effectively uses combined user / carer / professional /clinical resources when developing and implementing new integrated models of care.