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?