The real reasons we still don’t co-produce

By Alex Fox. CEO of Shared Lives Plus and trustee at SCIE

It’s rare to hear senior public service and voluntary sector leaders talk openly against the idea of co-production. Some still confuse it with consultation. As I heard a senior leader say recently, “We will come up with ideas and then co-produce our plans with local people.” (If you’ve already come up with the plans, it’s not co-production.) Many still describe it as difficult, either in terms of the process (despite so many co-production toolkits out there from Think Local, Act Personal; the Coalition for Collaborative Care, SCIE and others), or in terms of it being risky and time consuming. 

It is risky: it involves placing trust in groups you do not normally work with, and being willing to take the first step forward, knowing that the other side may just take a step back. It also takes time, but how much time do we waste rushing headlong in the wrong direction, coming up with plans that never work, because the most important people were not part of the planning conversation? That’s why in my book, I argue for a slow policy movement.

But I always think that when something is talked about so positively, but done so rarely, there must be something else going on. Here are some reasons we don’t co-produce which we don’t talk about.

1. Heroic leadership. The news pages of a number of trade magazines/ websites remain dominated by stories of who is moving in and out of the big jobs. We remain hooked on the idea that the right leader will make or break a service. We see this happening: an inspirational leader comes in to a troubled organisation and galvanises the team around a new vision with great results. But for every example of a leader achieving this, there are dozens of it not happening, as well as some of leaders being key factors in toxic cultures. The culture of looking to powerful individuals is part of the problem: it creates the conditions for disempowerment, hopelessness and at times, bullying. But most people with any power in public service organisations are somewhere on a career path predicated on the value of the brilliant individual leader. It can be easier to be a leader than an ally. Co-production is the opposite of heroic leadership: believing in it is difficult if you aspire to be the hero.
2. When co-production is real, the group of people involved in decision-making doesn’t just grow, it diversifies. This means that co-production is at odds with monocultures. The gender imbalances and “snowy white peaks” of those at the top of the NHS and other public service organisations has been well documented, but there is also a less-frequently talked about class divide: those running public services and charities come from predominantly middle-class backgrounds; whilst health inequalities and the impact of the social determinants of health mean that those making most use of those services and charities are significantly more likely to be working class. Co-production is part of the effort to diversify decision makers, and those efforts are resisted by any number of conscious and unconscious biases.
3. Co-production can only work where there are people with lived experience in a position to co-produce. That usually means not only having their own lived experience, but also having the support, training and networks that anyone else needs to be an effective decision maker. No-one can be ‘representative’ of a large and diverse group of people who use services, unless they have been chosen by a number of those people, and ideally are in regular communication with them. This can only be achieved by investing in training and development for individuals, and more broadly investing in user-led and grassroots organisations. Our public services are reluctant to do that at the best of the times and these are not the best of times. User-led organisations are falling by the wayside in alarming numbers: our social capital and our co-production capacity is reducing just when the argument is being won for the value of co-production. This needs to be reversed.

The common theme running through these three problems is power: its unequal distribution and the discomfort those with it feel talking about it, let alone sharing it. I’d be interested to hear other barriers to co-production which you are seeing but which aren’t talked about. Naming these barriers is only a first step to changing them, but it is a start.

This blog was originally on Alex's own blog page, Escaping the Invisible Asylum. 

Co-production - could it apply to other aspects of our lives?

By Eleanor Mould, SCIE project coordinator

As someone new in the social care sector, I had hardly heard of co-production until I started at SCIE and I was assigned to the co-production team as a project coordinator. When talking to SCIE's Pete Fleischmann and Kate Pieroudis about their work, which they are so clearly passionate about, it’s hard for that passion not to rub off on you.

I started to research co-production; reading articles, watching YouTube videos, and reading the SCIE and TLAP webpages and available literature. ‘The principle that those who use a service are best placed to design it’ doesn’t sound like a revolutionary concept, yet it is.

Attending the different co-production meetings at SCIE has opened my eyes to new ways of working together, power-sharing, and the development of services. The respect, passion, hunger for change, and lack of hierarchy present at these meetings is an inspirational change. These meetings are a place where everyone and every opinion can be heard. A place to be respected, relax, discuss serious topics with a renewed sense of energy, and constructively challenge topics. These meetings and all those who are involved are a breath of fresh air.

It made me think why the notion of ‘nothing about us without us’ doesn’t apply to more aspects of our lives. Coming from a politics and security studies background the idea of power-sharing is, as you can imagine, rarely discussed. Seldom do politicians or those involved in security want to relinquish the power they hold. If only politicians could see that by power sharing and co-producing more policy on different topics, they are not losing anything, rather that they could gain a wealth of knowledge and experience, ‘don’t shift power, share it’.

I believe co-production in the social care system and its progressive impact, can be a shining beacon for making co-production mainstream. We should use the example set by co-production to constructively challenge the status quo and make co-production a requirement by law.

What is power? Who has power? How do we share it?

By Roy Curtis  

“The use of the term ‘partnership’ does not mean that equality has been achieved.” Marian Barnes

Power in health and social care should reside with people who use services and other people with lived experience. But it doesn’t always. Services and support should be developed in accordance with the expressed needs and wishes of people with lived experience, but they’re not always.

Decision-making powers in some organisations are not always acquired through talent or knowledge that is useful to communities, but can be arbitrarily seized by individuals who are shameless enough to do so. It’s open to anyone to say what they want, represent what they want and project themselves however they want; they don’t have to be sincere, authentic and truthful. Shameless leaders take advantage of the good manners and fear of people who have been trained to think of themselves as deficient through a lifetime’s experience of having this message imposed on them.

I know that oppressed groups have access to accurate forms of knowledge about their oppression and the power relations that sustain it. I understand the idea and theoretical desirability of partnership working, but I don’t want to be a junior or token partner in initiatives and agendas that are grounded in and controlled by individuals and agencies who are distant from the issues that affect me.

I am interested in activity where people with lived experience play an instrumental role in:

·       Deciding what will be talked about

·       Guiding the discussion

·       Developing plans of action

·       Implementing plans and evaluating their effectiveness.

I reject rule by self-selecting elites who put the pursuit of their own interests above the needs of their neighbours and fellow citizens. I reject the fantasy of the ‘strong leader’ model promoted by these elites and their allies. I favour participatory democracy and collective working. I trust communities to define the issues that concern them and to find solutions to their problems through knowledge sharing and purposeful action.