Sharing power – Making it Real in Norfolk

by Hayley Burwood, Jo Clapham, Julie Brociek-Coulton, Penny Holden, Tom Fadden and Mary Fisher


Co-production cannot work without sharing power and decision-making. This invariably means that one group has to give up some power in order for others to gain influence. In Norfolk a three-way partnership has been set up so that Adult Social Care commissioners and County Councillors share decision-making more equally with people with lived experience of using Adult Social Care
Services. Our blog shows how we share power by making sure everyone can participate, co-chairing, co-opting councillors and actively championing co-production.

Hayley Burwood, Co-chair

Making it Real Norfolk

People with lived experiences can be left voiceless because documents or the way someone presents information is inaccessible. At Making it Real we try hard to be inclusive so, not only do we provide accessible information, we provide it in an inclusive way. For example, giving ourselves enough time to digest the information. Hayley co-chairs Making it Real Norfolk and has developed a guide for visitors to the Making it Real Board so they can prepare their presentations in plain English and easy read format. Hayley says, “Sharing power is about the team all working together. Putting all those views together is an amazing thing because everyone is involved.”

Jo Clapham, Co-chair

Making it Real Norfolk and

Adult Social Care

commissioner

Jo says, “As a Commissioner of Adult Services, I look at data such as how many people have used a service, how long for and what happened to them afterwards. But will this never tell me what it feels like to use a service, what really makes the difference and what can be improved. Meaningful decisions about services cannot be made unless we work together with the people those services are there to support.”


“Hayley is the elected co-Chair of the Making it Real Board and I usually co-chair the Board meetings with Hayley on behalf of Adult Social Services. The fact that we chair the meetings together is a good example of power-sharing. In fact, as Hayley is the elected Co-chair and I am not, I will always follow Hayley’s lead, and be there to support her and guide discussions when needed with my experience of the county council and adult social services. Hayley and I work
really well together as we bring our different backgrounds and experiences together to make sure that all Board members get to have their say.”

Councillor Julie

Brociek-Coulton

Councillors have been co-opted onto our board. Julie is Norfolk County Council Carers Champion. Julie says, “When I was asked if I wanted to be co-opted onto Making it Real I was really excited because I had heard of the good work the group does. Working with Making it Real has helped me to push through the council rights for disabled people and co-production. A good example of co-production was when we were putting a group together for the Carers Day on 14th June. I made sure that as Carers Champion for Norfolk we had 3 carers to give advice on what they thought would make the day a success. Thanks to them it was.”

Penny Holden,

Champion of Co-production

Penny is a Champion of Co-production. Such has been Penny’s activities, it was hard to know which things to omit from this blog. Penny is a strong advocate of peer support and better mental health services and she is
promoting co-production training. Penny says, “I have a lifetime’s experience of mental health services and I am also physically disabled. I took forward my ideas on peer support to adult social care and, as a result, a peer support project is underway.”


“We need to show people how to co-produce. Norfolk’s mental health services have been in special measures three times. My lived experience means I can help them to share power through co-production to find a better way forward.”

Tom Fadden, Chair of Equal Lives

Tom is Chair of Equal Lives, a disabled peoples’ user-led
organisation supporting disabled people in Norfolk and beyond. 

“As a new member of Making It Real I am really pleased to see the constructive dialogue between all members from many different backgrounds working
towards improving Adult Social Care Services for disabled people in Norfolk. I was particularly pleased the group were able to have discussions and share their experiences with the Director of Adult Social Care in Norfolk to give reality to what is happening on a day to day basis for people who use Adult Social Care Services. Co-production goes hand in hand with independent living and ensures that there is nothing about us without us!’”

Mary Fisher, Making it Real
Norfolk Coordinator

Mary Co-ordinates Making it Real Norfolk. Mary says, “Jo and her colleagues in adult social care helped us to meet with councillors and not one but three councillors asked to be co-opted onto the board. We have never looked back. We are sharing power more equally so everyone has a voice. It is no longer a “them and us” approach but is meaningful co-production.”

Making care better by working together

By Imelda Redmond, National Director, Healthwatch England

I was delighted to see that ‘Sharing Power’ was the theme for this year’s co-production week. It’s a topic close to Healthwatch’s heart, and at the very core of what we do – empowering people to speak up and encouraging professionals to listen, in order to make care better together.

The Social Care Institute for Excellence (SCIE) has been at the forefront of this movement for some time now, breaking down barriers, and supporting thousands of frontline staff and services to better understand the value of working in partnership with the public. 

At Healthwatch, what we always see is that services work much better when people are listened to and invited to give their opinion on what’s working well and what isn’t. We’ve heard some great examples of how, when we as health and social care experts take a step back to gain a fresh look and respond to what people want, it can lead to inspiring changes.

For example, Tony from Durham spoke up because he struggled to find a care home for his mum as there wasn’t enough information available online. His council took the time to listen, and now ensure that every care home in the county publish consistent information about their service on a single website, making it easier for families to find support.

But for every story like Tony’s, we unfortunately do hear others where experiences are not positive. This week, we published a report highlighting people’s experiences of dementia care, and the devastating effect on families when they ask for support but feel ignored.

So I must ask, why aren’t we consistently making time for these important conversations? Whilst resources in health and social care are undoubtedly overstretched, and time is limited, I fully believe that if professionals and the public continue to work together we can improve care even further.

How can we govern cities differently? The promise and practices of co-production

By Beth Perry, Catherine Durose, Liz Richardson and The Action Research Collective

National Co-Production Week sees the launch of research findings on the promise and practices of co-production in governing cities differently.  The Jam and Justice research project looked at what is needed to connect decision-makers, civil society and citizens (‘the jam’), involving those usually excluded from such processes to address urban issues (‘justice’).

The research was co-designed between three Universities (Sheffield, Manchester and Birmingham), a VCSE membership organisation (GMCVO), and an Action Research Collective (ARC), made up of people recruited from diverse walks of life.

The ARC developed ten small-scale action research projects.  Each project looked at a distinct urban issue: for example, how energy is produced for cities, how public money could be spent to produce more social value, how people could be better supported to live a good life in their own homes, and what new roles local politicians could play to work even more productively with communities. We also explored routes to participation for women, people who feel disconnected from formal politics, and younger people. 

Our report  out today, How can we govern cities differently? Thepromise and practices of co-production identifies seven practices of co-production.  These include: designing for openness, shaping the dynamics of participation, blending expertise, humanising experiences, linking voice and values, connecting with formal policy and decision-making and holding the process.

The report cautions that there is no simple ‘fix’ or method for co-production.  But it has potential to contribute to transformative changes, such as shifting imaginations about the possible.

‘Jam’ needs ‘justice’, we conclude, ‘if co-production is to address the big urban challenges of our time.

To realise the promise of co-production, without replicating its pitfalls, requires widespread cultural change, different kinds of leadership and institutional reform.

Download the report here, and find out more about our work by visiting our website: jamandjustice-org.uk. You can also contact us by emailing b.perry@sheffield.ac.uk.

If you’re reading from Greater Manchester, get in touch to find out how you can join the community of practice around co-production in the city-region to #CoProduceGM.

Power to the people!

By Steve Palmer, Communications Manager at the Social Care Institute for Excellence

A popular TV sitcom in the 1970s starred Robert Lindsay, playing Wolfie Smith, the self-proclaimed leader of the revolutionary Tooting Popular Front, the goals of which were to gain ‘Power to the People’. The show, called Citizen Smith, didn’t rock the establishment, because the chances of popular revolution in Tooting were fairly unlikely. In fact, people often like democracy because you don’t have to be the people with power. You can get on with your life, bringing up families, dealing with challenges and being aspirational, just because you delegate responsibility for bin-collection, having a decent local hospital and accessing social care, to others.

But could it be that we could look at the idea of power in a different light, forty years after Wolfie Smith was advocating it in South London? Co-production is a word that’s getting very popular in social care circles. It means seeing people who use services, and carers, being centrally involved with the design, delivery and evaluation of care services.

Power surge

But it’s also about power. As we approach Co-production Week, organised by the Social Care Institute for Excellence (SCIE), the theme for 2019 is “Power”. This might sound a bit pie-in-the-sky, but during the week we’ll be exploring how power can be shared more equally between professionals and people who use services - and carers. This is important stuff.

A board member at SCIE, Alex Fox, recently put it like this: Co-production is risky. You have to place trust in groups that you normally don’t work with. And it can take time. But he points out that much time is wasted because the most important people – people who use services and carers – were not part of the planning conversation.

Oxfordshire and Birmingham

Again and again we think, and the evidence suggests, that where you have this sort of input from experts-by-experience, then people’s experiences and outcomes can improve. SCIE has been working in Oxfordshire to embed co-production into their adult social care services. A group of Co-production Champions is made up of people who use services, carers, Council staff, professionals from health and social care, and voluntary sector organisations who are learning and working together to make change happen.

Birmingham City Council’s People Directorate is one of Think Local Act Personal’s Making it Real sites. It has developed a range of structures to support co-production work with citizens. These include: Two citizen-led quality boards that co-produce minimum standards for services; making sure that people who use services are involved as early as possible in specific projects and at all stages of service development; and allocating resources and staff time to supporting co-production.

I wonder what Wolfie Smith would make of this new demand to share power? There’s no storming of the barricades, but there is a hope that we are dismantling barriers to getting things done in the way that people who use services – and carers – know is more likely to work. And I think Wolfie would quietly agree that Co-production Week in July is a great place to embrace this.

From engagement to co-production – How we do things in Leicestershire

By Claire Cluer, Co-Production Officer for Adult Social Care within Leicestershire County Council.

I started in this role 3 ½ years ago and only now with the Engagement Advisory Panel do I feel like my role has come alive!

Whilst true co-production can and should be strived to achieve, and we do have some great pockets of success, we recognised the need to focus and improve on all the layers that build co-production as the concept that it is. 

What did we learn?
I started off with a small co-production planning group that co-developed some staff guidance around basic engagement. At its very first meeting I remember a carer saying to me, “this is all well and good but if people above you are not committed, what’s the point”. This comment stuck with me.

Lessons learnt over the first 3 years include:
• Senior governance is crucial for any advisory / working group 
• Building working relationships takes time
• Sharing power can feel like it is unwanted. As well as offer it, we need to support and nurture this skill and confidence in people

What are we doing now?  
We have launched our new Engagement Advisory Panel. The work is governed by our Departmental Management Team. The panels will have 9 members representing different areas of social care. Its purpose is to support the increase both quality and quantity of engagement related work when producing strategies and designing/reviewing services.

The panel will review engagement plans and provide constructive criticism, suggestions and support. Members will receive training to support them in this role and will be shaping the content of this.
They will also co-produce a one-page yearly plan. It will have clear actions to improve how the council works with people who use our services and their carers. 

This process will make the council more accountable in how we engage and work in partnerships with the people who use our services.

Staff Briefings

We are also holding two staff briefing sessions during co-production week. These are to inform staff about the panel and how they can work with them, as well as raising the profile of co-production and other good working practices.

You can keep updated about the development of the panel 

“Laura, I’ve got some good news.”

By Laura Wood, lived experience practitioner

I was perched on the stairs with the phone to my ear, and Suki Westmore at Mind was calling to tell me that I’d been selected as one of the lived experience facilitators on a project to develop quality assurance principles for maternal mental health peer support.

Once we had hung up and my victory dance was complete, I began to consider the practicalities – and, I suppose, to form my expectations. I had undertaken a fair amount of mental health involvement work already in various contexts and I thought I knew the drill. I was used to feeling, as a “service user” rather than someone from a third sector background or a clinician, that I was seen as a bit second-rate, less skilled, and only really useful for rehearsing my own story. 

Once someone genuinely patted me on the head. Decades of poor mental health meant that I hadn’t achieved the big dreams I’d always had and this, coupled with the fact that as a lived experience practitioner I was effectively patronised for a living, meant that I felt permanently frustrated and that my confidence was pretty low.

I anticipated that I would be helping to plan and deliver some consultation events and focus groups, which I did – but I was also treated as an equal partner in designing and delivering the project as a whole. This was totally unexpected and an absolute game-changer. It wasn’t true co-production, as the structure and timeline of the work was established before I came on board and we weren’t able to conduct the interviews or write the principles themselves, but staff intentionally gave us as much agency as they possibly could at every opportunity. This meant that we were invited to the table whenever there was a decision to be made. 

We met with the funders. We networked and promoted what we were doing. We designed and delivered every detail of those events and focus groups. We gave feedback on everything we couldn’t actually do ourselves within the parameters of the project, and changes were made accordingly. Budgets were managed so that we were paid fairly for our time, which made me feel valued and valuable, and enabled us to do the work justice.

The co-design process offered the perfect combination of autonomy and support. It showed me that I can make things happen, take the lead, that my expertise can be recognised and valued by others. I felt a powerful sense of ownership over the project, and I was encouraged further by enthusiasm amongst the wider maternal mental health community. 

Everyone who participated was so passionate and invested in good peer support for mums; many went above and beyond, emailing me resources to inform the work and checking in regularly to ask how it was going. It was a privilege – and very validating - to be their point of contact, to be associated with a piece of work which they recognised as so important and so needed. True co-production is rare, but I hope this example has demonstrated some of the benefits when we aspire toward and actively pursue that ideal.

Designing work rather than making suggestions

By Angela Slater, Senior Lived Experience Leadership Officer at Mind

As part of SCIE’s Co-production week on 1-5th July 2019 we are holding a staff event on 3rd July at our head offices in Stratford to highlight the many positives and benefits of co-producing work and sharing power. It is a big part of our values and goals at Mind to involve people who experience mental health problems in all of our work and something that we aim to continuously develop. 

Co-production is an increasingly common concept in the influence & participation work that we do at Mind, as well as for organisations that we work with. For us the difference between co-production and other methods of influence and participation that we use is that in co-production people with lived experience play an equal role in both designing and delivering work, rather than making suggestions that professionals are responsible for deciding upon and implementing. Here at Mind we would like to see this happening where ever possible in our work.

With this in mind we will be co-producing our co-production event aimed at the increasing number of staff at Mind head offices to attend. Seven people with lived experience are joining myself and three Mind Influence & Participation Coaches to design and deliver the event. As we work together we we are starting to see what we want the key outcomes to be, what the event will look like and how it will be delivered- so watch this space….

To help with our work around involving people Mind has created an Influence & Participation Toolkit which is a comprehensive resource designed to develop understanding and support the meaningful involvement of people with lived experience of a mental health problems in the development of organisations and their services. It is available publicly for anyone to use and can be found here. 
 .
 We are always looking for examples of good practise from different organisations including examples around co-production so if you have a piece of work that would make a good case study then please do get in touch with us at LivedExp@mind.org.uk 

Current case studies about co-production can be seen here.