Get active with co-production

By Leanne Wightman, coordinator of Get Yourself Active

How do you solve the problem of getting people to lead healthier lifestyles? Whilst the policy wonks scratch their heads, many of us continue to indulge in frowned-upon eating habits and stay resolutely on our sofas, instead of heading out for a brisk walk or a cycle ride after eating our five a day portions of fruit and veg.

Experts can help – from dieticians to fitness coaches, there are people who will assist us, when we are ready.

For some of us, of course, getting physically active may be more problematic and that’s certainly true for disabled people. A combination of inaccessible facilities, poor transport links and financial difficulties throw up what can seem like insurmountable barriers.

Co-production

Can the principles of co-production help with these sorts of problems? Of course they can, because disabled people know what the problems are and can help identify how to sort them out.

That’s what we found when we started working with disabled people’s user led organisations to help broker access to physical activities and sport for local disabled people, which included funding posts for local coordinators.

Having lived experience of disability meant they were able to bring new knowledge and resources to local sports providers, helping guide them on the best way to provide services to disabled customers.

They also helped providers build relationships with disabled people’s organisations, deepening understanding of the needs of local disabled people and encouraging providers to think about a long term approach.

Less need for support

We know co-production is not a quick fix, in the leisure sector or anywhere else. But we also know that disabled people are much less likely to get involved in physical activity than non-disabled people, and miss out on the benefits that brings. There’s improved fitness of course, and improved wellbeing and less social isolation. Our research also suggests there may be a positive impact in terms of people needing less support in the shape of social care or GP services.

Whilst the policy wonks continue to scratch their heads, maybe they should be looking at co-production as a tool to make things happen?

Get Yourself Active is a project run by Disability Rights UK with support from the National Lottery and Sport England. An evaluation of the project has been launched. Copies are available here.

The advantages of sharing power - from a football referee

By James Anthony, Communications Coordinator, Social Care Institute for Excellence 

At age 16, I had my first taste of having ‘power’. I had qualified to be a football referee, putting myself at the centre of the game I loved. 

When I first stepped onto the pitch, I assumed that being strict on the rules and never letting my authority be questioned was the right approach. Put simply, I didn’t want to share any of my power.

When games got tough, and the players turned against me, I guessed the poor attitudes were because they didn’t like what I was telling them.

Over time, I learned instead that paying attention to how the players wanted to play the game made them much happier. Rather than dictating to them, I began to ask players if they were happy with the pitch conditions and check with goalkeepers that they were ready before kick-off. I started asking whether a fouled team wanted to have a quick free kick or wanted to stop for longer, and restart again later with the whistle. 

There’s also a fantastic rule in football known as the ‘advantage’ rule, which allows a team to keep playing if they’ve been fouled but feel it hasn’t affected them. I’d often shout “play on – advantage!” following a foul and let the players continue going forward, or call it back for the free kick if they weren’t happy. These ‘advantages’ are a great way of giving some decision-making power to the players, working together, and keeping them content.

When you experience sharing some of your power, and realise it makes the experience better for all involved, you begin to wonder ‘why can’t we deal with other situations like this?’

As I moved to working in the social care sector – I realised this approach could be applied there, too. Co-production, working in equal partnership with people who use services and carers in the development of their services, is based on that idea of sharing decision-making power. 

There ought to be more opportunities of empowerment in social care just as the ‘advantage’ rule in football helps keep things fair. Perhaps the sector could learn something from the footballing world and realise – like I had to – that sharing a little power can go a long way to improving things for everyone.

SCIE's Co-production Week 2019 

Co-producing Research: How do we share power?

By Dr Gary Hickey, Senior Public Involvement Manager, INVOLVE (INVOLVE supports service user and carer involvement research) 

Gary Hickey 

Co-production, as an approach to research, is gaining traction.  At INVOLVE, in an effort to move toward clarity on what co-production means to research, we led on the development of some guidance (See here - pdf file) identifying some key principles and features involved in co-producing research.  The key principle is the ‘sharing of power’.  

The idea is that ‘the research is jointly owned and people work together to achieve a joint understanding.’  Easily said - but how do we achieve this in practice?  Research teams are often, and with all best intentions, hierarchical; with a chief investigator leading a team made up of researchers of various grades.  And how do we ensure that public members truly have a voice in decision making?  How do we also ensure that the knowledge of public members is respected and valued?

We will explore these issues in our second #How2CoPro event, Co-producing Research:  How do we share power? on 12th March. Last year the same event was such a success that we are back again with a bigger event and looking forward to learning together once more!  

Our key aim for the event is that we all share experiences, and provide practical examples, of how power can be shared in a co-produced project. We will also update you on various co-production initiatives and opportunities that we know of.  

At the event we have a range of quality speakers including Simon Denegri (National Director for Patients, Carers and the Public, National Institute for Health Research), who will update on co-production in the National Institute for Health Research; as well as a range of speakers (public members and researchers) who will share their experiences of, and techniques for, sharing power.  The event will end with a panel discussion on sharing power and will include SCIE’s Head of Co-production, Pete Fleischmann.

This event is sponsored by: Centre for Public Engagement, Kingston University and St George’s, University of London; INVOLVE; University College London Centre for Co-production in Health Research.

You can register for the event and see the agenda here. Twitter Hash Tag: #howtocopro   

Making it Real – something wonderful this way comes?

By Caroline Speirs - discussing power, which is the theme of Co-production Week 2019. Caroline is Head of Think Local Act Personal (TLAP). A longer version of this blog is on the TLAP website

‘Don’t shift power. Share it’. This sums up the thoughts of Halima Khan, from the innovation foundation Nesta. Halima believes that sharing power can open up new solutions. That’s TLAP’s intention with Making it Real. It’s our new approach to what good citizen-focused care and support should look like. It’s a framework that creates space for a different model of power – a shared power.

By virtue of a great partnership, TLAP holds a privileged position that provides us with a multi-dimensional perspective. We get to speak to national leaders and decision makers. We meet regularly with practitioners and we work up close and personal with people with lived experience via our work with the National Co-production Advisory Group. Viewed through that lens, we get to see up close the gap between the rhetoric of what ought to be supportive policy and legislation and the reality of what’s happening on the ground.

The view isn’t always a good one. We see an exhausted colleague who accesses care and support questioning what he needs to do to live his life. We see a parent who worries about a system that cannot see what her grown up daughter has to offer society, only how much she costs.

What does any of this have to do with power?

Quite a bit I think. Clearly the impact of unprecedented cuts has some role in creating a harsh gate keeping system but it would be wrong to apportion all blame at the door of austerity. We have, after all, lived through financially healthier times but processes were no less harsh and stifling when we had a bit more money in the back pocket.

The beauty and the power of Making it Real is that, applied properly, it gently encourages a shift in relations. It generates a change in focus and supports a new outlook, one that is far more about relationships than transactions. An approach focused on a conversation, on what matters, on a life not a service.

Making it Real in Manchester

I began to see what a turbo charged version of this could look like in Manchester TLAP ran a session on Making it Real at the annual conference for Directors of Adult and Children’s Social Services. Something interesting happened Some barriers were dismantled and a few roadblocks removed. Not only did the world continue to spin on its axis but it did so with gusto. The challenge now is to harness that energy and that optimism to go further and deeper and create the transformational system change we’ve spoken about for so long. I am hopeful that with the arrival of the long-awaited social care green paper, we will see a clear commitment to working in this way.

Think Local Act Personal will do everything it can to support that.

Searching for the Aha! moment. Co-production in care

By Sophie Chester-Glyn, Managing Director, Manor Community

When I mention the phase ‘co-production in care’, I often get a confused look or blank stare back. It doesn’t quite roll off the tongue and takes some explaining before you get that ‘Aha!’ moment. Over the past two years we have strived to get that ‘Aha!’ moment throughout our organisation. Coming up to co-production week, we’ve reflected on how we’ve embedding it into our care.

Our journey started in early 2016 when I was asked by a manager what colour I wanted to have one of our care homes painted. My response was ‘I don’t know, I don’t live there’. Even though we knew about co-production we obviously weren’t yet living and breathing it. So, we began to change the culture of developing services from a bottom up rather than top down approach.

Using technology has been crucial. We collaborated with a software development company which helped us adapt an internet Cloud based product into an accessible staff and client intranet site. We are now integrating real-time feedback systems such as Survey Monkey into our intranet site. This enables clients to connect efficiently with senior management. They can now individually and quickly vote on everything from their care experience to activities, staff practice and service design. This also enables clients, families and staff to have a direct input into strategic decisions-making. Feedback on this new system has been fantastic. Both staff and clients enjoy using the system and it has proved to be a great way for co-production to be fun and interactive.

Getting feedback from people is crucial, but co-production is more than that. In fact, we have found some people misunderstanding co-production as simply engagement. Some local authorities might let people know about their plans after the decisions have been made or without providing accessible means whereby people can have an input. TLAPs ‘co-production’ ladder has been helpful in explaining the ‘co-designing’ aspect of co-production. Involving people in writing policies has helped us. 

We support people with mental health, learning disabilities and autism. Within this client group we have an enormous amount of talent. Over the past few weeks we have been hiring people who we support to help edit and design our operational policies, this has been especially exciting for those who have a particular skill in accuracy and attention to detail. We have also consulted with the people we support on our easier read documents on voting, staying safe in the heat and internet security.

When deciding how to implement our social values policy, one of the people we support found out about a local charity that helps feed the homeless. He expressed an interest in supporting the charity. Now one of our care homes and its residents help prepare and service meals to homeless people in Bristol. This gives everyone a feeling of achievement and self-worth and contributes to our community involvement.

Co-production has brought great benefits to our culture and quality of care. Events like Co-production week help to share good practice and spread the word. So hopefully more people can understand what co-production is, how to do it and to get that ‘Aha!’ moment.

Promoting co-production in the care sector

By Penny Holden, with Martin Symons, Members of the Making it Real Norfolk Board - and Mary Fisher (Making it Real Norfolk)

With special thanks to Christine Futter and Sarah Steele from Norfolk and Suffolk Care Support, for their contribution.

The recent CQC Report “Better Care in My Hands” found that people with long-term health and care needs are least likely to report feeling involved in their care and in making choices about their daily life. Making it Real Norfolk believes the best way to improve services is to ask the people who use those services what they need and how best to provide it. If co-production is taken seriously then, as Martin Symons says, “Co-production works for everyone, people feel they have choice and are in control ”.

Martin Symons and his Boma

We want to use our skills and lived experience to improve service user involvement and promote co-production in the adult care sector. We began this work at the Norfolk Care Conference in Nov 2017. Two of our members, Penny and Martin, developed an idea and have taken the lead role in promoting it. Penny says, “we are the people who currently use services, we are people who will using the services in the future and we are the people who will use services that are currently not available. We have lived experience of our own conditions, we are the experts who can help care providers to get it right. Co-production ticks all the boxes and it is the future.”

A bit about us – We are a group of people with lived experience of disability and unpaid carers. We have links to community groups, user led organisations and strategic partnerships. We work in partnership with Norfolk Adult Social Care and Norfolk County Martin Symons and his Boma Penny and Martin talking to care providers Making it Real Norfolk board meeting Council – councillors are also co-opted onto our board - so that service design reflects the voice of service users and carers.

We have teamed up with Norfolk and Suffolk Care Support (N&SCS). N&SCS support the health and social care market to deliver health and social care excellence; they do this by supporting the care market to develop skills, knowledge and values of the paid and unpaid workforce. We have worked with Norfolk & Suffolk Care Support in the past and they have a proven track record in their commitment to seeing co-production in practice. We will soon be starting work with N&SCS to coproduce a set of resources for care providers to use. The resources will highlight good practice and provide a guide to improving service user involvement for those groups identified in the CQC report who report feeling less involved in their care than other groups. 

The project also includes an event to showcase the resources to care providers. We will co-host the event with N&SCS. This will give us a chance to network with care providers and talk about ongoing involvement. Mary says, “When people are involved in shaping their care, people feel that they are part of the solution and not the problem”. Work begins on our project with care providers on 11 July 2018 and we are really excited. Wish us luck! 

Christine 

Mary 

Penny

Sarah 

On the board in Oxfordshire

By Ben McCay,  Team-Up Board member and member of My Life My Choice, Oxfordshire

My Life My Choice asked me if I wanted to visit a co-production board meeting in Oxfordshire, which was on the 3rd April 2018 and I said I would like to attend.

At the meeting it was explained to me by the board members that they wanted people with experience of using services within Oxfordshire to come and visit to see if they would like to become a permanent member of the co-production board.  Danie who is the co-production lead at Oxfordshire County Council explained to me and the other people visiting about the co-production aims and plans. I was thanked for visiting.

My Life My Choice asked me if I would like to become a permanent member of the co-production board and explained if I did Danie and some of the other board members would interview me about why I wanted to become a board member and what my motivation for joining was and what did I think I could contribute to the table. 

I thought I could use my experiences of using services to help lead the way in designing good quality co-produced services. I had an interview.

I then attended my second meeting as a full board member. At the meeting we had to review the Oxfordshire co-production champions training. The board did one day of the training and were asked to give our feedback.

I gave positive and constructive criticism to help shape the training for the champions. I really enjoyed working in small groups at the training discussing how to put literature into plain English. We then wrote down our plain English and fed back to the other groups.

After the training I felt I had a better understanding of what co-production is.

I attended the co-production festival in Camden which is part of co-production week and enjoyed being part of group discussions and feeding my ideas back to the other people. I learnt more about SCIE and enjoyed the music and seeing The Lost Voice Guy perform.

I am looking forward to being on the co-production interview panel to help employ a new member of the co-production team. 

I am very pleased to be part of the work the co-production board are doing in working towards promoting co-production and shaping services to improve them in the future.