A carer’s view. Co-production in action in Oxfordshire County Council

By Kathy Liddell. Family Carer to a 21 year old daughter with a Learning Disability and Autism

SCIE has been working with Oxfordshire County Council (OCC) to support them to understand and develop co-production.

As a family carer of a daughter with a learning disability and autism, I found moving into adult social care from children’s services a daunting and worrying time.  It is a complex system with so many changes and without the right support and information as a family carer you can be left feeling confused and unsupported not knowing where or who to turn to or what to do next. 

When the opportunity to be part of the Moving Into Adulthood Service came up I was keen to be involved.  By using my own experience and that of other families I know,  I hope to help change the way things are done in the future; to make it easier for families to know what moving in to adult hood actually means for their family member; who they can turn to  for the right help and support; where to get the right information and to ensure that family carers are involved every step of the way – all whilst ensuring that the person using the service is at the centre of any decision. 

The opportunity to sit round the table with the people who organise, deliver and use the services, means that family carers like myself and the people we care for have a real say in the way that services are shaped and delivered. We are able to share our own personal experiences of what does and does not work. 

What has been clear is that everyone sitting round the table wants to see a change for the better. I think working together at this level has provided a unique opportunity to make a real difference to everyone involved. 

The fact that the lead for working together is coming from the Head of Adult Social Care means that the need for change is been taken seriously. As a result I hope that those families who will soon be embarking on the Moving into Adulthood Journey will, as a result of this change in approach, have a smooth and positive experience.

Co-production leads to innovation in social care

By Kate Terroni, Director of Adult Social Care at Oxfordshire County Council

SCIE has been working with Oxfordshire County Council (OCC) to support them to understand and develop co-production.

Co-production is all about the sharing of power. The belief that if you ask people what they want, you will get a constructive answer; that professionals are not the font of all knowledge and that innovation can sit with people who access services and their families. Ultimately, we want people who use services to challenge professionals and tell them what is most important to them when designing those services.


As part of our work on co-production we set up Oxfordshire’s Co-production Board, which the group has named ‘Team-Up’. We asked them to define their vision of co-production and they said:

Co-production means people are involved in designing, delivering, reviewing and choosing a service, when that service affects the community.

The reason co-production is important is because when people who use services, their families and carers are involved in designing services it makes the services much better for people and more sustainable.

I recognise that using co-production is difficult and presents a significant challenge to the way we work. From the council’s perspective it means we have to be willing to relinquish ‘control’; to be prepared for the process to take longer in order for people’s input to be meaningful and to have confidence that they can design services within budget.

Many people are used to managing a budget and understand the realities of having a finite amount of money. Being open and honest about the amount of money available also means that people understand the challenges the council faces in balancing its budget. 

We’ve received positive feedback from the people who’ve been involved in some of our initial co-production projects; with a good example being the work to redesign the way people transition from children’s to adult’s services.

Our overall experience has been that by involving people as partners in the design of services, they often think of solutions that we as professionals haven’t considered. Involving people in the design of services usually means that we’re likely to get it right first time.

Kate Tweets @kateterroni
Co-production in Oxfordshire on Twitter @oxoncopro

Overcoming the barriers to co-production

By Deborah Ivanova – Deputy Chief Inspector Adult Social Care (London and South) Care Quality Commission

At the Care Quality Commission I have the pleasure of taking part in our bimonthly adult social care co-production events which are invaluable both to the organisation and to me personally.  The success of co-production lies in the impact it makes: at CQC we do things differently as a direct result of our sessions, but it’s not always easy.  We work to overcome the barriers to co-production by creating accessible, interesting, well attended and useful events. 

Making co-production events worthwhile is all about including a wide variety of people, which we do by inviting a mix of providers, experts by experience, public representatives, voluntary groups and more. The diversity is part of what makes them so special and we are always inviting new faces to make sure we have a mix of people who have unique ideas and points of view. 

When we have the right people around the table it’s important to make sure the discussions are focused. We look at topics which people are really passionate about and we have facilitators to draw everyone together to make sure we have a focused discussion.  I often take on the role of facilitator, which can be challenging when not everyone has the same opinion! As each table discussion draws to a close we present the key points visually and verbally, making sure we have agreement on what is important to take forward.

Making co-production events accessible to everyone is important and we try to structure the day to make sure everyone can get involved. If anyone has special requirements, such as where they sit or needing information in different formats we make sure this happens. We want everyone to feel they can contribute their views and have open conversations.

To make co-production real we need to recognise what the barriers are and create events which people want to attend and where they are listened to. I look forward to discussing this more on the panel at the upcoming SCIE co-production festival, and hope to see you there.

Calling on evidence co-producers

By Pippa Coutts, Policy and development manager, Carnegie UK Trust

I am becoming a veteran of alliances, such as the Alliance for Action and the Alliance for Useful Evidence, as well as working in various third, statutory and academic collaborations. Not surprisingly, I believe in the value of working together to try to overcome complex problems: and perhaps co-production is the holy grail of collaborative activity, when power and roles are truly shared. However, preparing for a talk today on the co-production of evidence, I was struck again by the huge potential but degree of change that’s needed for co-production to happen.

An appetite for co-produced evidence

Carnegie UK Trust has a long standing interest in the use of evidence in the pursuit of improved societal wellbeing. It also believes that giving people more control enables wellbeing. These objectives have led us to think about the possibility of co-produced evidence. The appetite for this was demonstrated in a recent survey where over two thirds of respondents reported they participate in the co-production of evidence. This also hints at one of the issues that might be hindering co-production: lack of conceptual clarity. What do people mean when they say they participated in the co-production of evidence? If we were to measure that activity against the principles of co-production how far would it measure up?

We want to hear your ideas

One of the reasons that I ask this is because, looking around it is difficult to find many instances of co-produced evidence. In the discussion paper, the Scottish Approach to Evidence, we concluded that the Scottish policy context with a focus on partnership and people is ripe for the co-production of evidence, but the evidence base lags behind. This includes both examples of co-produced evidence and evidence for the impact of co-production on outcomes. Two different concepts, but ones that have sometimes been conflated, to the possible detriment of co-produced research. Last year, to encourage more co-produced evidence, at a Roundtable with Newcastle University’s Institute for Social Renewal, we called for more clarity on what is good quality co-produced evidence. Following this, The Trust is continuing to explore how to assess the rigor and value of co-produced evidence, and I’d be delighted to hear your ideas.

Co-producing the development of Later Life Groups in prison

Contributors: 

Ahmed, prisoner 

Jolie Goodman, Programmes Manager for Empowerment & Later Life, Mental Health Foundation.

Jamie Bennet Governor HMP Grendon and Spring Hill

Jolie: The Mental Health Foundation has a decade of expertise in peer support and self-management initiatives, including running self-management groups at Parc Prison Wales.  I have managed the Standing Together project, facilitating peer groups in the later life housing sector. 

I’m co-producing the development of later life groups with staff and prisoners at Grendon and Spring Hill Prisons. I want to use the blog to reflect on the process and through conversations with a prisoner, Ahmed and Jamie Bennett the Governor of both prisons. Grendon is a closed therapeutic prison and Spring Hill, is an open prison. 

Prisons are major providers of social care for men in the country. The later life groups will be a combination of self-management and peer approaches., using the expertise of prison staff and prisoners to co-produce this work, through meetings, focus groups and a loneliness survey. 

Ahmed: During my experience in my role as Diversity and Equalities orderly I have spoken to many prisoners over the age of 50 about the stresses of being in prison and the impact this would have later in their life when they are released back into the community.

Bringing people together and enabling them to know that they are not alone is a form of empowerment and connection that I have experienced through group-work in prison. The recent focus group that took place in HMP Springhill showed the need of such an initiative. Residents are eager to be involved and are looking forward to the next step in the introduction of the loneliness survey.

Jamie: Prisons are having to respond to the needs of a changing population, including the rapid growth in the number of older prisoners. As a result, prisons are considering how they adapt. For example, how does the physical environment have to alter? What activities should be provided? What help do people need for life after prison? Which organisations does the prison need to connect with?

Although working with professional experts is part of the answer to these questions, much of this can come from the men themselves. They have hopes and aspirations for the future. They have time and energy to invest. They have skills and talents to contribute. 

Developing the capacity for self-help and empowerment is a way of improving the quality of service we provide and enabling the men to use their individual and collective abilities to support each other. 

Jolie: The findings  of the co-produced loneliness surveys will support and shape the funding bids for the later life groups.

This is what co-production looks like

By Sharon Allen, Chief Executive, Skills for Care

As I was sitting at our national conference earlier this year, listening to Disability Rights UK Ambassador Sir Bert Massie, Tina Coldham, Chair of SCIE Co-production Committee and TLAP chair Clenton Farquharson, being very clear about what people who need care and support need to think about when recruiting staff, I thought; "this is what co-production looks like".

Their lively and utterly frank discussion was one of the highlights of our conference and in this Co-production Week, a reminder of why we must include the lived experiences of fellow citizens in everything we do.

It’s something I’ve been committed to throughout my career because it is obvious to me that if we don’t include the voices and experiences of people who actually use care and support services, we end up doing things that neither work nor are person centred.

One the key drivers in our sector is leadership and leaders like me have to model in our organisations, that co-production is not an optional extra.  I'm fortunate that colleagues in Skills for Care get this and we work together to make it happen.

A great example of co-production is our information hub for individual employers which came out of a sector roundtable event. A smart idea, driven from day one by individual employers who provided invaluable insight and experience when the specification for this hub was being developed. They continued to guide and advise the project all the way through and in 2016/17 there were more than 40,000 page views on the hub.

Our Employing Personal Assistants toolkit was another project co-produced with employers. We worked with members of People Hub (the Personal Health Budgets Network) to ensure this resource was equally relevant to holders of Personal Health Budgets. The toolkit has proved popular because it is fit for purpose with 6066 people accessing the toolkit and 16000 page views.

Underpinning this was the creation and implementation of a participation policy so people offering their expertise are appropriately supported and reimbursed as no one should be out of pocket when they support co-production.

Our recently published autism guides were co-produced with people with lived experience so they were able to shape guides that could actually have an impact. Some of that co-production group also made videos to increase the awareness and understanding of autism which can be viewed here.

More recently we had a representative from West of England Centre for Inclusive Living on our Adult Care Trailblazer group which has done some brilliant work in creating the new apprenticeship standards for our sector.

These examples are illustrations that we are making progress and I am also aware there is more we can and must do.

That’s why I’m making a pledge this week to continue to drive our co-production work forward. Not only is it the right thing to do, it makes sense if we want to create products and services that actually make a difference.

Co-production in Jersey

Paul Michel and Sophie Holmes are both physiotherapists from Jersey General Hospital, who work within a newly formed co-production group where service users and staff members have combined forces, to drive positive user-led changes. Here is their summary of how the process is going so far:

Why did we start co-production?

As physiotherapists we feel we know what our patients want and always have done. We are empathetic, good listeners and keen to implement change. On the other hand however, we value patient feedback, and so we were keen to embrace a new way of working in partnership. Although initially daunting, we wanted to see what feedback we would receive, and were excited about the direction that would take us, in terms of shaping our future service.

how did we start the process?

In November 2017, we invited service users to our first ever co-production workshop. The day was a great success, we received training from the Social Care Institute for Excellence (SCIE), completed a variety of team bonding exercises, and co-produced our core values (see picture).  Many improvement ideas were generated and we formed a steering group with service users, who were kind enough to give their time to help drive change.

Where are we now?

We’re in the infancy of our group, 6 months in, enjoying tackling some of the main issues head on. It’s really interesting listening to what our service users truly want compared to what we previously perceived they wanted! We were told that co-production is challenging at our training, and it is, but my word is it rewarding!

Our values ensure we don’t get upset by what we hear, we respect that we don’t know everything and that’s not a bad thing. It’s no longer a ‘them and us’ mentality, it’s us all working with equal power together. The great thing is that the work we are doing and recommendations we are making are being fully acknowledged and supported by the physiotherapy Senior Management Team. This breeds confidence that change can and will happen. And that is exciting!