Co-production: not rocket science?

By Pete Fleischmann, Head of Co-production, SCIE 

Co-production is about people who use services and carers working in equal partnerships with professionals to design and deliver services; and I don’t often hear someone arguing over the value of co-production.

I do however, hear people say that it isn’t, or shouldn’t be portrayed or perceived as, rocket science. But if it is so simple a concept, why aren’t most health and social care services delivered in co-production?

I think the answer to this question is in two parts

Firstly people are complex and contradictory, have different working styles and are very diverse in many other ways too. So working in really equal partnerships is not, as it turns out quite as easy as it sounds on paper.

Secondly the systems that we have created to provide and health and social care systems are fiendishly complicated. So introducing co-production into these systems and trying to get real change is a pretty tricky business. 

Training days

To do co-production well it is important that everyone involved has the same understanding of exactly what co-production is. We have two training sessions in the lead-up to Co-production Week:

Co-production: an introduction. A CPD-accredited course giving an introductory overview of co-production and how its principles can be applied in the workplace.

Paying people who receive benefits training course. Giving an overview into best practice in terms of co-production and the benefits system.

If you go to the links above, both courses have feedback from delegates who have just finished a day’s training.

So, is co-production straightforward? Well, for instance, it’s not easy making sure that a meeting or activity is accessible, especially if the people who are attending have a wide range of access requirements.

So actually doing co-production well can have its challenges. But we’re here to help. As well as our training we have a wide range of other co-production resources. And please get involved in the third annual Co-production Week from 2 July 2018. All of this can help you find that, with a bit of support from us, co-production isn’t always rocket science.

Guidance on co-producing a research project – a first step

By Gary Hickey, Senior Public Involvement Manager at INVOLVE (About INVOLVE)

Gary Hickey 

Last year I made a pledge at SCIE’s co-production event to develop some INVOLVE ‘Guidance on co-producing a research project.’  I’m delighted to be able to say that we did it!  The guidance was co-produced with colleagues from across the National Health Institute for Research and beyond and is our first step in moving toward clarity on what is often a contested issue.  

It was an enjoyable, if difficult, exercise.  We have five key principles:

• Sharing of power 
• Including all perspectives and skills
• Respecting and valuing the knowledge of all those working together on the research
• Reciprocity
• Building and maintaining relationships.

We have drawn on the expertise and work of others to develop this guidance.  We asked many people – who often had a great deal of experience in co-production - to comment on the emerging principles and key features. So thank you for your contributions and I hope you can see your comments reflected in the resulting guidance.  

Our intention is not to promote co-production as a ‘gold standard’ or preferred approach to involving the public in research.  Rather we just want to further prise open the co-production opportunity.  People can use the guidance to steer and critique their own, and others’, work.  Our next step is to collect examples of co-produced research which show our key principles and features in practice.  

Please do send in your examples 

Co-production presents challenges to how we think about, fund, do and manage research.  Indeed, when developing the guidance some people told us that the challenges are insurmountable and that we should give up.  I’m pleased we didn’t heed this advice. As Martin Luther King once said:
‘You don’t have to see the whole staircase, just take the first step.’

Co-production: Walsingham Support

By Dominique Richards, Personalisation Officer at Walsingham Support @walsinghamuk

"Co-production isn’t new – it’s something that organisations, including ourselves, have been practising for a while."

Our Values

Putting people at the heart of everything we do was one of our founding principles. Ensuring the people we support have a voice and the opportunity to shape the support they receive has been central to our ethos from day one.

The Way Forwards

At its core, co-production recognises that everyone, regardless of ability, has unique skills, knowledge and experiences that when pooled together will deliver more effective outcomes.

Co-production doesn’t just benefit those who receive support, it benefits everyone involved.

The Real Difference

Co-production isn’t new – it’s something that organisations, including ourselves, have been practising for a while.

Our personalisation standards and personalisation audit were co-produced with people we support back in 2015 as well as our professional boundaries policy. The policy itself was conceived and led by people we support who consulted staff members and professionals as opposed to the other way around, unique in our sector.

The next step for the social care sector, collectively, is to ensure that co-production is integrated across all policies, practices and processes as standard.

Our Next Steps

To ensure that we continue to push our work around co-production and as part of our commitment to Social Care for Excellence’s Co-production Week (3^rd-7^th July), we are creating a brand-new co-production working group.

The group will consist of people we support, family members, staff members, professionals and independent advocates and will be officially launched at a one day co-production conference. Led by an independent facilitator, it will ensure each voice is heard and given equal waiting, with each attendee having a decisive role to play in the group.

This conference is just the start as we move away from ‘involvement’, where people we support are just consulted, and head towards a process where the people we support are fully intergrated from start to finish. 

We want a society where people with disabilities have full control over their lives, where their voices are not only listened to, but heard.

*If you would like any more information about co-production and what we are doing to embed it, please contact Dominique Richards, Personalisation Officer Dominique.richards@walsingham.com

Co-production, co-production, co-production

By Gerry Nosowska, Director, Effective Practice

Co-production Week gives me the opportunity to reflect on what co-production means to me and how I can embrace it.

I am far from an expert on co-production. Although my social work training and practice has always emphasised working with people as equals, I am a long way from true co-production. I like to manage situations, I have blind spots about power, and I have habits for how I do thinks which significantly get in the way.

So this blog is not about how to do co-production but instead what I have learned from my small steps about why to do it.

1. It feels right: On the few occasions when I have taken a co-production approach - sitting down with a blank piece of paper and starting with ‘what do we think we should do?’ - it has felt much better than turning up with a plan, a form or an agenda.

2. It teaches me about myself: The times when I have co-produced work, I have been called out on many assumptions I make about who is ‘professional’ and who can do what. It is uncomfortable but I need to hear it.

3. It results in better work: The co-produced projects I have been involved in have all been so much better than anything I or social workers alone could do. The Role of the social worker in end of life, palliative and bereavement care contains stories and language I have no experience of. The Carers website contains case examples and tips for practice that speak straight to me. The Position statement and charter for disabled adults and social workers contains actions that I had not considered.

So for these three reasons, I will keep going with co-production. I have written a commitment for this week. And please, if you are thinking about co-production, do it; if you are doing it, keep going; and if you know how to do it, help us beginners.

Evolve: co-producing how we work with our customers.

By Pia Hansen, Special Projects Manager, Evolve Housing and Support

We are about to launch our new approach to support this summer. Last year we worked with staff and customers to review how the existing approach was going. Customers were happy with the support they receive and at the same time some areas for improvement were identified. Customers wanted a focus on what is strong and positive about them and on their relationship with the wider community, which led naturally into focusing on a more asset-based approach to working.

A working group of staff and customers was set up in late October to jointly create this new approach to support. As a group, we designed the new approach and the paper work, made sure staff and customers could review and feedback at every stage and eventually agreed on what it would look like. The new approach, which focuses on a customer’s wellbeing, their satisfaction with where they live, their community connections and their aspirations, is proving to have a positive effect after the initial pilot. One customer said about his experience of the new support plan: “I have really enjoyed being able to take the time to complete this and I feel like it is mine and something I can work towards. I have liked looking at my strengths…’ .

Customers and staff worked together to review the feedback from the pilot and to make any necessary changes. They also worked together to develop training for staff on how to work with the new approach which is in the process of being delivered. Over 60 staff and customers have been involved in this process with over half of these being our customers. The design, decisions and training work around the new approach have been done in partnership with our customers, and has resulted in a great new way of working for the organisation.

One of our managers said: “Co-production allowed us to test ideas and bring current lived experience to the planning process. This is essential for any new support approach and invaluable to the ethics of design.  By focusing on co-production, we have been able to get all parties to take ownership in its design and delivery and develop it into something that works for all and not something that is just implanted on our clients.”

None of us is smarter than all of us! The hidden meaning of co-production

Clenton Farquharson and Nic Crosby. Clenton Farquharson MBE is chair of the Think Personal Act Local Board. Nic Crosby is Director at GatherBuildWork.net. Both are happy to continue this discussion should you be interested.

We are all people, people with lived experience, experts by experience; we may need support all our life or we’ve all looked after a family member who does, we’ve worried about how they are getting on in hospital, whether people are looking after them properly, many of us have experienced mental health challenges and most if not all know someone close who has…the list goes on.

Real co-production is about building mutually trusting and respectful relationships, where we each listen and value each other contributions, discuss, often disagree, and may be even argue.  We are all people with lived experience and we are, when it comes to taking forward the improvement of support for people, actually working to make the world a better place for ourselves and our own families, relations, friends and local communities.

Yet, there is this great divide between those of us being supported and those of us doing the supporting, where those of us being supported report that although there is a much headlined approach of ‘nothing about us without us’ our experiences are nothing like this.  We, who are doing the supporting seem to forget that we are just the same as those we are supporting, we forget that it might be us or a close family member needing support; we, who are doing the support start to believe that we know best, we start not to listen to what those of us who need support are saying and we start to use complicated and exclusive language which means others can’t understand, can’t take part.

And so, we have this thing called ‘co-production’, a bit of jargon yes but vitally important and essential.  We have to have ‘co-production’, guides to co-production, commitments to co-production and blogs like this one because the relationships between those of us being supported and those of us doing the supporting have to change and have to set ‘nothing about us without us’ not as an aspiration but as the foundation for everyday work and support.

For us both one of the clearest markers about a commitment to real co-production is the language being used. Not just when horse riding becomes ‘equine therapy’ or bouncing on a trampoline ‘rebound therapy’, but in publications, at conferences and in all our work to improve services.  All the energy being put into ‘coproduction’ as part of the work to improve services and support means nothing if the language used is difficult to understand and excludes the very people whose expertise and views should be at the centre.

The more complicated and exclusive the language we use the clearer it is that our commitment to co-production is paper thin and very much tokenistic.  So we, like others are keen to champion a ‘speakeasy^[1]’ approach to all that we do, using language that is as inclusive as possible, as easy to understand for the whole community and to challenge language that works against inclusion and taking part.

Using straight-forward language, avoiding jargon and thinking about the words we use is only part of co-production, yet it says so much about how genuinely committed we are. Co-production comes from building trust, trust is a bit like love, both parties have to feel it.  Despite investment, energy and much activity it feels like this two-way trust is not reality for most of us and is a long way off.

So, that favourite ‘3 top tips’ bit:

1.     Make ‘nothing about us without us’ a reality; in your own work and the work of your organisation, involve people who will know best and remember that you are also improving support and care for members of your family and maybe yourself.

2.     Make a personal commitment to ‘speakeasy’.  And, like the both of us, know that in making that you should expect to be challenged about the words and language you use, this is the only way we are going to get better.

3.     If you can make a commitment for your organisation to always ‘speakeasy’.  Discussions, workshops, and meetings should be inclusive and welcoming for anyone and everyone who needs to be there.

^[1] Speakeasy is not trademarked or copyrighted.  You are welcome to make a similar commitment and to publicise it, however like us it means you are going to have to get used to being challenged until you get it right!

Co-production in Action in Hampshire

By Robert Droy, Chair of Hampshire Personalisation Expert Panel at SPECTRUM Centre for Independent Living. 

@RobDroy1973  

For me personally, this year will mark 20 years of working on coproduction. Back in 1997, it wasn't actually called coproduction, it was often called user involvement, but the aims and objectives were the same; how to get statutory services to involve people in designing, delivering and evaluating services in a meaningful way rather than just a tokenistic way.

Fresh from graduating university, I had seen first hand the discrimination that many Disabled People face when trying to find employment. Despite the government's ‘two tick’ system, statutory services seemed reluctant to employ Disabled People, let alone give them genuine chance to influence the development of services.

When I finally got a job in the user led movement, I met many of my peers wanted the same things I wanted. I also started to meet staff within the local authority who could see the value that service users could add when developing services. Over the next decade, in Hampshire at least, we were lucky enough to work with the local authority on a number of exciting projects, particularly around Independent Living and empowering Disabled People to have more choice and control over their lives. This resulted in the formation of the Personalisation Expert Panel, a group of service users and carers who work with senior managers in a coproductive relationship on social care reform. I have chaired the PEP for the past 9 years.

Despite the worsening financial situation, in Hampshire we have continued to work closely with the local authority and now with the Clinical Commissioning Groups to ensure that service users’ voices are not only heard but that we are around the table with senior managers when key decisions are being made.

Last Friday, 40 service users, carers and senior managers formed a Transformation Coproduction Board to specifically look at the Transformation plans that are being made for the next 2 years. Senior managers will not only report on what their plans are but also will need to specify where coproduction has or will take place and what effect it has had.

The Board will not replace the existing coproduction groups in Hampshire such as the PEP but will ensure meaningful coproduction remains a priority over the next 2 years and beyond. This is an great example of coproduction in action and how things develop over time. SCIE’s Coproduction Week is an excellent opportunity for all of us to share and learn from others’ examples.