What is co-production?
There are inconsistencies between the many definitions of co-production that exist (Beresford, Bolton, Cooper, Donnellan, Miller, Moriarty, Pike and Watts, 2015), however there are some key features of co-production:
- People are defined as assets with skills and their existing capabilities are built upon.
- Barriers between users of services and professionals are broken down.
- Mutuality and reciprocity is present – people work together to achieve their shared interests and get something back for being involved.
- Services are facilitated to be more than service providers enabling them to be agents for change.
(Social Care Institute for Excellence, 2013).
The move towards co-production and personalisation began in the 1970s and since then has gained significant ground in terms of policy context and in practice (Beresford, Bolton, Cooper, Donnellan, Miller, Moriarty, Pike and Watts, 2015).
Understanding when participation becomes co-production
There are varying levels of participation ranging from non-participatory action, through tokenism to citizen control (Arnstein, 1969).
Co-production occurs towards the upper end of Arnstein’s ladder of participation and involves professionals transferring more power to service users than occurs at lower levels of the ladder (Beresford, Bolton, Cooper, Donnellan, Miller, Moriarty, Pike and Watts, 2015). Arnstein’s ladder of participation can be used by organisations to assess where they are in terms of their level of engagement with users of services and to plan how they will develop this.
Co-production itself, although occurring at the upper end of the participation ladder can also happen at different levels; on an individual level, users of services might be supported to make their own decisions about the support and services they receive and on a more strategic level, users of services might be invited to work in partnership with professionals to design and deliver services
Why is it important?
Involving people in the design, delivery and ongoing development of services is important on an ethical and emotional level, as it can support those involved to develop their skills and promote their wellbeing. In addition it can improve services and has also been shown to contribute towards efficiencies in public services (Involve, 2015).
Not only can co-production lead to improvements in services, it can be incredibly rewarding on a personal level. Involving people with lived experience never fails to deepen my understanding of how life is for a range of people in different circumstances and provides me with a perspective that I would not otherwise gain on my own. The knowledge gained through co-production with people with lived experience helps to shine a light on what is important to them and the wider group they identify with, and in turn provides opportunities to work with them to generate ideas and develop strategies that will go some way to overcoming the identified challenges. Without engaging with people with lived experience, I know the usefulness and the quality of the work I do would suffer.
In my early career working with people with learning disabilities, I was fortunate enough to work with a group of colleagues who genuinely believed in a rights based approach to supporting people – an approach that really underpins co-production. During this time I worked closely with the people we supported and through multimedia advocacy facilitated them to voice their aspirations, develop the support they received and be involved in their annual reviews and in wider decision making processes. In my experience, this approach led to a better quality of life for the people I supported and in turn positively impacted on their wellbeing. It also enabled me to develop positive relationships with them and in some cases reduced their levels of anxiety which in turn reduced instances of challenging behaviour.
Working with carers
At Research in Practice for Adults (RiPfA) I am currently working with older carers and practice experts to produce a series of Podcasts and a publication that aims to support social care professionals to work effectively with older carers. Working with carers to understand their unique experiences and what would support them to feel able to continue in their caring roles with confidence, is key in developing resources that enable social care professionals to provide effective support.
As part of this work I have spoken to a number of carers on a one-to-one basis and will be meeting with a group of carers in mid-July. The joy of working in this way is that a great many things have come up that I would never have considered on my own.
The next stage will be working with carers and practice experts to create useful resources that support those working in practice with carers. These resources will be published in February 2019 and I will write follow up blog on what was produced as a result of this work.
It has been a privilege to speak with a number of carers who have given up their very precious time to share their experience and expertise with me and I am looking forward to speaking with more carers over the coming months. Working in this way is enriching and I feel immensely grateful I work in a sector where the opportunities for engaging in co-production with people with lived experiences are so vast and fruitful.