Co-production is a fascinating topic – with direct relevance to the lives of people with care and support needs.
It can be thought of as partnership, where all involved in services have equal roles in creating and delivering those services. This includes people with lived experience, carers, families and practitioners. It’s the most far-reaching way in which people with lived experience influence services.
I first wrote a briefing on co-production back in 2014. At that time, the concept was relatively new in the sector and there was a lot of excitement surrounding it. Co-production emerged at a similar time to personalisation in adult social care, and the two concepts were often positively linked. In personalisation, people gained choice and control over their own care and support; co-production was about people increasing control over what that care and support looked like in the first place. They slotted together in how organisations moved away from a service-led model towards an outcome-focused one.
Now the landscape is very different – and the knowledge base has evolved significantly. With this updated briefing, I draw clear links between the literature on co-production and working with people in a wider strengths-based way, something now far more embedded in adult social care. Although strengths-based practice is often thought of as an individual relationship, where people and practitioners work towards that person’s own outcomes, co-production exists in natural harmony with it. After all, co-production draws from the strengths of people with lived experience, using these strengths to improve services for all.
However, and despite positive evidence and policy pushes supporting co-production, it is striking that it is still a challenge to achieve in practice. Why might this be? The research offers some possible reasons. It’s clear that co-production is an approach that requires time and patience, and does not result in overnight service transformation. Senior leaders have to support it at the highest level, arguing for funding while simultaneously giving up their sense of control over the process. In a time of flux for adult social care, this can be hard to do.
Recently, there’s also been more attention paid to just how important it is to take a conscious and deliberate approach to diversity in co-production. This isn’t only an ethical point. If a wide variety of people are going to be accessing a project, there needs to be a similar diversity in those who design and deliver it. It’s clear from the research that co-production, like other structures in society, can systematically exclude people from black and minority ethnic backgrounds, people on a lower income, and those with more complex care and support needs. Addressing diversity is closely linked to reflecting on power (and how to give it up), and this is explored in the briefing.
Despite the challenges, when writing the briefing, I found numerous examples of projects where co-production had resulted in positive service change – even if it wasn’t the change people expected! If there are messages in getting co-production right from these projects, they are: foster trust, bring in a wide range of voices, be patient, and don’t expect one particular outcome – because you’re unlikely to get it. But you could get something far more valuable: the true voice of lived experience in services.