Co-production
1. What is Co-production?
There are numerous descriptions of co-production available:
‘Co-production is when an individual influences the support and services received, or when groups of people get together to influence the way that services are designed, commissioned and delivered’ (GOV.UK: Care and Support statutory guidance).
‘Co-production is not just a word, it is not just a concept, it is a meeting of minds coming together to find shared solutions. In practice, co-production involves people who use services being consulted, included and working together from the start to the end of any project that affects them. When co-production works best, people who use services and carers are valued by organisations as equal partners, can share power and have influence over decisions made’ (National Co-production Advisory Group).
‘Co-production describes working in partnership by sharing power between people who draw on care and support, carers, families and citizens’ (SCIE: Co-production: what it is and how to do it).
‘The relationship where professionals and citizens share power to design, plan, assess and deliver support together. It recognises that everyone has a vital contribution to make in order to improve quality of life for people and communities’ (New Economics Foundation).
2. Why Co-production is Important
Co-production has benefits for people and carers, but also for staff who work in services, organisations and communities.
When implemented effectively, co-production can help the Local Authority to achieve many of the main principles of the Care Act 2014.
Some of the key benefits of co-production for people and carers are:
- Increased self-confidence, self-esteem and a sense of empowerment;
- Better health and wellbeing;
- Increased engagement and trust;
- More equality and diversity in services and support;
- Reduction in inappropriate or disproportionate interventions;
- Higher levels of satisfaction with, and awareness of, services.
3. Values and Behaviours of Co-production
There is no definitive list of values and behaviours for effective co-production. The following are those identified by:
- SCIE;
- NHS England and the Coalition for Personalised Care;
- New Economics Foundation (NEF).
SCIE
In their resource, Co-production: what it is and how to do it, SCIE identifies the principles of equality, diversity, accessibility and reciprocity as critical values for putting co-production into practice:
Equality: Everyone has assets to bring to the process. Assets refer to skills, abilities, time and other qualities. No one group (professionals, experienced or less experienced people who draw on care and support and carers) should have a greater role to play.
Diversity: Co-production should be as inclusive as possible. Care should be taken not to exclude people from participation because of the nature of their difficulties, or where they live.
Accessibility: Accessibility is about ensuring that everyone has the same opportunity to take part fully, in the way that suits them best. It is also about making sure information is accessible and provided in an appropriate format.
Reciprocity: Reciprocity is about getting something back for putting something in. It helps build a sense of togetherness and makes people feel needed and valued.
For further information, see SCIE: Co-production: what it is and how to do it/principles.
NHS England and the Coalition for Personalised Care
In their Co-production Model, NHS England and the Coalition for Personalised Care set out the following values and behaviours needed to ensure co-production becomes part of everyday practice:
(Source: NHS England and Coalition for Personalised Care)
New Economics Foundation
The New Economics Foundation (NEF) recognises six main important behaviours (parts) of effective co-production:
| Behaviour (part) | Explanation |
Recognising people as assets |
Seeing people as equal partners in designing and delivering services, rather than as passive beneficiaries or burdens. |
Building on people’s capabilities |
Recognising that each person has abilities and working in ways that support these to be developed. This includes supporting people to do use those abilities to benefit their communities and other people. |
Developing two-way reciprocal relationships |
Mutuality between everyone involved in co-production, including individuals, carers and professionals. |
Encouraging peer support networks |
Peer and personal networks are often not valued or supported enough. Effective co-production builds these networks alongside support from professionals. |
Blurring boundaries between delivering and receiving services |
Blurring the usual line between those people who design and deliver services and those who use them with more people involved in getting things done. |
Facilitating not delivering to |
Public sector organisations enable things to happen, rather than providing services themselves. An example could be supporting people who use services to develop a peer support network. |
4. Co-production in your practice
The guidance in this section of the chapter is for practitioners involved in front line services with responsibility for establishing needs, meeting needs and carrying out reviews. If you work in commissioning, please see TLAP: Co-production in commissioning.
The aim of co-production in your practice should be to make decisions and complete assessments, plans and reviews together, in equal partnership with the person with care and support needs/carer.
This involves recognising the person’s/carers expertise in their own life as someone with lived experience and then working together co-productively to define goals and outcomes, focusing on what a person/carer can or could do, and what needs to be in place so they can use these strengths to improve their outcomes and lives.
The following are some practical steps that you can take to maximise opportunities for co-production in your practice:
- Clearly explain what is happening (or going to happen) so the person/carer understands and can decide how they want to be involved;
- Encourage the person/carer to be as involved as possible in whatever process is taking place. Consider the support they may need. For example, support of a family member or an advocate;
- Make sure conversations/meetings are held at a time and place that works best for the person/carer, taking into account their needs and preferences;
- Address any communication or accessibility needs – throughout the whole process, provide information in the right way so it can be understood and used effectively;
- Take time to build rapport and trust – these are essential for effective co-production;
- Focus on the person’s/carer’s strengths and abilities, and explore opportunities to use and build on these (a strengths-based approach);
- Invite and encourage the person/carer to problem solve and identify their own solutions;
- Allow time for everyone involved (the person/carer, yourself, other professionals etc) to share, process and discuss information, views and ideas;
- Give equal weighting to all ideas and options and consider each on their own merit;
- Agree the outcome of assessments, plans and reviews together.
It is important that you check yourself from time to time to make sure that your approach is one of ‘doing with’ not ‘doing to’. If it is the latter, consider what you can change to make it more co-productive.
Effective co-production cannot be rushed. Therefore, it can be more challenging to fully co-produce assessments and decisions that are urgent. However, there will always be opportunities for some elements of co-production to be implemented, whatever the situation.
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