Autumn In-Brief 2018 V10 FINAL - Flipbook - Page 10
The principles of co-production
Sue Salas looks at collaborative relationships
Over the last few years we have seen a rise in interest in
and commitment to co-production in health and social
care. The term co-production was first used by Professor
Elinor Ostrom in Chicago in the 1970s so that the Police
and community could both be instrumental in tackling
rising crime rates in the city.
There are many definitions and levels of co-production.
Co-production can take place at an individual, group or
community level. One definition is: “A relationship where
professionals and citizens share power to plan and
deliver support together, recognising that both have vital
contributions to make in order to improve quality of life for
people and communities” (Slay & Stephens 2013).
Previously, people have been passive recipients of health
and social care; however, the Care Act 2014 has been
one of the key drivers in the increasing importance given
to co-production. Local Authorities now have a duty to
promote the wellbeing of their local population and to
deliver a range of services. The Act refers to coproduction several times and states that co-production is
“when an individual influences the support and services
received, or when groups of people get together to
influence the way services are designed, commissioned
and delivered”.
The Five Year Forward View for Mental Health
implementation document also highlights that coproduction is important in moving forward and delivering
on plans for the future. The report highlights the
importance of co-production with people with lived
experience of services, their families and carers. It also
highlights the importance of working in partnership with
local public, private and voluntary sector organisations.
There are seven key principles associated with coproduction which have been identified and are a useful
framework to use (Bennett et al 2008):
Principles
One
People are involved in the process from beginning to
end.
Two
People feel safe to speak up and listened to.
Three
Issues which are important to people are worked on.
Four
Meetings, venues and materials are accessible.
Five
There is clarity around how decisions are made.
Six
People’s skills and experiences are used in the
process of change.
Seven
Progress is evaluated and can be evidenced.
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Co-production is a collaborative process where
individual patients/clients/service users are no longer
viewed simply as passive recipients of care. The
fundamental power dynamic between the individual and
health or social care staff changes where the staff are
no longer the “experts”. This is in line with the
recognition that in the majority of cases the best person
to advise on a person’s problems, needs and care is
the individual concerned. Co-production means that the
relationship between staff, individuals and community
members is an equal and dynamic one.
Benefits and challenges
Whilst there is a lack of a robust evidence base in
relation to the benefits and challenges of co-production
a number have been cited. The benefits which have
been identified in relation to co-production include:
1. A reduction in inequalities by supporting and
facilitating access to the views and experiences of
individuals who may previously not have been
heard. Co-production is about involving everyone. It
gives staff permission to think about how to engage
with and hear the voices of those who are not
currently being heard (for a variety of reasons). It
may be that they are a carer and do not have the
time to attend meetings, or they may be someone
whose first language is not English or someone
with mobility problems or who has problems getting
to meetings due to transport difficulties. Via coproduction the aim is to involve and engage with
people and find practical ways and solutions to
doing so.
2. More cohesive local communities. Co-production
has a real potential to bring together people to work
collectively to make a meaningful difference to the
design and delivery of their local health and social
services.