Co-production is about design and delivery

By Sarah Rae, Co-founder of PROMISE Global

I have struggled with severe and enduring mental illness since my late teens. However, it was not until I was admitted to an acute ward at the Cambridgeshire and Peterborough NHS Foundation Trust (CPFT) in 2005, that I became interested in the design and delivery of services. This was because during my 6 month stay, I saw so many things that could have been done differently, which spurred me on to train as a Patient Leader. 

When Mind published their report on physical restraint in June 2013, I was curious to find out what CPFT was doing to reduce reliance on force. I approached the Clinical Director of Acute Care the following month to learn more about the Trust’s approach. Our meeting sparked some exciting ideas and together we founded PROMISE (PROactive Management of Integrated Services and Environments) www.promise.global

PROMISE aspires to break new ground in the mental health field. From the outset, the work has centred on supporting staff and service users on a journey towards eliminating reliance force within CPFT. Soon after inception the initiative attracted global attention and it continues to grow apace. There are 5 founder members: Cambridge, Yale, Brisbane, Prague and Cape Town, which has led to the formation of a global knowledge network for proactive care.

I co-lead PROMISE and as a collaborative pair we model good practice. Co-production is very much at the heart of everything we do and it’s one the PROMISE core values. Valuing lived experience is central our ethos and it has been hardwired into the project from the start, which has helped to ensure that the work remains grounded and relevant to the needs of patients. 

Co-production is all about power sharing and giving equal weight to lived experience. However, in my experience, patients are all too often seen as problems rather than problem solvers with untapped skills. With their unique insights they are ideally placed to work collaboratively with clinicians but in practice this rarely happens. In this way, ours is an unusual partnership, as we have an open relationship built on trust and honestly. 

Importantly, there is also room for challenge and when our opinions differ, we agree to disagree. With a project of this size, we’ve found that one of the best ways to ensure that all decisions are taken jointly is by talking daily to decide on a plan of action. This new way of working has been a complete revelation to me and I’m looking forward to the day when it becomes the norm.