From one service user to another

By Ali Wright, Deputy CEO, The Advocacy Project

As a charity that supports people with learning disabilities, mental health issues and dementia to speak up about the services they use, The Advocacy Project places service users' voices and co-production at the heart of its work.

Our most recent co-production initiative involved working with service users to tackle loneliness in London's care homes and mental health inpatient wards, through a Christmas card appeal.

One of the user-designed Christmas cards 

People in care homes and mental health inpatient units have told us how lonely Christmas can be; many of them don't receive visitors or Christmas cards. We spoke with other service users about this and, together, we came up with the idea of creating our own Christmas cards to send to individuals in care homes and inpatient wards.

As The Advocacy Project is shaped by those we work with, we felt the design of the cards needed to come from the very same people — as an act of solidarity. People with mental health issues, learning disabilities and dementia, created their own original artwork for the cards.

This project has spurred positive action among our service users, who have been able to deliver a piece of work that they know will benefit other service users, based on their own experiences.

Jill and Sandy, who have been married for 23 years and have learning disabilities, love painting and drawing. They've spent a large part of their life trying to convince people, including their art teachers, they are capable of achieving their aspirations.

They said: "Christmas is about giving and the cards will give a little joy to other people during the festive period."

One of the other seven artists, who was in a mental health ward for a prolonged period of time, describes herself as one of the "lucky ones", as her daughter would come and visit her in hospital.

Now in recovery and volunteering with The Advocacy Project, Giorgina told us that Christmas can be a really difficult time of year for those in mental health wards. She said that the most important thing is "having people around you that care" and that "it's the little things that make the biggest difference".

Jasmine, aged 16, who volunteers with The Advocacy Project during her school holidays, also produced a piece of artwork for the cards. She says: "The Christmas card appeal will show people in care homes and inpatient wards that other people are thinking and care about them."

Working together, we have also been able to increase awareness about issues of isolation among the general public and health professionals. The cards are being sold to members of the public to cover the cost of producing and sending them to people in mental health inpatient wards in three London hospitals in Westminster and Kensington & Chelsea, as well as care homes in Westminster.

Co-production in Lambeth: ‘it’s the way we do things around here’

By Lou Thomas, the Innovation Unit

To deliver different, better, lower cost public services, public professionals and citizens need to embrace co-production. At Innovation Unit, we know from our work in radical innovation that it is a practice and a mindset that is at the very heart of transformative change.

People’s needs are better met when they are involved in an equal and reciprocal relationship with professionals, working together to get things done. When citizens don’t just participate in the process of designing and delivering new services, but they own it.

We’ve been working with the Lambeth Living Well Collaborative to enable just that.

Lambeth is one of the most deprived areas in the UK with a mental healthcare system struggling to handle high levels of referrals and people stuck in secondary care. Like many other healthcare systems around the UK, it has seen its funding cut significantly in recent years.

The Collaborative was formed in response to these challenges. It is a group of service users, GPs, providers and commissioners dedicated to transforming Lambeth’s mental healthcare system. We are helping them to prove that co-production will work on a large scale and drastically improve outcomes for people with mental health problems, regardless of the severity of their condition.

Opening up the process sounds a daunting task but the simplest of adjustments can have a profound impact on culture and ways of working. A monthly open invitation to breakfast in a local social enterprise cafe, run by people with lived experience of mental health issues, was the catalyst in Lambeth. New offers like a peer support service and community options team were quickly established to support people out of secondary care and into sustainable community based support and services.

These breakfast meetings were just the start. They provided a simple opportunity to be part of the conversation about challenges, and created a shared vision that co-production is “how we do things around here”. To date, the Living Well Network approach is seeing real impact, with a significant month on month fall on referrals to secondary care.

During co-production week, Lambeth shows us that strongly co-produced services are the only way to meet people’s needs and aspirations. It addresses a variety of issues facing commissioners ranging from how to better connect with communities to identify opportunities and challenges within them, to how to better assess outcomes, and encourage providers to work collaboratively.

With patients fully embracing the principles of co-production - ‘nothing about us, without us’ - Lambeth has created long-term, sustainable impact, whilst dramatically improving healthcare experiences.

To find out more about Innovation Unit’s work transforming public services through co-production, visit our website

Is it time to consider offering people payment for co-design activities?

By Sam Hudson from Überology - and former SCIE trustee 

For years there has been the expectation that people will give their time for free to help public sector organisations to make decisions about how to improve, what services to offer and whether they are offering a high quality service.

We are now starting to have a split, with some organisations offering payment for certain activities, others deciding that they will not offer payments at all, and a raft of organisations in-between wondering what on earth to do.

The systems needed to offer payments for citizen involvement activities are starting to formalise this work and have the potential to create a more business-like approach, and this, for me, is the outcome that I am most excited about.  You need a budget to pay people, an audit trail and a very clear sense of purpose.  Paying people requires the service to seriously consider why they are doing a particular activity and what they hope to get out of it.  The quality of insight, listening to a wider range of voices and being as inclusive as possible becomes all the more important.

Imagine you are an organisation who would like to support a local voluntary sector organisation to deliver service-user-led involvement activities, or you might be hosting a co-design event and offering payment to people taking part – both will require some kind of procurement or payment system. Perhaps by having real money attached to this kind of activity ensures that it won’t be a tick-box exercise. You are not going to spend hundreds of pounds on getting insight that you then won’t use are you?

There is much debate about the power differential that exists between those “outside” and those “inside” the system and the impact of paying people on this relationship.  For instance, when you have members of the public, who use services, working alongside people who work in the system, making key decisions and co-developing services, can a payment offer start to balance out this difference?  Offering payment has implications for the relationship an organisation has with the people it involves, when there is money involved the relationship changes.  

From what I have observed so far, it does not appear, as some would have expected, that views are compromised, as far as I can tell, it’s more that there is a change in expectation on both sides.  We don’t yet know the full impact of this change in dynamic and it will be interesting to explore the implications of this over the next few years.

This is a tricky area to navigate.  There will always be people who are more comfortable volunteering their time and there is evidence that this is, if managed well, a fulfilling activity that can lead to all kinds of benefits for the person involved, as well as the organisation they volunteer for.  Offering payments and other kinds of support such as reimbursement for travel, or carers, as well as other development opportunities can be a real incentive and there is evidence that it widens out the kinds of people that might want to get involved both in terms of background, lifestyle and age.  

There is a great deal of evidence that overcoming financial barriers can make a real difference when trying to be more inclusive.

More than anything, I hope that the introduction of the option of payment will ensure that we end up with well-planned and focused co-design activities that are properly evaluated and the differences that participants’ insights and ideas have made documented and shared.

For a full version of this original blog including Top Tips visit www.uberology.co.uk

Welcome to the Dementia Underground Resistance Charm Offensive!

By Larry Gardiner - Secretary, Meadow Brook Residents Association, Oxford. 

A while ago I was asked to speak at a conference on dementia. I have a condition called Mild Cognitive Impairment. The request came with very little advance notice. It was my first public speaking event, and as events unfolded, nearly my last.  As I stood to make the opening remarks to this very large audience of the great and the good there was a long silence; my mind had gone, completely blank. Whatever thoughts were passing between my ears, they resolutely refused to fall out of my mouth. 

Gradually a nervous giggle started to bubble up in the room. The giggling increased and soon broke out into a wonderfully hilarious rolling laughter... And then it came; I simply said the first thing that entered my mind. "Welcome!" I paused. But by this time the laughter was beginning to subside and I could clearly see they were on my side, probably a bit grateful for the opportunity to laugh; "Welcome!" I repeated and I looked out of the window. "Welcome to the Dementia Underground Resistance Charm Offensive!" I said. Heaven alone knows why. They roared approval, some applause broke out, a few rose to their feet, the rest soon followed. I grinned sheepishly at them like a loon. Blind panic gripped me; how on earth would I ever be able to follow that? 

As an object lesson in what can happen when 'word finding' starts to become difficult, this was not a bad start. Feeling that, with such encouragement, some further risk taking might be in order; I mistakenly thought I could do no wrong and I promptly launched into a completely impromptu and rather rambling stream of consciousness. Anecdote after pointless anecdote presented themselves to my poor little addled brain with barely any semblance of order to them. I completely failed to see the 'wind up signal' from the conference time keeper.   

"Aha!" I said with needless dramatic emphasis. "The time has come..." At which point I tailored off for an equally dramatic pause while my mind searched again for something good to close with. "... ... for each of you to sign up as the founding members of the Dementia Underground Resistance Charm Offensive!" They leapt to their feet for another prolonged and enthusiastic spontaneous standing ovation and, at a stroke, my baptism by fire as a public speaker was finally over. 

Of course I had wanted to say a great deal about very serious subjects. I wanted to explain my 'word finding difficulties' and my 'face blindness' and my Mild Cognitive Impairment. I wanted to protest the complete lack of a life journey pathway for people diagnosed with dementia; I wanted to advocate for post diagnostic support for people living with dementia. I wanted to ask why the world's fifth largest economy could not look after the most vulnerable of it's older citizens. 

People started slapping my back as I stumbled off the platform and out to the foyer. Then they started to shake my hand. Some even hugged me! Over coffee a sort of queue formed as one-by-one people came over to chat. Some had anecdotes of their own, loved ones with dementia they were caring for, others asked for advice about their own disordered memory and chaotic brain function. At lunch I didn't get a chance to pass a morsel between my lips. Pledges, promises, offers, suggestions, and solidarity like tsunami waves of fellow feeling washed over me. 

Human beings are wonderfully made. We are not simply another herd animal on the evolutionary curve. We are hard wired to want to connect. We are capable of symphonies. We are capable of poetry. We are capable of balletic leaps into the unknown. We are full of optimism. We are full of compassion. We are full of altruism. We are full of incredible resourcefulness. We are mercifully merciful. We are capable of great kindnesses!

Co-production is about filling in a blank sheet of paper together

By Fleischmann, Head of Co-production, SCIE 

Co-production is about filling in a blank sheet of paper together, was one of my tweets on the first day of national co-production week during a twitter event to launch week. It sums up co-production quite well but it also covers what co-production week is all about. It’s not what one organisation or individual can do but what we can do together. It does feel like that’s what we are doing filling up a blank, calendar with events, tweets, good practice examples and launches. 

SCIE has done a few things in the run up to co-production week including running a training course last week, setting up this blog spot and updating our free web materials to make them easier to find and navigate. We are looking forward to our festival of co-production later this week. But what is making the week really great is what other organisations are doing.  It fab that organisations like the Care Quality Commission (CQC), Voice ability, Macmillan Cancer Support, the Innovation unit,  Look Ahead  and Turning Point have publicly supported the week. Andrea Sutcliffe, Chief Inspector for social care said ‘I have long been convinced of the value of working in co-production with people who use services, carers and their representative groups as well as providers, staff and other partners.’ For more about CQC and co-production see bit.ly/29d0cVv . 

In Hampshire the new User Led Organisations Network launched in Winchester on 4th July. This is important because the role of user-led organisations in owning co-production is vital if co-production is not to become diluted and watered down.  It is critical that smaller organisations, disabled people’s groups and other user groups engage with co-production. It is these organisations that will keep co-production rooted in communities and continuing to struggle with the real issues.  On 6 and 7 July a Leadership for Empowering Healthy Communities cohort in Loughborough are holding two co-production labs to develop co-production. 

On Friday 8 July the week will close with an event about New Belongings project, a wonderful initiative that employs Care leavers to help local authorities all over the country develop more co-production in their services for care leavers. 

It seems a long way off but next year Co-production Week will be Monday 3 July to Friday 7 July. It is never too early to start thinking about what you can do during the week! 

Could co-production become diluted?

By Laura Able, Co-production Steering Group and Network member

My gut reaction was that I didn't like the word co-production when I first heard it. The term sounds mechanistic.  I found I was not alone in my reservations amongst many grassroots service users.  I do believe in and aspire to be part of co-productive approaches and feel I have been part of this collective concept for many years.  It is grassroots and hasn’t just been parachuted in from America or anywhere else. We were already and are co-producing.  

Co-production builds on user/carer involvement and participation in all its diverse shapes and sizes.  People have warmed to co-production because it offered new and fresh beginnings it rekindles the real values that underpin real power sharing. The down side is the more popular it becomes the more diluted. Co-production is about citizenship as Pamela Fisher tells us and she is wondering if coproduction is a social movement.  Is it like the disability or mental health movements?  Let’s hope so. 

Co-production in Scotland

By Ashleigh de Verteuil; People Powered Health and Wellbeing. 

This blog first appeared on this website 

Co-production is increasingly being recognised as an essential approach to Health and Social Care. Scotland’s drive towards person centred care has seen various policy drivers reference co-production as a priority in shaping the future of Health and Social Care services.

In the Chief Medical Officer’s annual report, ‘Realistic Medicines’, Dr Catherine Calderwood outlined the importance of co-production going forward in Scotland’s Health and Social Care agenda:

‘The future model of care is one with an empowered patient in a shared decision-making partnership with the clinician. There needs to be co-creation of care packages that include prevention and rapid access to services when required.’

Studies have shown that Doctors often recommend treatments and interventions that they would reject themselves. This shows a lack of shared decision-making, basing treatment on assumptions and unclarified expectations.

For example, a study found doctors believe that 71% of patients they’re treating with breast cancer would see keeping their breast as a top priority. In reality, this was only 7% of breast cancer patients’ top priority.

In the landscape of integration, for us this means empowering Health and Social Care Partnerships to be able to co-produce in order to support better outcomes for health, wellbeing, and integration. We want people to be able to influence their own health and wellbeing, and contribute to the design, delivery, and improvement of support services. When people are given the opportunity to co-produce their care, they are more likely to follow treatment plans, are less likely to suffer from unnecessary medical interventions, and be more satisfied with their outcomes. Nesta has recognised the potential of the Third Sector in helping integrate co-production initiatives, naming PPHW as a programme that can help achieve policy targets.

The importance of co-production, person centred care and asset based approaches can also be found throughout the recent National Clinical Strategy for Scotland, which identifies ‘a need to increase co-production with patients and carers’ as a current challenge. Self management education, Peer Support, Health Coaching, Group based activities, Asset Based approaches are also features outlined by Nesta, in partnership with the Health Foundation.

The argument for change is clear, but how do Health and Social Care professionals put this into practice? We hope to be able to facilitate that change, using the voice of lived experience so that going forward, PPHW will ensure that Scotland is, and continues to be, at the forefront of co-production.

Click to read the Realistic Medicines Report and the National Clinical Strategy as well as Nesta’s reports.

Co-production in Hampshire

By Robert Droy (Chair of Hampshire’s Personalisation Expert Panel) and Graham Allen (Director of Adult’s Health and Care, Hampshire County Council) 

The timing of SCIE’s first ever co-production week presents us with an excellent opportunity to reflect on why we feel in Hampshire that it is so important to work collaboratively to solve the issues that we face together.

As the song goes 'breaking up is hard to do', in our experience, working together can be just as tough, particularly during difficult times. It takes courage and determination but it also takes mutual respect. 

Too often it can feel like service users and carers find themselves on one side of the argument with health and social care professionals on the other side.

It is true to say that we all have different roles to play, different experiences, and different approaches to the opportunities and challenges that lie ahead; as the scale of the task increases, we must approach these with a renewed commitment to work together, to listen to each other, to seek the views of a diverse, and sometimes divided, community,  and to focus on the most pragmatic solutions for all of us.

In Hampshire, over the last decade, we have tried to put our differences aside and tried to develop a different kind of conversation. A conversation that is realistic, grounded, pragmatic and one that focusses on our shared values and principles. The principles of choice and control are non-negotiable for service users, but how we achieve that is up for discussion. On the flip side, both 

Health and Social Care have to do more with less. Many people may not like to hear that, but it is the reality of the situation we find ourselves in.

Currently, we each, as individuals, have the right to be involved in the decisions about how our own care needs are met, and as a collective we have the responsibility to ensure our contributions to discussions about the wider system lead to the best possible outcomes for all citizens.

This is where co-production comes in. By working together we can try to achieve a solution that maintains those principles. That's why co-production can sometimes be slow, it can be frustrating, but it can also be incredibly rewarding when an agreement is reached. We need to be honest that it doesn't always work but that doesn't mean we should stop trying.

A former colleague once said: “We will always have goals and targets, some we will miss and some we will reach, but what really matters is how well we work together”. 
For us, that sums co-production up perfectly.

The co-production revolution

By Rachael Wallach, SCIE trustee and Founder of #HackOnWheels

We’re at the vanguard of a disability revolution. This revolution is about co-producing and personalizing things not just services. I’m going to tell you about one of the first revolts; how a steampunk enthusiast and a carpenter from South Africa co-produced prosthetics. 

In 2011 Ivan, a steampunk enthusiast from the USA, made a functional mechanical costume hand. Richard, a carpenter from South Africa who had lost two fingers in a woodworking accident, saw a video of the hand on the internet. He reached out to Ivan and they adapted the design into a functional prosthetic hand for Richard. They posted a video of their design on the internet, which the mother of a boy who was born without any fingers saw. She asked whether they could make a prosthetic hand for her son. They agreed but quickly realized that the boy would grow out of the hand very soon. So they looked for ways to adapt the design so it could be made more easily. 

The solution they hit on was 3D printing. Instead of copyrighting their 3D printable design they shared it “openly" online so that anyone could freely use, adapt and make it. The design attracted hundreds of thousands of comments. People left messages saying that they needed a hand or that they had a 3D printer and would be happy to make one. Within two years 7,000 people had joined the e-NABLE community and had co-produced customized hands for over 2,000 people in over 40 different countries. 

The real magic is that when people started making the design they adapted and refined it to better meet their individual needs and personal preferences and then shared their improvements and adaptations with the community. 

The adaptations are particularly exciting because they have enabled products to be developed that would never have been developed commercially because they would only be used by a small number of people. Like a hand for holding a viola bow, a hand for holding playing cards, and a Ben10 hand.

e-NABLE is one of the first revolts but it is not unique.

Earlier this year I started #HackOnWheels. We’re co-producing an online library of open source designs for fully customizable wheelchairs. We’re doing it with hackathons where people who use wheelchairs and people who don’t come together to design and make collaboratively.       

In the Making brings disabled people and designers together in local maker spaces to identify individual access challenges and 3D print solutions. At “Hackcess” young people with disabilities, designers, and hackers make personalized aids and tech. Ability Mate is an online open source library of designs and instructions for making co-produced assistive tech and TOM Global have a co-productive innovation challenge, with a prize of $10,000.

So why not celebrate co-production week by joining the revolution: download some free software like 123D Design, visit your local maker space or come to our Makathon on 16 July. Because co-production is about more than services; it is about disabled people co-designing, co-making and co-producing things. 

Co-production: Children, young people and their parent carers

Caroline Bennett, Senior Development Officer, the Council for Disabled Children (CDC)

Social innovation young people event, March 2016

We're excited that the Children and Families Act 2014 enshrines in law the Section 19 principles in relation to the involvement and participation of children, young people and their parent carers.  This has created a number of opportunities for meaningful co-production at both a strategic and individual level. In some areas this has included disabled children and young people and those with special educational needs being part of local authority work on the Local Offer or the development of Education, Health and Care plans and processes, as well as more person-centred approaches to individual assessments and planning.

CDC have been focusing on co-production with a range of audiences through a number of our ongoing projects in Social Care and transition.  As part of the Social Care Innovation Programme we have been working with five local authorities to explore challenges and potential innovative solutions in relation to assessment of disabled children, young people and their families.  

The programme has four key principles that have underpinned our work and one of them was meaningful co-production with children, young people and families but also with all professional stakeholders across education, health and care; children’s and adults services; and the voluntary and community sector.  You can read more about our work in Transforming culture and practice in children’s social care assessment.

One of the initial outputs from this work is a postcard we have co-produced with young people to share some top tips for professionals on how young people would like to be engaged in their own assessments. You can download it here.    

During co-production week we will be delivering interactive training on the Mental Capacity Act 2005 and supported decision making with Face Front Inclusive Theatre, a group of learning disabled artists, who we have worked with to develop and deliver the performance and training workshop. You can find out more information about the events, which are happening in the first week in July, on our website. 

Co-production: Practicing what they preach?

By Anonymous 

I am one of many service users who are concerned about the increasing adoption of co-production as a term whilst not really practicing it at all. These are the organisations who might bring in someone to do co-production on a project or for a short time, make lots of noise about it through their publicity, and then revert back to the normal hierarchical way of working with just token service user involvement. 

They really do not get it. 

I am wary of naming organisations, but I recently went to a meeting in an organisation that has claimed it has co-production at its heart. But when they were challenged about some recent examples of where they had done things without telling us, let alone consulting us, the manager said that they had not done so because co-production was too expensive! 
We are in this terrible situation of having been engaged to co-produce and yet we are being ignored. 

But because they have kept us loosely engaged, in that we are on an email list and get notified of meetings, they still claim they are co-producing! When we go to the meetings it is usually a surprise to find out what decisions have been made about us and without us. Our influence isn't really there, as shown by the manager's response to the query above. 

I appreciate SCIE asking for our experiences because it is important to learn from our bad experiences as well as the good ones. Sometimes pointing out what co-production is not can prevent other organisations new to the concept from making the same mistakes.

Co-production conference

By Jim Leyland and Ben Deutsch of Touchstone, which provides a range of innovative services that improve health and wellbeing.

Delegates at the Leeds event 

Touchstone is a wellbeing and mental health charity based in Leeds, working with diverse communities. We wanted to share our leadership principles with partners and worked collaboratively with them and people who use services to host a coproduction conference.

The day offered a mix of formal presentations, great examples of coproduction and workshops. The key note speech focussed on building on citizenship and promoting democratic professionalism.

Examples included redesigning recruitment policies and procedures with people who use services, effective support planning and designing training for organisations.
The workshops focussed on asset based approaches, reciprocity and developing social networks.

Delegates gave their suggestions for a deeper development of co-production, both in Touchstone and other organisations.

• Challenge language used to make it more accessible and less about “them” and “us”.
• Embed coproduction values into tenders we submit for contracts.
• Set up a coproduction network that would meet regularly and include service commissioners in network events.
• Develop agreed standards on coproduction (and do this in a way that still allows diversity and difference).
• Encourage funders and commissioners to employ asset based approaches – particularly looking at assets of the most marginalised communities.
• Identify and target areas where coproduction would have greatest impact.
• Develop a coproduction toolkit.
• Run a similar conference in other regions and also conferences for more targeted areas – neighbourhoods, rather than cities.
• Coproduction needs to involve a diverse range of people – respecting that their will be a range of opinions and points of view both among people who access services and also among those who provide them.
• Avoid lecturing or colonising communities.

The day was closed by a local poet with lived experience of accessing services, who composed and performed a poem summarising the various views of coproduction that had been expressed by delegates.

“Services need to be available, enthusiastic and keen,
Valuing clients input, helping develop goals and a shared dream.”

“How do we develop awareness and use language accessible to all? Coproduction is essential for everyone and should not be tokenistic or small.”

“Changing traditions, challenging status quo and people with their own agendas; Think about the language we use – everyone’s a value remember.”

Hear the full poem here

Experiences of co-producing new routes into social work

By Ziaul Choudhury, a member of the Think Ahead Service User and Carer Reference Group

For about a year I’ve been involved with Think Ahead, the charity running a new programme for graduates and career-switchers to become mental health social workers. The Service User and Carer Reference Group has been shaping the development of the programme since its inception.

As well as attending regular meetings of the group to offer my opinions and experience, I have been part of the assessment centres used to determine who is accepted onto the programme. I interviewed candidates alongside a qualified assessor, asking questions from a service-user perspective. I also wrote a blog to help interested graduates understand how a social worker helped me through my psychosis.

I feel that input from me, and the other Reference Group members, really makes a difference and is an integral and important part of the Think Ahead set-up. The staff take my involvement seriously and see it as a valuable part of the programme. A service user has experience and skills (of recovery, managing their illness, personal strength, and so on) that are vitally important in helping others who are going through similar things, and I believe the Think Ahead team really understand this and value these qualities. No one is judgemental and everyone is personable and approachable.

My involvement with Think Ahead has also helped me in many ways. For instance, I’ve been able to gain new skills and experiences. It has been helpful in building my confidence to know that I am part of doing something which is positive and valued. I feel I am being listened to and helping to make a real impact within mental health.

Overall, I have found being involved with Think Ahead to be very exciting, and I look forward to each meeting and event that I attend.

What co-production means to us at a mental health support organisation

By Anna Lewis, Senior Consultant on behalf of the team at ImROC

In support of SCIE’s Co-Production Week in July 2016

When I asked my ImROC colleagues to express what co-production means to them, these were some of the words people used – partnership, equality, strength, humanity, humility, discovering, sharing, learning, giving, receiving, growing, collaborating, appreciating, exploring, innovating, fun. And for me, hope.

What is ImROC? The Implementing Recovery through Organisational Change (ImROC) programme is a new approach to helping people with mental health problems.

While each of us has a uniquely personal journey, we share common co-productive experiences with each other and with many more who are embracing new ways of meeting challenges in our ever-changing world. We are part of a global effort to change the nature of conversations, to rebalance power and to mobilise our energy and talents around our shared aspirations.

In our work supporting recovery for all, co-production is something we try to model as well as champion in others. What matters most to us is that we are true to the values and principles of co-production. As a diverse group of people with both professional and lived experience, we thrive on our collective wisdom, talents and skills. Our community of extraordinary individuals is united by our shared belief in the power of recovery. Our culture and identity are built on a belief that we can inspire more, achieve more and falter less when we work together in equal partnership. 

Power is shared, strengths are drawn out and nurtured, and improvement celebrated. Together we see new possibilities, we challenge, we make mistakes, we learn from each other. Through this, we break down barriers, we share responsibility, and we try to contribute to healthy and happy communities.

Co-production is a way of life for us in ImROC. Like life, it can be as difficult as it can be rewarding. This summer ImROC will be publishing a briefing paper about co-production, in which we will share more of our experiences and encourage you to do the same. Keep an eye on our website for more information.

ImROC works in partnership with communities in the UK and abroad to develop systems, services and cultures that support mental health recovery and wellbeing. Our mission is recovery for all.

Co-production is personal and political

By Pamela Fisher, Senior Research Fellow, University of Leeds 

Co-production involves a redistribution of power. In the first instance, this requires respect for people’s choices and preferences about their care.  For this reason, policy initiatives such as the introduction of personal budgets and the personalisation agenda constitute progress – they help to re-instate marginalised people as self-determining citizens. Choice is a cornerstone of co-production, but, equally, it should be about much more than this. People sometimes wonder how personalisation differs from co-production. My response is that co-production supports people’s choices but recognises that they do not make choices in circumstances of their own choosing. Many people in mental distress are caught up in complex and oppressive entanglement of powers which severely constrain choices. 

What about a person who can’t face getting out of bed because of the emotional, mental, social and material challenges which they face? ‘Fine’, some would say, ‘that’s their choice’. After all, it’s a key liberal principle that people can make choices as long as they don’t harm others.  And, anyway, co-production should provide freedom to get up and go to bed when you want. What tends to get overlooked is that identity is a relational, not an individual, achievement or process. Everything we remember, think and feel is a co-creation.  It has long been argued that personal autonomy is embedded in relationships of interdependence. A feminist ethic of caring potentially offers the basis for a way of thinking about citizenship that recognises everybody as interdependent and having the potential and responsibility to be caring and cared for. We are all dependent on each other for our sense of self.

A person’s sense of self is undone by injustice and isolation, and it can be repaired through solidarity with others. The survivor identity emerged as a result of a political and collective response to institutional oppression. The breakthrough occurred when mental distress was no longer regarded as a personal tragedy but as political issue which demanded collective action. A liberal understanding of identity risks turning back the clock by once again by placing all the emphasis on the individual and their personal choices. This is why the expression ‘user led’ should be used with caution. If it’s all down to people’s choices then they can easily be written off as unable or unwilling to appropriately manage their lives. The unwell person can be left in bed all day without consideration of the relations of power and powerlessness that make staying in bed the most appealing option.  

Co-production should be about solidarity and engagement, not neglect justified by a rugged individualism which fails to challenge the social relations which hold people in situations of despair. Co-production should enhance and extend personal choices but it should do so whilst resisting the political and social conditions in which those choices are made. 

Blog: Reimagining Professionalism in mental health: towards co-production

The benefits of co-produced services

By Ann Macfarlane, Member of the Co-production Network and former SCIE trustee.

Co-produced services are about professional people and the expertise of those who require services to share their knowledge, plan, develop a strategy and take action to the benefit of all parties. The result of this equality and diversity work is to enable those involved to understand what empowerment means and the choice and control that will evolve. 

Commissioners, managers and front line staff will enjoy their roles and jobs more, those who need and use services will know that their statutory and community providers have a better grasp of an individual’s situation and can identify and prioritise what will enable a disabled or disabled and ill person to gain, retain and/or maintain control in their life as much as they want or are able.

Co-produced work will lead to best practice, provide a new learning experience and job satisfaction. In turn this will mean less time dealing with complaints and cause less misery to those who are dependant on support. Evaluation and outcomes will provide wellbeing, with money and services more appropriately distributed. 

It may even mean less time is wasted, with the same or less money devoted to excellent provision and outcomes. There will be times when co-production may throw up obstacles and usually working on solutions will provide additional learning with further empowerment.

There is nothing to lose and much to learn, achieve and gain for all involved in co-production.

The Co-production Police and accountability

By Kevin Minier, carer. 

Many of us have been heavily involved in ‘co-production’ activities where we were:

1. not involved until the end (rubber-stamp or not as the case may be)
2. the solution has already been decided
3. your suggestions do not fit the current model and so are rejected
4. you thought you were listened to but none of it appears in the final service
5. you were ‘consulted’ and you never hear of it again
6. they did not even offer you travel expenses let alone an attendance fee
7. they gave you two days notice, the times were impossible due to your other commitments, and they would not even provide lunch
8. the venue did not consider physical access or sensory requirements
9. you noticed that key stakeholders were not present or even invited
10. you noticed that key comments were not documented - ignored.

We need Co-production Police.  A best practice checklist for TRUE co-production.  Everybody involved in a ‘co-production’ activity could score against this checklist highlighting to the service provider the effectiveness of their co-production process.

Name and shame – if necessary.

There is a call for better patient and public involvement especially in the health and social care sector.

Now is the time!

Co-production: A one-night stand?

By Laurence Clark, comedian, writer and actor who has cerebral palsy

I’m excited to be performing at SCIE’s Festival of Co-production on 7th July.  I first came across c-oproduction when I was working on a project with Trafford Council for Breakthrough UK about ten years ago.  It was explained to me as follows:

• Consultation is a one-night stand
• Co-production is a long-term relationship.

I’ve used this definition whenever asked ever since!
At the festival I’m going to perform an extract from my new stand-up comedy show Independence which is going to be at the Edinburgh Fringe festival from 3-28 August.

Independence is somewhat of a hot topic at the moment, whether it’s the EU referendum or Scotland.  But this show isn’t about either of those things, because that would be a bit dull.  Instead it’s about what independence means to me.  As someone who has used self-directed support for all of my adult life, for ages I’ve wanted to do a show about my experiences.

Also independence often gets misunderstood by the general public.  It’s not about doing everything yourself because, for someone like me that’s never going to happen.  You might as well ask me to solve world hunger as tie my shoelaces.  Both would take me the rest of my life and end in abject failure!  But it’s not the stuff I cannot do that frustrates me, it’s the myth that it’s not OK to ask for help.  After all, as John Donne once wrote “no man is an island”, except the Isle of Man!