Co-production shouldn’t be on Lonely Street

By Tina Coldham, SCIE trustee and Chair of the SCIE C-Production Network

This blog first appeared on a blog called Reimagining Professionalism in mental health: towards co-production

A few weeks ago, I was at an event looking at employing disabled people in the NHS, or indeed increasing the numbers of disabled people working there.

I joined a workshop which was looking at co-production in the NHS with its services users, and there were two examples from a mental health trust.  They both seemed well meaning and had good user involvement to the point that they were co-producing, which was great to see.

I sat with them over lunch and chatted some more and one of the managers, who was a unit leader and had a certain amount of autonomy in his role, said that he felt “very lonely” at times co-producing.  This stunned me, and I asked him to say more. He confirmed to me that if the prevailing culture of an organisation is not to co-produce, then those that do so are sticking their necks out.  They can become very vulnerable to criticism and lack of support as they are viewed as a dangerous maverick by others within that organisation.

I thought about why it was that I was so shocked by his statement and considered my experience at the Social Care Institute for Excellence – SCIE. SCIE was established in 2001 and produces knowledge resources, bespoke training  and consultancy for the social care world to help drive improvements in users and carers experiences of social care, for them to ultimately have a better life.

From the beginning there was a strong emphasis on involving people who use services and carers and the first Chair of SCIE was disability activist Jane Campbell, now Baroness Campbell of Surbiton.  SCIE established a participation team who were dedicated to making sure users and carers were involved in SCIE and were properly looked after in doing so.

SCIE decided that it would step up to co-produce its work with service users and carers in 2011. It stepped up its ambition for involving users and carers throughout the organisation at a strategic and organisational level, made sure there was resourcing in terms of staff and finances to do this, and began a journey of discovering of what co-production means in practice in an improvement agency trying to help the social care field up its game.

So where are we now?  One of our cores values is to co-produce, specifically to “co-produce our work with people who use services and their carers to identify what works and how that knowledge can be put into practice”. We have a co-production charter to help guide our work. We conducted a board recruitment recently, and out of four new members, three identify as disabled people.

I am a board member too and I also chair the Co-production Networkwhich is there “to support user, carer and equality groups’ involvement in SCIE’s strategic decision making and provide a pool of stakeholders which SCIE can work with to co-produce projects and programmes.”

We have a Co-production team of four within a staff group of less than 70, with a dedicated budget for its work and direct experience of mental health, disability and learning difficulties.  All staff are trained in why co-production is important to their roles, and we are now offering training and consultancy on co-production to the field from the perspective of knowing what we are trying to achieve and hoping to inspire others to work in this way.

From 4 – 8 July we are holding the first National Co-production Week, encouraging everyone to showcase their co-production work. We are also holding a co-production festival on the 7Th of July to celebrate all the good stuff happening, and also starting to draw up a co-production manifesto to get people and organisations to pledge to go the co-pro route like SCIE.

With all this going on, I hope that we can arrive at a point in future where no-one feels very lonely in an organisation when trying to work in a co-productive way.  Indeed, my challenge to you is to answer the question, “Can you give any examples of where co-production or user involvement has had a positive impact on policy or practice?”  We can then carry on the conversation together – and make sure co-production is never a lonely experience.

Co-production: Grotesqueries and Hungarian horror films?

By Penny Pepper, writer poet and performer 

As an avid movie buff, when I think of the word co-production, immediately I see flashing up in the credits - especially a 60s British horror: A Black Snake - A Red Skull – Hungarian Co-production. Yet writing this blog I can see that co production has played a crucial role in my life and my work, alongside collaboration. 

When I moved to London in 1985, a young punk, the idea of Independent Living hinged upon the reverse of co-production. To struggle alone, to surround yourself with gadgets and medical grotesqueries so you could attempt to do everything yourself. For me, this meant failure, unstable health and episodes of ongoing mental distress. Ironically my work, even then, was always approached with a sense of co-production, whether this was as a singer-songwriter, a poet or a writer. Punks were the epitome of that notion: do it yourself, collaborate, co-produce. 

As a user of Personal Budgets (PBs) and its predecessors for 22 years, I’ve always employed my own personal assistants directly. Unsurprisingly the road has been rocky as much as it has been smooth. These days those like me, who are ex ILF users, are in a stasis of anxiety that the stability of our hard-won independence erodes daily via welfare cuts. 

Approaching a care review with the concept of co-production would be welcome, but sadly my own recent experiences were alarming. The Care Act seemed to be interpreted as a means of re-animating that old style of independence, the resurrection of those grotesqueries, of physio and OT assessments. Not to create co-productive relationships as a means to independence, but cutting budgets by pushing those on PBs into ‘rehabilitation’ and the damnable Must Try Harder medical model ethic.

There is consolation. From my current PAs to work colleagues, varieties of co-production come into play for me, meaning that however impaired a current assessment procedure declares me to be I can still work as a writer and a speaker, working the well oiled co-production that is my life as a disabled creative. And thankfully – at the moment! – I can go to the toilet when I need to.

Penny’s site

Co-production and leaving care - the road to amazing

By Matt Langsford, Expert Advisor, New Belongings Project. 

Co-production has been a pivotal part of the New Belongings project to improve support for care leavers. It has co-production at the heart of everything it does and without co-production it wouldn't have achieved the amazing things it has achieve.

The guiding principles of co-production - equality, diversity, accessibility and reciprocity - have helped local authorities to make the cultural change to enable the co-production of services being delivered to care leavers.

And the benefits of this way of working couldn't be greater. The local authorities involved are now providing enhanced and more effective services that meet the needs of young people who are leaving care. The local authorities are now benefiting too: while they had to put in funding at the start to make co-production happen, they are now achieving savings and reduced costs as a result of working this way.

As a care leaver myself, I think it is imperative that the co-production of services continues on this trajectory. It's the only way to ensure that young people receive the help and support they need for them to lead successful lives and be active members of society.

I am really excited by SCIE's first ever national Co-production Week and Festival as this gives others the opportunity to learn from actual experiences of working in a co-productive way. And I believe this will inspire others to start on the journey of co- producing services with their service users.

The opportunity to celebrate the successes of co-production will give a boost to its long term success in all health and social care sectors and also to inspire others to start down the road to co-producing services.

Co-production, mental health and film-making

By Sybil Ah-mane, Flexible Films 

I first came across the word co-production about 5 years ago when working on a film with SCIE. Having been part of the mental health service user movement, I was concerned that this was another piece of jargon that wouldn't last. Five years on and I am now convinced that the concept has meaning and has been a driving force for change.

I like the idea that the notion of co-production is fluid and has scope for growth and change - it means that we are still learning and willing to adapt. To me, the main thing is that whenever you are creating something, it should be co-produced by both users and workers of services. The power should be equal which is a hard thing to create so simple things like making sure everyone is involved throughout, communication is accessible, the decision making is thought through is vital. Working in this way requires a change in culture but once systems are put in place and people realise its value, it's a fairly simple process and so much can be gained.

There has been a lot of successes in co-production - from planning architecural spaces to implementing new systems to changes in care plans. Co-production can be used in most circumstances. In fact, we are conscientious in using it in our film-making practice and have found that bringing people on board during the creative process means the films are richer and more meaningful. 

I feel a lot has changed from when I started using services 27 years ago - it's now much more about real input rather than being asked opinions that may or may not be taken up. I'm really glad co-production has helped move things on.

Flexible films 

Modelling co-production

By Patrick Wood, Patrick Wood Training & Consultancy

One of the things I like best about being involved in the SCIE Co-production Network is that SCIE practices what it preaches. There's always a danger that approaches to health and social care that seem innovative and radical at first sight become diluted or recast when powerful people and organisations get hold of them but this isn't the case with SCIE and co-production. 

I first became involved in the network through being part of the group that developed a Co-production Learning Programme for SCIE Staff. This project provides a good example of how the principles of co-production can be put into practice.

The development of the programme involved people with phsyical disabilities, people with learning difficulties, older people, care leavers and people with mental health problems working alongside SCIE staff and associates. The process resulted in a one day training programme that enabled participants to understand the principles and values of co-production and learn how to implement and embed a co-production approach in their work. 

It was a real pleasure to be involved in something that allowed people from a wide variety of different backgrounds to work together with a common aim. To enable this to happen, the project created the conditions necessary to allow for equitable relationships between all participants, which involved paying due consideration to issues like the timing of meetings, prompt payment of fees and expenses, the provision of accessible information, and modelling co-production principles and values in the way in which things were done.

Not only was it rewarding to play a part in a project that modelled co-production in action but it was also pleasing to be involved in something that made excellent use of finite resources to facilitate a productive process with a concrete and valuable end result.

SCIE - Co-production in social care: What it is and how to do it

National co-production week – nothing about us without us: 4 – 8 July 2016

By Pete Fleischmann,  Head of Co-production at Social Care Institute for Excellence

We're holding National Co-production week to celebrate good practice in co-production. As part of the week we are running a training session for people who what to find out more about co-production.  We hope that other organisations will tweet and blog about what they are doing around co-production in the lead up to the week and in the week itself.

 

My interest in co-production was shaped by my experience of mental health issues and psychiatric services. In my late teens and early twenties, I experienced a series of mental breakdowns.  In the early eighties there was no advocacy, no personalisation, no talking treatments and certainly no co-production. So I was treated with drugs and electric convulsive therapy. I had very little say in how I was treated. Though in some ways things have improved, sadly the mental health system still has a long way to go.  

I think co-production is the way forward for all social care and health services. Co-produced services have a much better chance of fulfilling people’s real needs. Co-production acknowledges the expertise of professionals but also says that the experience and knowledge of people who use services and carers is equally important.    Co-production indicates a much greater degree of equality between people who use services and professionals. It also involves acknowledging that professionals usually have more power and resources than people who use services. Co-production is about trying to equalise the difference in power between users and professionals.

Over the last few decades the disability and mental health user/survivor movements and other groups such as care experienced young people and people with learning difficulties have built up an enormous amount of expertise around how to work together in user only spaces and also how to work with professionals. I believe it is really important that the development of co-production puts at its centre the lived of experience of people who use services and carers. It is vital that we apply the principles of co-production to the development of co-production. This might sound like it is not even worth mentioning. But as with all ideas, as co-production becomes more mainstream it is in danger of becoming diluted. We cannot assume that co-production will not become tokenistic and watered down. 

One protection against this happening is to make sure disabled people, older people, people with learning difficulties and care leavers are driving the development of co-production in genuinely equal and meaningful partnerships with professionals.

I hope that one day in health and social care we will look back to the time when users and carers weren’t involved in developing and delivering services as a sort of Dark Age which now seems strange and irrational. Then co-production won’t be something special just the way things are done and it will be hard to imagine doing things differently.

More on Co-production week

http://www.scie.org.uk/co-production/week/

Introduction to Co-production training

http://www.scie.org.uk/training/co-production/co-production-introduction.asp

SCIE’s NHS accredited Guide to co-production includes 16 new and updated practice examples http://bit.ly/1xEpWA3

Co-production Week: people who use services and carers coming together as equals and they know what works well

By Cecilia Mercier, Admin Support Assistant on Co-production team

I have got a learning difficulty and I am on the SCIE co-production team. I learn a lot from my team and they learn a lot from me.

Things are busy for the Co-production team with the big Co-production week and the festival coming up. The festival, on the 7th July, is going to be an exciting, fun-filled day and it is going to be different from what we have done before.

Co-production is about everyone coming together and taking part as equals. It is about talking to different people, sharing life stories, looking at the problems they might have and working out what works well. It means that everyone has a voice and it shows that no one is better than anyone else.  

At the festival we are going to be celebrating co-production and how important it is. People should be proud when co-production is done well. Without everyone coming together services will not work well.  

Service users and carers know what works well and if co-production is done in the right way, things will work better and people are happier.