Co-Production: Good Idea or Swear Word?!
The focus was on how communities in West Norfolk and the people who make decisions about health services can work together. This is in response to the imminent co-production way of commissioning and delivering health and social care in the region. Co-production recognises that the lived experience of those who use services is a valuable resource when designing and delivering services. Professionals and users both have expertise and while this expertise is different both are equally valuable.
David Cameron has been quoted as saying the following about co-production:
“The public become, not the passive recipients of state services, but the active agents of their own life. They are trusted to make the right choices for themselves and their families. They become doers, not the done-for.”
The more I learned about co-production the more I could see similarities with the social model of disability. The social model shifts policy away from a medical/charity/care agenda into a rights led/equalities agenda.
In the differing medical model disabled people are split for convenience into medical groups and doctors know best and tend to be the gatekeepers and adjudicators for resources
There is also a similarity between the medical model described above and the ways in which health and social care has historically been. My grandparent’s generation would be far less likely to challenge the judgements of health care professionals. They arguably had a greater trust in ‘experts’ to ‘know best’ and had no opportunity to contribute.
However, much has changed in recent years, including demand of services and rising expectations. Another notable change is that we tend to see ourselves as consumers of services.
The event introduced the notion of co-production. Speeches were given by a user who has contributed her lived experience to influence services and a local Head of Integrated Services. There were opportunities to network and explore what skills and experiences participants had to contribute to a co-production environment.
The final activity of the day was several group SWOT analysis exercises. Interestingly, all groups came up with as many Strengths and Opportunities as they did Weakensses and Threats to working in this way to deliver and commission services in the area.
There was some healthy scepticism in the room but the amount of participants who put themselves forward to be Community Voice Representatives in the future far exceeded our expectations. Those selected will be tasked with seeking the views of the community and give them a voice when health and social care decisions are made.
Even the sceptics agreed in the principles of co-production, their trepidation was more about whether it will work in practice. A fair comment as this is going to be a massive challenge. At a time when public services face enormous challenges, perhaps a new approach may prove to be what is required?
It is early days for this region to work in this way, but what struck me was that co-production was already some sort of swear word! Many people had a real aversion to the word which I can only attribute to the recent use of it by politicians and policy makers. I have since found out that the word co-production was first coined about four decades ago. So, while the word seems new to our vocabularly and a buzzword to politicians it is actually not that new. It doesn’t seem to have taken long to go from buzz word to swear word! For me, the most important thing is that everyone supported the principle.
Whilst not underestimating the scale of the challenge, and assuming it does what it says on the tin, co-production can only be win/win if all involved embrace it and work together.