We're looking forward to the eighth national Co-production Week from today.
Co-production is about working in equal partnership among people drawing on services, carers, families and citizens. It's about putting people with lived experience at the heart of the decisions that are made about them. It's the right thing to do. If your council doesn't embrace co-production in adult care and support services, it means you are probably missing a chance to get it right when it comes to improving people's lives.
Building on our bespoke support to local authorities on co-production including in preparation for Care Quality Commission assurance, we were funded by the Department of Health and Social Care to run a major survey on co-production in the UK. It's a big survey in that nearly 1,000 people took part; that's both people with lived experience and also people in the social care workforce. The good news is that 72% of the workforce and 56% of people with lived experience have heard about co-production. It's more than encouraging that so many in the care workforce recognise and embrace co-production.
Managers and frontline
However, dig a little deeper and you find some interesting results that present challenges, especially to local authorities who feel that they're ‘doing' co-production well. For instance, our results reveal that leaders and managers have different views and experiences of co-production, compared to those on the frontline. We found that most senior managers thus those with the least exposure to frontline working, have a much better knowledge of co-production than those working in direct care delivery. It wouldn't be unrealistic to wonder if this should be the other way around.
One respondent told us: ‘At the moment people can throw the word [co-production] around without any real meaning'. It looks like something needs to be done about this disconnect. A third of workers state that the organisational culture of their place of work can be a barrier to successful co-production. In fact, we've found instances of misinterpretation of what co-production is or involves, particularly from staff in direct care roles. Some consider co-production to be the same as person-centred care, interprofessional working, and integrated care. These are important things but they're different from co-production.
Lived experience and co-production
We heard this from someone with lived experience who completed our survey: ‘Co-production's important to me because I am the one that knows what I need to live my life. I should get to influence, shape, and decide on how my care is delivered, when and how and by whom'. We found that 59% of people with lived experience report having had opportunities to be involved in co-producing their own care and support, whilst only 37% have been involved in co-producing services or policies. Food for thought for commissioners. Of the former group, almost a half say that this has positively affected their care and support. So, it's going in a good direction for some, but more can and must be done.
Disillusionment and barriers
Many respondents – both in the workforce and those who draw on services - spoke of a sense of distrust and disillusionment with co-production, saying it can become diluted and lose its meaning. Others voiced experiences of ‘co-production for the sake of co-production', describing it as a box-ticking exercise or commenting on staff within social care only paying ‘lip service' to the approach.
Key barriers experienced by social care staff, when implementing co-production, are time (reported by 47%), organisational culture (31%), cost (26%) and communication (25%). However, results suggest that when workers in the public sector have good opportunities for partnerships with people with lived experiences, then co-production is more likely to happen.
Calls to action
Following analysis of the data and working in partnership with members of the National Co-production Advisory Group and SCIE's Co-production Steering Group, we have drafted a number of recommendations to see co-production more securely embedded in care services. For instance, there is a need to prioritise comprehensive co-production training, particularly on co-production, for every staff member working in adult social care. This can empower them with the knowledge of co-production, what it is and how to apply it across diverse roles in the sector.
However, staff working in adult social care need sufficient resources to do co-production effectively, and meaningfully. To avoid instances of misinterpretation and misunderstanding, a consistent definition of co-production needs to be shared widely. Other recommendations include sharing practical examples that bring the skills, values and behaviours of co-production, to life. All of the ‘Calls to action' feature throughout our report align with their respective sections to emphasise their significance and relevance.
This Co-production Week we've heard from many organisations, from Wigan to Hampshire and from Northern Ireland to Liverpool, about the amazing things that providers are doing during the week. Yet co-production isn't just for Co-production Week, and SCIE will continue to offer support to local authorities who would like assistance with coproduction, working alongside organisations continuing to put people with lived experience at the heart of designing, delivering and evaluating the services that they draw on.
Kathryn Smith is chief executive of the Social Care Institute for Excellence
