Is the sector ready for co-production, asks Alistair Sinclair.
‘Co-production is an idea whose time has come,’ states Right here right now: taking co-production into the mainstream, a New Economics Foundation (Nef) and NESTA report on how involving users in the design and delivery of services is the way ahead for public services. ‘The idea, put simply, is that people’s needs are better met when they are involved in an equal and reciprocal relationship with professionals and others, working together to get things done,’ it says.
Is ‘recovery’ ready for co-production? I considered this question a few weeks ago while attending a recovery conference hosted by Derbyshire Healthcare NHS Foundation Trust in partnership with Phoenix Futures. A wide range of professionals and people from the UK recovery community gathered to share some of their knowledge and experience and talk about the assets that exist within services and communities.
Delegates heard from Professor John Strang of King’s College, London, Phoenix Futures chief executive Karen Biggs and Seamus Watson, national programme manager for wellbeing and mental health at Public Health England. Themes included the individual nature of recovery, the need to improve treatment and recovery rates and the importance of engaging in ‘conversations’ with service users, families and communities.
The conference was a ‘fantastic opportunity for individuals and groups to demonstrate their passion, motivation and drive to champion recovery – not as a buzzword but as an individual journey that services must support and be focused on,’ said deputy chief executive of Derbyshire Healthcare NHS Foundation Trust, Ifti Majid. ‘Some fantastic examples of what works and what doesn’t were showcased and discussed. The energy in the room was palpable.’
There was a real sense of a shared enthusiasm for change and for doing things differently, and the importance of quality of life and community in the initiation and sustaining of recovery was stressed many times. Though the word was never used, it felt – with all the reference to assets and engaging with the community – that what many people were perhaps talking about was the need for ‘co-production’ and a greater recognition of the importance of the ‘core economy’.
‘Family, neighbourhood, community are the core economy,’ says Professor Edgar Cahn in the Nef manifesto. ‘The core economy produces love and caring, coming to each other’s rescue, democracy and social justice. It is time now to invest in rebuilding the core economy.’
I believe that the Derbyshire Trust, in its drive to establish a strategy for ‘whole system’ recovery orientation, its commitment to recovery awareness training for all trust staff and its intention to establish 90 ‘recovery guardians’ is beginning to explore what co-production means and its central role within recovery-oriented services. We are seeing similar beginnings in many other services but there’s a long way to go and there’s always the danger of buzzword substitution, something we’ve already seen with ‘recovery’.
As another Nef document states, ‘If we get it right, then co-production will help rebuild public services as equal and reciprocal partnerships between professionals and the people they serve. If we get it wrong then we may see the post-war welfare state dismantled without sustainable alternatives, while citizens – especially those who are poor and powerless – are left to fend for themselves.’
If you’d like see a real attempt at a bottom-up approach to co-production you could start small (but beautifully formed) and pay a visit to the Recovery Initiative Social Enterprise (RISE) in Kingston-Upon-Thames. This community-led enterprise has been quietly developing an approach to co-production that may well see them established as the backbone to a recovery revolution in Kingston.
I attended a RISE co-production workshop last month and heard how they were working on equal terms with local services, academics, clinicians and the community to establish something new – an integrated community-led model which will bring recovery, asset-based community development and co-production principles together to create RISE Community CONNECT, its explicit aim being to ‘tackle poverty and inequality through access to community and education’.
As Elvis Langley, an independent consultant who has been involved with RISE since its beginning said at the workshop, ‘Service user involvement is not co-production, consultation is not engagement. Co-production provides opportunities for personal growth and development to people, so that they are treated as assets, not burdens on an over-stretched system.’
We live in interesting times. The demands on the welfare state are not going to diminish and it will increasingly struggle to provide care to those in need ‘from the cradle to the grave’. As austerity continues to bite we are faced with a stark choice – we can sit and agree that times are awful and ‘somebody should do something about it’ or we can look to the neglected ‘core economy’ – our community – and begin to rebuild and recover.
Another report from NESTA and Nef, Public services inside out, published in 2010, outlined a co-production framework with the following key characteristics – recognising people as assets, building on people’s existing capabilities, promoting mutuality and reciprocity, developing peer support networks, breaking down barriers between professionals and recipients and facilitating rather than delivering. Recovery in the community has been developing within this framework for quite some time. Perhaps it’s time for services to catch up? DDN