Page 11 - TalkCare_Issue5_Online.qxp_OACP Talking Care Issue 4 July 2017
P. 11

 The theory is good, but how does co­production work in practice?
I believe co­production should:
• Treat everyone as equals with an
equal voice
• Recognise people as assets rather than passive recipients of services
• Foster a spirit of collaboration and mutual support to co­design services and bring about system change
The group was made up of people from areas such as finance, IT, clinicians, administrators, service users and social care, all walks of life.
This was a huge learning curve, not just for me but also because it was a new way of working for the CCG to share and develop the skills that could be taken forward to help and support others.
In the process, the so­called experts became facilitators and there was a cultural change as patients and professionals became true equals.
“It was an empowering experience and I wanted others to have that measure of control over their own treatment, with their lived experience taken into account, not just their condition. It’s the whole person approach”.
Working with C4CC has helped broaden my experience and horizons and also strengthened my belief that all public services, but in particular the delivery of health, can be improved by using the principles of co­ production.
Its origins date back to the late 1970s and research done by Elinor Ostrom and a team at Indiana University into soaring crime rates on the streets of Chicago, where the police force had become increasingly alienated from the public.
Ostrom recommended that the police should forge closer ties with communities by forsaking their patrol cars for walking the neighborhoods and having a more visible presence.
She argued that the police and the community had a shared interest in reducing crime rates and were mutually reliant on each other to achieve that goal.
The term co­production was used to describe this new relationship and the ideas generated by that early research have since been used in many areas of public services in many countries.
Its application within health and care has gathered pace in the UK since the mid 2000s, initially driven by disability and mental health rights groups, but now accepted as good practice across a whole range of other settings.
With the government and all the major political parties calling for the integration of health and social care services, the case for co­production and the innovative thinking that underpins its principles has never been stronger.
We all need to work collaboratively and develop a shared culture within health and social care to help collapse the artificial divide between the two.
The health system will work much more effectively and use less scarce cash and resources if it utilises the assets of the very people it is treating, through more person­ centred care.
It needs to draw on their energy, wisdom, experience, knowledge and skills – and the relationships between them – love, empathy, watchfulness, care, reciprocity, teaching and learning.
I see the core principles of this approach to be similar to the operating system of a computer, the platform on which all public services run to the benefit of society should be based, putting the user first.
C4CC is a relatively small organisation but its arguments are carrying greater weight among policy makers, with the NHS Five Year Forward View (FYFV), recognising the value of people and communities being given a real say in shaping services.
The FYFV talks about empowering people to participate in the NHS as a social movement and to involve them in discussions about care planning.
It is an acknowledgement that the co­ production model has the potential to work for everyone, whether for the individual or at local, regional or national levels.
Myself and other members of the C4CC co­production group, who also have complex health problems, are living proof that such approaches can change lives for the better. Co­production is not just a word, it's not just a concept, it’s a meeting of minds coming together to find a shared solution for the benefit of all.
In practice, it involves people who use services being consulted, included and working together from the start to the end of any project that affects them.
Co­production enables citizens and professionals to share power and work together in equal partnership, to create opportunities for people to access support when they need it and to contribute to social change.
A way of working whereby citizens and decision makers, or people who use services, family carers and service providers work together to create a decision or service which works for them all.
The approach is value driven and built on the principle that those who use a service are best placed to help design it.
Society needs to find a way to ensure that people have the right support, knowledge, skills, power – and of course confidence to play their part.
         To lean more about The Coalition for Collaborative Care (C4CC) and Co­production visit:
   Seven practical steps to make co­production happen in reality:
Use open & fair approaches to recruit
a range of people who use health and care services, carers and communities, taking positive steps to include under represented groups
Identify areas of work where co­production can have a genuine impact, and involve citizens in the very earliest stages of project design
Train and develop staff and citizens, so that everyone understands what co­production is and how to make it happen
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Get agreement from senior leaders to champion co­production
Put systems in place that reward and recognise the contributions people make
Build co­production into your work programmes until it becomes ‘how you work’
Regularly review and report back on progress. Aim to move from “You said, we did,” to ”We said, we did”

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