The power of co-production

We are pleased to share this Housing LIN guest blog by Debra Edwards, a co-production champion for TAPPI, which was originally featured as an article in Care Management Matters on July 4, 2023.

In a previous life I was a midwife for the NHS – a job I loved. But in 2012 lupus and rheumatoid arthritis meant that I could no longer work. Two years later I had major spinal surgery and I’ve been a wheelchair user ever since.

As someone with a health professional background and a disability, it’s been interesting (and sometimes frustrating) to observe how the care, health and housing worlds try to support individuals like me.

You don’t go through something as life changing as spinal surgery without it affecting you mentally. I had a breakdown and was admitted to a mental health unit but had to wait three days for an accessible room. It turns out that mental health facilities don’t always cater for physically disabled people.

Once I was discharged, I regularly met with different health and social care teams. On most occasions, I would have to repeat my story but, on the days I felt low, I would leave things out – I didn’t always have the energy to start from scratch.

The biggest shock was the limited choice I had around my own care. People often made decisions for me, rather than with me. They would tell me what care I needed rather than listening to my preferences and it felt like everyone had a say in my life apart from me.

In late 2016 I began volunteering and was asked to be an ‘expert by experience’ by a local mental health trust. They wanted to restructure their pathway with people who had lived experience.

I jumped at the chance and we began co-production – a process that’s all about sharing power and decision making equally with people who draw on services. The team listened to my story, took notes and responded to our feedback.

The whole experience felt empowering and meaningful and the next time we met things had changed. They had put a passport system in place where your story goes before you as you move around the mental health system. By them involving us, we had changed the experience for others.

Last year I got involved in co-production again, this time around housing and care. I live in a supported housing scheme in North London and Haringey Council, which manages the scheme, asked me to become a co-production champion for Technology for our Ageing Population: Panel for Innovation (TAPPI). The project is all about identifying how technology can help senior citizens to lead the life they want.

Over the past 12 months, I’ve worked with Haringey Council to introduce technology to senior residents. Darshan Savani, TAPPI Project Manager in the adult transformation team, has listened to me and other residents and he is now acting on our suggestions.

Being involved has led me to reflect on the ingredients that make co-production a success. I want to spread the word so other organisations can effectively design and deliver care and housing services in partnership with the people they support.

Lay the foundations

Like most things in life, co-production must have principles. If these are respected by everyone involved, there is more clarity and co-operation from the start.

The Social Care Institute for Excellence has developed some useful values for putting co-production into practice:

Equality (everyone around the table is treated the same).
Diversity (no one is stopped from taking part because of their race, gender, age, sexuality or disability).
Reciprocity (if you put something in, you get something out).

Accessibility (making sure everyone can take part. This might mean using clear language, holding events in accessible venues, having shorter meetings or more breaks, putting support in place for people who aren’t familiar with video meetings, and taking things slowly).

Give yourself time

The TAPPI co-production champions group that I am part of is made up of male and female senior citizens, disabled individuals and also staff from the housing and care organisations involved. We wanted to put a really representative group in place, but it wasn’t easy. It has taken months to recruit, brief and build trust and understanding. Bear this in mind as you set out on your co-production journey.

Clarify your aims

Be intentional about why you are co-producing. What outcomes are you hoping to achieve? What will happen if you get unexpected results? Remind people of your aims at the start of each co-production session and take your time so everyone understands the purpose and scope. Revisit these aims at the end to see if they have been achieved.

Make it meaningful

Co-production is a buzz word but sometimes it’s done in name but not in practice. For example, residents might be consulted on the development of a service, but not equally involved in its creation, from the start.

When co-production is just a tick box exercise, it can breed ill feeling between professionals and residents and there might be an unwillingness from residents to participate in future projects.

Pay participants

If residents are sharing decision-making with care professionals, they should be financially rewarded. This ensures people feel valued and helps to create equity amongst everyone.

Get facilitation right

I’ve seen, first hand, the skill it takes to facilitate co-production sessions. Working with Co-production Works during the TAPPI project, they have spent so much time building relationships with we champions, making sure everyone has a chance to voice their views, keeping the group focused and clear but also feeling valued and heard. Think carefully about who will facilitate your sessions and the skills required.

Change workplace culture

Holding a co-production exercise is a good first step but look at how you can embed equal partnership working within the culture of your organisation. The principle of being inclusive and valuing the unique contribution of people with lived and learned experience should be threaded into strategy, leadership, governance, behaviour and skills.

I strongly believe that getting co-production right will benefit not only the people who draw on your services, but your staff and your business as a whole.

Find out more about co-production at https://coproductionworks.co.uk/ (opens new window)

For more information on the TAPPI project, visit https://www.housinglin.org.uk/TAPPI (opens new window)