Co-production

What is Co-Production?

Co-production works in collaboration with the delivery of public services with people rather than to them, enabling individuals to become effective agents of change. Co-production is the basis of forming an equal relationship between professionals, the people using the services, their families, and carers. Co-production recognises the contribution of individuals towards the creation of sustainable health and social care opportunities.

Co-production breaks down barriers between service users and staff, builds on an individuals’ existing capability and builds on concepts of reciprocity and mutuality meaning that individuals get something back for the effort they put in, with everyone working together to achieve a shared goal.

Here is a useful definition from the Co-production Network for Wales: ‘Co-production is an asset-based approach to public services that enables people providing and people receiving services to share power and responsibility, and to work together in equal, reciprocal, and caring relationships. It creates opportunities for people to access support when they need it, and to contribute to social change’.

Rationale

The Care Act 2014 is one of the first UK legislations to include the concept of co-production as part of statutory guidance and co-production is one of the main principles of the Social Services and Well-being (Wales) Act 2014. The legislation states that ‘Local authorities should, where possible, actively promote participation in providing interventions that are co-produced with individuals, families, friends, carers, and the community.

‘’Co-production’’ is when an individual influences the support and services received, or when groups of people get together to influence the way that services are designed, commissioned, and delivered.’ Although this definition refers to influencing support and services, co-production refers to doing with – in an equal and reciprocal partnership, doing for – engaging and involving people and doing to – trying to fix people who are passive recipients of service. Co-production focuses on the best approach for person-centred care within the community and on the assets of individuals on how best to support a patient/person or organisation. It involves healthcare professionals understanding the needs of
patients and engaging with them when designing and delivering services. It is a positive approach and focuses on patient strengths rather than limitations.

When to use Co-Production?

Co-production across the NHS refers to involving patients, their families, and communities in designing and delivering healthcare services. It is used in situations where healthcare providers recognise that they need to work in partnership with patients and service users to develop and deliver effective quality care.

Co-production can be used in various healthcare settings, such as in the:

Development of healthcare policies and/or services
Service redesign
Provision of care

For example, it may be used to:

Improve the design of healthcare services to ensure that they meet the needs of patients and their families.
Encourage patients and service users to become more involved in their care., recognising their knowledge and experience of their personal situation or condition.
Develop healthcare policies that reflect the views and experiences of patients and communities.
Empower communities and patient groups to develop their own healthcare services and initiatives.

Overall, co-production is used when there is a recognition that involving patients and communities in healthcare decision-making can lead to better outcomes for all parties involved.

The Benefits of Co-Production

Co-production is built on the concept that people who work in services and those who use services are the best people to suggest improved ways of working together. There is strong research to suggest that taking participating in co-production has a wealth of benefits for health and social care organisations (Mockford et al, 2012).

Increased engagement and social capital
Genuine empowerment and ownership
Improved health and wellbeing
Stronger, more cohesive communities
More relevant and effective services
Sustainably and value for money

How to use Co-Production?

Co-production in healthcare involves working in partnership with patients, their families, and communities to design and deliver healthcare services. For co-production to become embedded in our working practises we will need to create a culture of positive behaviours and values to provide a foundation for co-production to flourish.

A culture of ownership, shared understanding, openness, transparency, commitment, clear communication, and respect for both patients and staff need to be present. A change in culture may be necessary to pursue co-production and the support of management teams is vital. Once this culture has been established, we can start to work towards co-production in health and social care. Here are some steps to follow when using co-production in healthcare:

Identify your goals	Begin by identifying your goals of co-production. What do you hope to achieve by involving patients and communities in the design and delivery of healthcare services? This could be anything from improving patient satisfaction to increasing the effectiveness of healthcare services.
Identify your stakeholders	Identifying your stakeholders who will be involved in the co-production process. This could include patients, their families, healthcare providers and community leaders.
Develop your plan	Develop a plan for how the co-production process will be carried out. This could involve setting up a steering group or conducting focus groups or interviews with patients and community members, holding workshops or other collaborative events.
Engage your stakeholders	Engage your stakeholders in the co-production process. This could involve reaching out to patient and community groups, healthcare providers, and other interested parties to gather input and feedback on the healthcare services being provided to them.
Co-design and co-deliver	Co-design and co-deliver healthcare services provided. Work collaboratively with stakeholders to develop and implement healthcare services that meet the needs of patients and their families.
Evaluate your learning	Evaluate the co-production process and learn from the experience. This could involve conducting surveys or focus groups to gather feedback from patients and community members, as well as healthcare providers, and using this feedback to improve the co-production process moving forward.

Overall, co-production involves working collaboratively with patients, their families, and communities to design and deliver healthcare services that meet their needs. By involving stakeholders in the process, co-production can help to improve patient satisfaction, increase the effectiveness of healthcare services, and ensure that healthcare services are delivered in a way that is inclusive and equitable for all.

The Co-production Ladder

Helpful tips

Be transparent and inclusive: It is essential to be transparent and inclusive when implementing co-production. This means involving patients, their families, and communities in all stages of the co-production process, from planning to delivery. It also means being open and honest about the goals of co-production and the roles that stakeholders will play in the process.

Emphasise shared decision-making: Co-production is all about shared decision-making. It is important to create a culture of collaboration and inclusivity, where patients and their families are seen as equal partners in the design and delivery of healthcare services. This involves valuing their input and feedback and empowering them to make decisions that affect their own care.

Measure impact and celebrate success: Co-production can be a long and challenging process, but it is essential to measure the impact of the co-production process and celebrate its successes. This can help to build momentum and support for future co-production initiatives. It is also important to acknowledge and learn from any challenges or failures encountered during the process, and to use this knowledge to improve future efforts.

Additional resources

Visit our website or email us at improvementcymruacademy@wales.nhs.uk to find out about the improvement courses we can offer.