Part 3. Doing co-production

Co-production will look different depending on the kind of organisation you’re in, what your role is, and how much scope you have to influence the shape of services or strategy. There may be systemic barriers to implementing co-production as widely as you wish to, but there is usually something you can do co-productively wherever you are. Some co-production is always better than none, and it all counts.

Like we’ve said before, co-production is an approach and a way of thinking, so it’s not a process as such with a set number of steps to do in the “right” order. However, we can offer some pointers and things to consider to help you get started - with the caveat that they are presented in an indicative order, but you will keep revisiting them all as you develop your co-production practice. If you are already doing co-production, this might offer some additional ideas! The key is to keep checking in with the 5 values of co-production in whichever context you operate in. Below we consider what this might look like at the three levels of co-production. 

Individual co-production

If you can influence how you (and maybe your team) do your job, then you can embody the values of co-production in the way you deliver your service, through relational interactions with service users, patients and unpaid carers. 

• Valuing all participants, and building on their strengths: 
  • You look for and recognise the strengths, knowledge, ideas and experience (lived or professional) that people have to contribute, whether they are on your staff team or they are service users and unpaid carers who you support.
• Developing networks across silos: 
  • You help people become part of supportive peer networks and broaden their horizons by connecting with groups, activities, or other organisations that can contribute to supporting them.
• Doing what matters for the people involved: 
  • Your work is shaped around what matters to the individual. You ask how people are doing, what solutions they have already thought of,  and what a good outcome looks like for them, before you decide what’s best for them. 
• Building relationships of trust and sharing power:
  • You take the time to build connection, trust and understanding. Even when time is tight or you might only meet a patient or an unpaid carer once, you can take a relational approach by listening deeply and engaging in dialogue, demonstrating that they matter and that you value this moment of connection.
• Enabling people to make change happen:
  • You see your role as enabling people to change, not simply delivering a service.

Individual co-production happens mainly in the moments of interaction with your service users, patients and unpaid carers. It might feel simple and small, but the effects are powerful and important.

It might be helpful to think of individual co-production as a set of life or work practices, a bit like exercise; we don’t ask, “When will I be in shape and can I stop exercising? The human body never seems to get healthy." Likewise, co-production isn’t a to-do list item or a project that finishes, but it doesn't mean we can't get in better shape (personally, professionally, as a service, as an organisation and as a society).

Group co-production

If you can influence how your service functions and delivers to its objectives, then you can shape a service built on service user, patient and carer experience, by bringing a group together to co-produce your service design (or improvement or transformation). 

• Valuing all participants, and building on their strengths: 
  • You find ways to use and develop the assets and resources that are present in your teams; in your service users and unpaid carers; and in your networks and their communities. This will contribute to building everyone’s confidence and capacity further.
  • In practice, you might want to start by mapping who and what you know.
    • Map who and what you know (guidance)
    • Stakeholder mapping (pdf template)
  • Developing networks across silos: 
    • You help people to make connections with other actors, stakeholders, communities, groups or networks, by bringing together a multidisciplinary team of stakeholders from a range of backgrounds and experiences. 
    • In practice, here are some pointers about inviting people to join your co-production group.
      
      • Invite people to join you
    • Doing what matters for the people involved: 
      • You focus on creating good outcomes (the difference your work makes in someone’s life) more than on outputs (what you did and how much or often). To find out what these outcomes are, you start with creating dialogue, and you listen to those who are not usually heard in these contexts.
      • In practice, there are a few key questions you want to weave into the dialogue.
        • Listen out for ideas and strengths
    • Building relationships of trust and sharing power:
      • You respect everyone’s perspective and the value they bring to the table.
      • For people to trust you, you need to demonstrate trustworthiness. It’s up to you to show up, think with empathy about people’s experience in this group and challenge, close communication loops and tell people what’s happening as a result of their involvement. Don’t be a bad friend who only gets in touch when they want something!
    • Enabling people to make change happen:
      • You help people to build the life they want by enabling them to take action.
      • You enable your team and colleagues to work in a person-centred way.
      • You keep working on your mindset and values, and on how you understand (and relate to) power.
      • You learn that YOU don’t have to fix everything. (We’re trained to take responsibility, but this also disempowers others if we don’t let them do their share.)
      • You learn to say, “I don’t know. Let’s figure it out together.”; to show up with questions instead of answers; to bring the things only you can do, and to look or listen for the things only others can do, adding to your collective strength. 
      • You learn to show up with curiosity, compassion, empathy, kindness - towards others and towards yourself.

Group co-production holds the potential to transform services, outcomes and lives. If you’re being tokenistic you will not only waste everyone’s time (both professionals, and service users and unpaid carers), but also damage relationships, trust and goodwill towards any future participation or involvement endeavours. Make sure that if you’re embarking on a co-production process, you’re doing it for real, not for show; and that you are committed to act on the group’s findings.

Strategic co-production

If you can influence how your organisation operates and meets its statutory duties, then you can create a culture that puts service user and unpaid carer voice at its heart, by establishing policies and governance processes that foster co-productive behaviours across your organisation.

• Valuing all participants, and building on their strengths:
  • You demonstrate that you value everyone’s contribution, and you ensure everyone’s voice is heard.
  • For example, you make sure you provide your service user and carer co-producers with the support they need to take part fully; you have ground rules and you call our behaviours that fall short of respecting and valuing their presence and contribution. 
• Developing networks across silos:
  • You use networks to make positive change happen.
  • Connecting professionals with service users and unpaid carers creates shared understanding, increased insights, and innovation. You could set up service user and carer groups to maintain these connections on an ongoing basis.
• Doing what matters for the people involved:
  • Your monitoring and evaluation systems include measuring the good outcomes as defined by your service users, patients and unpaid carers; and they are a part of the process.
• Building relationships of trust and sharing power:
  • You ensure your approaches, systems and structures enable and encourage people to build connection and trust, and lead to shared decision-making. 
• Enabling people to make change happen:
  • You work in partnership with the service users and unpaid carers you support to co-commission, co-design, co-deliver and co-evaluate your services. For example, they are part of boards and steering groups.

Change at strategic level doesn’t happen overnight, but remain alert to the signs of co-production that you can nurture and develop. Strategic co-production creates frameworks that enable more group and individual co-production to take place, instead of practitioners having to find ways to co-produce in spite of the system they operate in.

Building your co-production plan

Now you’ve read through what co-production looks like at individual, group and strategic level, you will have a clearer idea of where your work and potential co-production projects sit. You may want to think through translating the values into actions in your specific context, which you can do on your own as a thought experiment, or as a team with your colleagues.

• You can download this canvas on a pdf template to print in A4 or A3.

As a follow-up, you might like to:

• Discuss what you've been learning with your team.
• Watch these short videos from the Scottish Co-production Network:
  • ‘Better chance than that’ (1’30”) about change led by people recovering from addiction; 
  • ‘My Opinion’ (2’15”) in which Jamie, a parent with learning difficulties, tells what it feels like when citizens aren't taken into account in service design and delivery;
  • ‘The F Word’ (1’20”) about not getting it right the first time and learning from “failure”. 
• Check out the National Principles for Public Engagement in Wales on the Third Sector Support Wales website. (A login is required to access the resources but registration is free.) These are useful guidelines for behaviours and practical approaches to deliver great person-centred engagement and co-production. 
• Meet as a team and fill in your co-production action plan canvas together.