Everyone is talking about co-production but exactly what is it? This section briefly describes the co-production approach of Co-production Works.
Co-production has become the default term for describing activities that involve citizens working with professionals to improve public services.
Co-production builds on and is related to citizen participation, public engagement, service user involvement and self-advocacy.
The Co-production Works approach to co-production is rooted in the Disabled Peoples’ and Mental Health User/Survivors’ movements’ ideas and thinking. But Co-production Works also uses models and understandings developed by the Social Care Institute for Excellence (SCIE) and New Economics Foundation (NEF).
NEF describes co-production as ‘a relationship where professionals and citizens share power to plan and deliver support together, recognising that both have vital contributions to make in order to improve quality of life for people and communities.’
SCIE says co-production is when ‘people who use services and carers work together with professionals towards shared goals.’
Co-production acknowledges that there are power imbalances between people who use services, carers and professionals. Usually professionals have more power and resources than people who use services and carers. Co-production is about doing everything we can to make equal these differences in power.
As well as defining co-production it is useful to think of it as a set of principles. At Co-production Works we like to use the four values of equality, diversity, accessibility and reciprocity developed by SCIE.
Equality – everyone has assets
Co-production starts from the idea that no one group or person is more important than any other group or person. So everyone is equal and everyone has assets to bring to the process. Assets refer to skills, abilities, time and other qualities that people have. This is different from approaches that focus on people’s problems and what they cannot do.
It follows from the previous principle that diversity and inclusion are important values in co-production. This can be challenging but it is important that co-production projects are pro-active about diversity. It has been found in work on the involvement and participation of people who use services that some groups are under-represented or excluded from such work, and this is likely to apply equally to co-production. People who use services can be excluded because of equalities issues or because of the nature of their impairment.
Access needs to be recognised as a fundamental principle of co-production. The process of co-production needs to be accessible if everyone is going to take part on an equal basis. Accessibility is about ensuring that everyone has the same opportunity to take part in an activity fully, in the way that suits them best. As well as physical access, ensuring that information is accessible and that it is provided in appropriate formats is a key part of making sure that everyone can take part in co-production.
‘Reciprocity’ is a key concept in co-production. It has been defined as ensuring that people receive something back for putting something in, and building on people’s desire to feel needed and valued. The idea has been linked to ‘mutuality’ and all parties involved having responsibilities and expectations.
For more about SCIE’s co-production principles see: https://www.scie.org.uk/publications/guides/guide51/what-is-coproduction/principles-of-coproduction.asp
Jigsaw model of Co-production
Another useful thing from SCIE is the jigsaw model of co-production. This is a way of looking at what needs to change in a organisation or project to become more co-productive. When looking at how to do co-production, it is helpful to think about organisations being like a jigsaw with four pieces. For co-production to work effectively, change will need to happen in each piece of the jigsaw.
The four pieces of the jigsaw are:
The beliefs and values that define an organisation and the way that it works
The way the organisation is arranged and the systems it has set up to carry out its work
How the organisation and the people who work for it carry out their work
Monitoring how the work is carried out and the outcomes or impacts that result from the work.
A little history
Nobel prize winning economist Elinor Ostrom first used the term co-production in relation to public services in the 1970s:
‘We developed the term co-production to describe the potential relationships that could exist between the ‘regular producers’ (street–level police officers, school teachers, or health workers) and ‘clients’ who want to be transformed by the service into safer, better educated or healthier persons.’
Edgar Cahn, a former staffer for Robert Kennedy, developed Ostom’s ideas in his book, ‘No More Throw–Away People, The Coproduction Imperative’
In the late 1990s, the New Economics Foundation (NEF) think tank strongly influenced by Cahn, introduced the co-production to the UK. NEF developed the following six principles of co-production:
- Building on people’s existing capabilities
- Mutuality and reciprocity
- Peer support networks
- Blurring distinctions
- Facilitating rather than delivering
- Recognising people as assets
Disability and mental health user movements
During the 1990s social movements of people with mental health issues, disabled people, people with learning disabilities gathered strength. People with experience of using health services, of disability and distress got together and formed groups and organisations to support each other and to improve services.
These movements promoted a Social Model of disability and mental health. Identifying discrimination rather than individual impairments as the reason for their exclusion from full participation in society. The Social Model sees disability as something that is socially constructed. Disability is created by physical, organisational and attitudinal barriers and these can be changed and eliminated.
A social model of mental health challenges the dominant medical model which sees mental health issues as the result of bad brain chemistry or faulty genes. The social model asks not what is wrong with someone but what has happened to them. It sees mental health issues as the result of abuse, trauma and structural inequality.
The contribution of people who use services to the development of co-production is often side-lined. But co-production works best when there is engagement with user and disabled people led groups.
These organisations have a wealth of experience, understanding and networks which can be incredibly helpful to any co-production project. They can help with things like knowledge and understanding of the locality and the issues effecting people, identifying people to get involved and advice on accessibility.