How I see co-production

By Alex Fox, CEO of Shared Lives Plus and SCIE trustee

Featured article - 21 July 2016

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Coproduction is a clunky piece of jargon for an important concept. There are lots of good definitions out there. Personally, the way I think of coproduction is that it is about everyone who is involved in a service or organisation, including those who use it and their families, making decisions together as equals, and then working together as equals to make those decisions happen. A truly co-produced service is co-designed with full involvement of people who use it and families from the blank sheet of paper stage, it employs people with current or recent lived experience in paid delivery and leadership roles and there are elected representatives of those people on its board.

There is lots which is co-produced about the sector in which I work, but at Shared Lives Plus, we felt and still feel that we have a lot further to go.

Shared Lives is a family-based way of providing people with learning disabilities, mental health problems and other support needs with the care and support they need in ordinary households. People are carefully matched with approved Shared Lives carers and when both parties feel there is a good match, they share home and family life, with 7,000 people living with their chosen Shared Lives carer as part of the household and 6,000 regularly visiting their Shared Lives carer for short breaks or day support.

So each Shared Lives arrangement is co-produced by the individuals and families involved. What people decide to do with their time together and how they live their lives is based on a care plan, but worked out day to day by the individual and their Shared Lives carer. Like any family life, it involves negotiation and give and take. Chris says: “I go to more places than before, like we just went to Brighton – I couldn’t do that before, there would be a lot more people involved and a lot of planning. Our trip to Rome would have taken much longer to plan for example. In residential I couldn’t go out to a club without having to do a risk assessment and care plan. I feel happy living here. A lot happy. I have independence but also care when I need it.”

We felt though, that the highly co-produced nature of individual arrangements was not reflected in our work to support the sector at a national level. So we are supporting and encouraging Shared Lives schemes to build independent local groups of people involved in Shared Lives who can help make local decisions and, inspired by the work of CHANGE, we have employed seven (very) part time Ambassadors, all of whom have current or recent experience of using Shared Lives. The Ambassadors speak publicly about Shared Lives. They are drafting a Charter setting out what good Shared Lives looks like, which we will be encouraging all local schemes to adapt and adopt with local people. They are also taking part in reviews of Shared Lives schemes.

The biggest impact we have felt as a team is that a group of people who we might previously have thought of primarily as ‘service users’ are now our colleagues. Some need support to take part in our work, but they expect to be treated as colleagues. The whole team has had disability awareness training and we have all needed to think about accessibility in team meetings and the rest of our work. For most of the Ambassadors, this is their first job, so they are learning what is expected and exploring their potential as their confidence grows.

As a SCIE trustee I have seen how co-production can be built into a board and I’ve been able to learn from members of the SCIE co-production network, as well as from the co-produced nature of the Think Local, Act Personal partnership, which SCIE hosts.

It’s easy to see the extra time and resources needed to co-produce as a nice-to-have rather than as essential, especially when money and time are tight. But public service sectors are locked in a cycle of rushing urgently towards poorly thought-through goals, which fail only to be replaced by the next set of ‘reforms’. I am increasingly convinced that co-production is the only way off that merry-go-round.

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