SCIE Research briefing 31: Co-production: an emerging evidence base for adult social care transformation

By Dr Catherine Needham, Queen Mary University of London and Sarah Carr, Social Care Institute for Excellence.

Published March 2009

Review date: March 2012

Introduction

The term ‘co-production’ is increasingly being applied to new types of public service delivery in the UK, including new approaches to adult social care. It refers to active input by the people who use services, as well as – or instead of – those who have traditionally provided them. So it contrasts with approaches that treat people as passive recipients of services designed and delivered by someone else. It emphasises that the people who use services have assets which can help to improve those services, rather than simply needs which must be met. These assets are not usually financial, but rather are the skills, expertise and mutual support that service users can contribute to effective public services. In the words of Cummins and Miller, co-production is about how services ‘work with rather than do unto users’.

Co-production has been the focus of much recent attention, within both public policy and practice. It relates to the generation of social capital – the reciprocal relationships that build trust, peer support and social activism within communities. Co-production is also being used as a way of talking about participation and community involvement in social care services in the context of personalisation. The Putting people first concordat asserts that the transformation of adult social care programmes ‘seeks to be the first public service reform programme which is co-produced, co-developed, co-evaluated and recognises that real change will only be achieved through the participation of users and carers at every stage’. This applies to adult social care service providers from all sectors. In proposals for new ways of organising and delivering social care services, people who use services have suggested that ‘service user controlled organisations can be a site where social workers are employed working alongside service users in a hands on way’. This encapsulates the essence of co-production in adult social care.

Given its increased profile, it is important to clarify definitions of co-production and assess its impact. Although there are no large-scale evaluation initiatives, a number of reports (from academics, policy organisations and practitioner groups) offer theoretical refinement and evaluation of practice examples, which together give some indication of the potential for co-production to be developed within adult social care. The reports also highlight potential concerns and limitations which need to be addressed when considering co-production as a way of transforming public service development and delivery, particularly in relation to adult social care.

Key messages

  • Co-production emphasises that people are not passive recipients of services and have assets and expertise which can help improve services.
  • Co-production is a potentially transformative way of thinking about power, resources, partnerships, risks and outcomes, not an off-the-shelf model of service provision or a single magic solution.
  • ‘To act as partners, both users and providers must be empowered’. Co-production means involving citizens in collaborative relationships with more empowered frontline staff who are able and confident to share power and accept user expertise.
  • Staff should be trained in the benefits of co-production, supported in positive risk-taking and encouraged to identify new opportunities for collaboration with people who use services.
  • People should be encouraged to access co-productive initiatives, recognising and supporting diversity among the people who use services.
  • The creation of new structures, regulatory and commissioning practices and financial streams is necessary to embed co-production as a long-term rather than ad hoc solution.
  • Learning from existing international case studies of co-production while recognising the contribution of initiatives reflecting local needs is important.

About the development of this research briefing

Background

Co-production is a concept and term that was introduced to UK policy in the Department of Health’s Putting People First policy for personalisation and transformation, and further developed by New Economics Foundation (NEF) (amongst other organisations).

Scoping and searching

Scoping and searching took place April to May 2008, and included international material. Key players including the Cabinet Office and NEF were consulted: policy papers were included.

Research briefing methodology

SCIE research briefing methodology was followed throughout (inclusion criteria; material not comprehensively quality assured; evidence synthesised and key messages formulated by author): see research briefing methodology for a full description.

Stakeholder involvement

The author is a topic expert. SCIE Partners' Council was consulted (day's conference), and the project overseen by Personalisation Project Advisory Group (including people who use services and carers).

Peer review and testing

Personalisation Project Advisory Group, including providers, users and carers, steered production and peer reviewed the product and key messages.