Co-production in social care: What it is and how to do it

Practice example: Action for Carers Surrey

About the project

Action for Carers Surrey was invited by Surrey NHS Primary Care Trust to join a coalition of local statutory and voluntary sector organisations, also including Surrey Independent Living Council (SILC) and Surrey County Council, to pioneer a system of direct payments for respite care for carers, using money from the National Carers' Strategy allocated to primary care trusts for this purpose.

The system was designed to help general practitioners (GPs) to decide whether a carer needs respite from their caring responsibilities. Provided the carer fulfils the eligibility criteria, the GP fills in a form online, which goes directly to SILC, the service user-led direct payments support service in the county. SILC provides the same services as it does for anyone else who receives a direct payment and processes the direct payment for the carer to pay for the respite break.

What has co-production meant to the project?

For Action for Carers Surrey, co-production has meant being treated and valued as an equal partner. It lobbied Surrey NHS to make sure that money from the National Carers' Strategy was allocated to primary care trusts to develop breaks for carers - unlike many other areas where the money was absorbed into the general NHS spend - providing evidence from carers of the value of such breaks to them. It has been involved in jointly developing the idea in the first place, the design of the scheme and putting it into action.

What has helped in implementing a co-production approach?

There is a well-established culture of cooperation in Surrey, with active partnership boards for planning social care services. All partners have been committed to the project on an equal basis.

What difficulties were there in implementing co-production?

GPs proved to be the weakest link initially as they were not familiar with the concept of offering a break directly, much less a sum of money for this. The project had to work hard - using a combination of promotion by Surrey NHS itself, as well as Action for Carers' GP Carer Awareness team - to persuade them to be engaged. In retrospect it would have been helpful to have had a GP as part of the design team, but in practice this would have been difficult and colleagues in Surrey NHS made a persuasive argument to get agreement for the scheme to go ahead.

What are the main strengths in the approach that has been taken?

Everyone has bought into the service. The project has been able to use existing service provision and practice (direct payments support through SILC) and build on it. The resulting system of direct payments for respite for carers is straightforward and avoids complex form-filling and referrals.

What have been the main outcomes of the project?

Over 1,500 direct payments for carers have been made. All the GPs in Surrey are signed up to the scheme. Referrals for the breaks are continuing to increase as awareness among both GPs and carers grows. The overall wellbeing and health of carers has improved and, by having a specific scheme aimed at carers, GPs have become more conscious of the issues for carers. The project has been so successful that there has been a commitment to continue funding through 2013/14, with the expectation that the new clinical commissioning groups (the new structure for GPs to buy services for their patients) within Surrey will want to continue when they see the evidence of its value.

How has the project worked to engage all sections of the community?

Events have been held to engage a wide cross-section of carers by advertising through other carer groups and specific impairment groups.

What advice would the project give to others?

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