Co-producing ideas and solutions to achieve better joined-up care

Joint working means valuing citizens as equal partners in co-producing and delivering joined-up care.

Challenges

• Managing our health and care is the responsibility of individuals and their families, communities, professionals and statutory services. Each stakeholder will have a different view of the optimum balance of responsibilities.
• Co-production with local people and communities will challenge the existing balance of power within the local health and care system, and is likely to require cultural change at all levels.
• Engagement with local people and communities can be superficial and an afterthought, rather than an integral part of the change process.
• Organisations often engage with the ‘usual suspects’ and miss out on the views, experiences and assets of seldom heard parts of the community.
• Health and care jargon can be difficult for people to understand, and can lead to misunderstandings.
• Balancing people’s expectations with capacity requires an open and mature debate with all parties.

Key actions

• Take a person-centred, not a servicecentred approach, to developing joined-up care.
• On an individual level, give people more opportunities to be involved in decisions about their own health and care. See People in control of their own health and care (The King’s Fund) and Person-centred care in 2017 (National Voices).
• Encourage and support people and communities to take an active role in service delivery.
• Co-produce solutions and services with local people and communities from the outset. The Social Care Institute for Excellence (SCIE) provides recommendations on how to develop coproductive approaches in organisations and projects based on a framework for change management. See Co-production – what it is and how to do it.
• Take an asset-based approach to partnerships with communities, including the voluntary sector and local people. Focus on what they can bring alongside their needs. See Asset-based places: a model for development (SCIE) and Public Health England’s A guide to community-centred approaches for health and wellbeing.
• The NHS Long Term Plan commits that all sustainability and transformation partnerships will become integrated care systems (ICSs) by 2020. ICSs will have a key role in working with local authorities and providers to make shared decisions on how to use resources, design services and improve population health. All STPs and ICSs will have a partnership board, which should include local government and voluntary and community sector partners. See Sustainability and transformation partnerships (NHS England, 2019) , and Making sense of integrated care systems (The King's Fund, 2018).
• Assess local progress in developing joined-up care by using tools such as the Better Care Fund self-assessment and evaluation tool and Shifting the centre of gravity: making place-based, person-centred health and care a reality.
• Have a clear engagement plan to ensure a comprehensive approach. NHS England has produced a bitesized guide, Principles for participation in commissioning, which outlines the rationale and principles behind participation, as well as reviewing the engagement cycle and setting out practical steps providers can take.