Local people: the real experts by experience for better joined-up care

At least five million adults use a combination of health and care services, and 6.5 million people provide unpaid care to relatives and friends, amounting to an estimated £132 billion a year worth of support. Around three million people undertake voluntary work within health and social care.

These are the real experts on how health and care systems do – or do not – work together to meet people’s needs. They provide the critical and unique perspective required to reshape the system, and they bring strengths and networks to support improvement. Yet their contribution is too often overlooked or undervalued.

As noted in the NHS Five Year Forward View, ‘patients, their families and carers are often “experts by experience” and their voice is crucial to service and system redesign’.

Furthermore, there is evidence, as shown in The King’s Fund report, Volunteering in health and care, suggesting that volunteering is not only beneficial for the people who receive help, but also for the volunteers themselves, in terms of improved self-esteem, wellbeing and social engagement.

Higher levels of social integration and lower levels of loneliness increase people’s health and happiness and have far-reaching consequences for educational attainment and the reduction of crime.

This section outlines approaches to supporting joined-up working through co-production, asset-based places, engagement and self-care.

new models [of care should] also draw on the “renewable energy” of carers, volunteers and patients themselves, accessing hard-to-reach groups and taking new approaches to changing health behaviours.

Simon Stevens, Chief Executive, NHS England

Co-producing change with people and communities

To make change effective, it should be coproduced with local people and communities. This means local leaders sharing power and responsibility with local people to design services and working arrangements that reflect their experience, needs and preferences.

To engage effectively with people and communities, providers will need:

SCIE’s co-production resource explains how to put co-production approaches into practice in organisations and projects. It uses a whole-system approach and a ‘jigsaw model’ for the management of change.

The four pieces of the jigsaw are:

Co-production jigsaw


Issues to consider include:

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Case studies

Tools and resources

How to... work together to achieve better joined-up care
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