Co-production in Oxfordshire: Three years on
Featured article -
09 July 2021
By Jo Barnicoat, Parent / Carer - and Karen Fuller, Deputy Director of Adult Social Care, Oxfordshire County Council
Jo and Karen are Co-Chairs of the Co-production Board.
How is it going? As stated in the introduction to the handbook – embedding co-production is like attempting to turn a tanker with a teaspoon. So, is the tanker moving or is it stuck like the Ever-Given in the Suez Canal?
Three years ago, the Co-production Board met for the first time excited and enthusiastic but not actually sure what co-production was or in fact what the boards purpose was. This understanding took about a year to truly reach a place where purpose and understanding was aligned. Co-production improves the way health and social care services are designed and delivered by putting an emphasis on a more equal partnership between professionals and people using services. Working together as equals builds better relationships (based on trust, respect and understanding) and helps to create services that actually work for the people using them.
It is a huge ask to change people’s way of working, for the workforce of adult social care to be on the same level as the people they are helping: and there is one of the problems, the word helping! It immediately creates a power imbalance. What exactly is their job? People who need to use adult social care are some of the most vulnerable in society, social workers are not helping them as such but facilitating their ability to live fulfilled lives within society. It is the power imbalance being constantly challenged, working together as equals that really drives us towards the shift we need. Simply, Co-production is the person who needs the service being involved in all aspects of designing care whether this on a personal basis or at the core of the council through true engagement via commissioning.
Three years on: Are they?
Like all long-term projects, co-production has had its ups and downs not helped by the pandemic and many lockdowns resulting in Oxfordshire Adult Social Care being, like all other local authorities, stretched to its limits. But it’s not all doom and gloom in fact we have made some significant progress Improving co-production practice within the council and across Oxfordshire, Involving more people across Oxfordshire who use services in co-production projects, involvement of people who use services in significant Council meetings for the first time eg Performance Scrutiny and involvement of people who use services in the recruitment to senior positions within the Council. This we are really proud of.
The local authority is a servant, not a master, a truth which on occasions is too easily overlooked. Vulnerable adults and their carers look to the state – to a local authority – for the support, the assistance and the provision of the services to which the law, giving effect to the underlying principles of the Welfare State, entitles them. They do not seek to be “controlled” by the state or by the local authority. And it is not the state in the guise of the local authority to exercise such control. The state, the local authority, is the servant of those in need or its support and assistance; it is not their master. And any attempt to control is likely to be counterproductive when it comes to a local authority “working together as it must with family carers.Lord Justice Mumby
Whilst this is absolutely the direction of travel we need to keep moving in at pace, without doubt, we need to constantly hold a lens up to ourselves by checking challenging and evaluating co-production to ensure that we are able to do more co-design and co-evaluation of services which is essential for continuing to scale up co-production in Oxfordshire.
Senior leaders genuine and real support of co-production practice is what will allow us to plan, design and truly deliver together moving forward. This kind of support is essential to ensuring projects/ pieces of work can actually be co-produced, Without this genuine support and commitment, people end up having to make concessions that compromise the co-production and end up making people involved feel it has been a tokenistic/ pointless exercise. Commitment and ambition will enable us to continue the great work we are doing in Oxfordshire.