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

What is co-production - Defining co-production

There is no single formula for co-production but there are some key features that are present in co-production initiatives. They:

• define people who use services as assets with skills
• break down the barriers between people who use services and professionals
• build on people’s existing capabilities
• include reciprocity (where people get something back for having done something for others) and mutuality (people working together to achieve their shared interests)
• work with peer and personal support networks alongside professional networks
• facilitate services by helping organisations to become agents for change rather than just being service providers. [3]

Some definitions of co-production include:

Co-production is not just a word, it’s not just a concept, it is a meeting of minds coming together to find a shared solution. In practice, it involves people who use services being consulted, included and working together from the start to the end of any project that affects them. [4]

A way of working whereby citizens and decision makers, or people who use services, family carers and service providers work together to create a decision or service which works for them all. The approach is value driven and built on the principle that those who use a service are best placed to help design it. [5]

A relationship where professionals and citizens share power to plan and deliver support together, recognising that both have vital contributions to make in order to improve quality of life for people and communities. [6]

A distinction has also been made between co-production and co-creation. In co-production, people who use services take over some of the work done by practitioners. In co-creation, on the other hand, people who use services work with professionals to design, create and deliver services. [9]

Co-production has been broken down into the following:

• co-design, including planning of services
• co-decision making in the allocation of resources
• co-delivery of services, including the role of volunteers in providing the service
• co-evaluation of the service. [10]

Some people argue that co-designing services (managers and citizens working together in the planning stages of projects), while important, must be accompanied by co-delivery (involving people in actual service provision).

It can also be useful to think about there being different levels of co-production. For example:

• descriptive – where co-production already takes place in the delivery of services as people who use services and carers work together to achieve individual outcomes, but activities cannot challenge the way services are delivered, and co-production is not really recognised
• intermediate – where there is more recognition and mutual respect, for example where people who use services are involved in the recruitment and training of professionals
• transformative – where new relationships between staff and people who use services are created where people who use services are recognised as experts in their own right. There is respect for the assets that everyone brings to the process and an emphasis on all the outcomes that people value, rather than just those—such as clinical outcomes—that the organisation values. [11]

The range of definitions and the proliferation of terms such as ‘co-creation’ and ‘co-design’ can be bewildering. However, there are a few things we can say with some certainty that transformative co-production is about:

• social care professionals and people who use services work in equal partnerships towards shared goals
• there is a movement from involvement and participation towards people who use services and carers having an equal, more meaningful and more powerful role in services
• people who use services and carers are involved in all aspects of a service – the planning, development and actual delivery of the service
• power and resources are transferred from managers to people who use services and carers
• the assets of people who use services, carers and staff are valued
• it is recognised that if someone makes a contribution they should get something back in exchange
• frontline staff are seen as a group that needs to have more autonomy and a greater role in planning services.

• Practice examplesOpen

  Action for Carers Surrey

  For this organisation, co-production meant that it was treated and valued as an equal partner in the coalition it brought together to develop a new service to provide breaks for carers.

  Birmingham City Council’s Adults and Communities Directorate

  The Adults and Communities Directorate defines co-production as ‘a way of working in partnership to understand and agree the things that need to improve and work together to change things for the better.’

  All Together Now

  This project defined co-production as ‘a value based approach that is about building relationships, is a force for good, and can be used in a variety of settings.’