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Co-Producing Co-Production...

Updated: Mar 22, 2023

Louise Patmore, our Systems change lead, reflects on an excellent Co-Production event we held recently...

One of the key objectives in Changing Futures is to really get Co-Production at the centre of our design and delivery of services and improve the way we can partner and network across the variety of stakeholders that are providing Co-Production.

Possability People provide Lived Experience Advisory Groups (LEAGs) into two areas, Brighton and Hove and East Sussex alongside Capital who provide for West Sussex into the mental health collaborative. We joined together to create this event in sharing knowledge and information, networking and learning together.

What was great for me was seeing many people that I know have been trying and doing this work for many years together in one room. Big room events are far less frequent than they used to be so the effect is greater, I think, of feeling the passion and commitment in the room.

The first thing that we did was play with some Lego, six pieces each and a few minutes to make something. Then we dismantled that and made something bigger and better together. What is great is watching a group grow. The ideas getting more extravagant and exciting and the joy and concentration that starts happening as people begin to piece together an unknown puzzle. We ended up with a stable for the fidget animals that were on the table. We were looking after things, making sure they were fed. We used another fidget toy, and I really liked the way the group used that toy in a “break the rules” type of way.

As I Watched I realised what was sad was that the people who don’t want to work in this way and hold on to power and authority are missing out on working in a more human, connected and happier way. It always works, never fails. The room was laughing and chatting alongside being creative and making progress, albeit with the Lego. Our model had dinosaurs safe, fed and together, a metaphor for what our system needs to do if there ever was one.

We then had a brave conversation between a Commissioner (Kenny) and Tasha from Possibility People. What really struck me was the openness, bravery and vulnerability Kenny showed with non-rehearsed Q&A. Answering questions on inclusion in meetings and how to support people, how to make it happen

and what barriers are there that make it difficult. The frank knowledge of what statutory obligations do to get in the way of collective decision making but the way to make that better is openness and honesty of what is achievable a process of learning together.

Tasha and Andree then took us through some definitions of co-production with some familiar processes and ladders. A conclusion that there was no one definition is symptomatic of everyone finding their own path. This is what is so exciting about it. People’s understanding is rooted in different contexts, different lives, so no one is wedded to one definition.

When I was working with recovery practice, there was no one leader. When you looked at medical practices there is the father of psychoanalyses. BF Skinner comes up with behaviouralist and so on but when you research recovery or co-production there are pieces of work, but can you name a person? No, and that’s how it should be, it’s a collective, people were involved.

Over the years the Co-Production models that have come out have become less them and us, less about the conflict. You can see this emerge with the newer leaf designed by NHSE with patient leads from around the country. Its more wrap around, more inclusive, more pragmatic, perhaps, recognising that other pieces of information need to be considered as well. Co-production has its place but it can’t be the only thing that happens. This was highlighted in the quiz we had well. What is and isn’t Co-Production. The ‘yes’ and ‘no's’ were all ‘maybes’ and ‘it depends’. It’s the quality and what happened before or what will happen next that defines whether co-production is useful and meaningful.

After some table reflections we moved to some example presentations of current practice. I think one of the issues we have is a failure to celebrate what we have done. We constantly look at what we haven’t done. I see many trapped in the dilemma of lack of confidence to say or of not really being aware. I think people that work in this way struggle with this a lot. So, it was great to see some examples. We even enjoyed a live demonstration of using cop-production in recruiting new staff with a group from West Sussex County Council for a supported living project. Answers given by the prospective candidates were given thumbs up or thumbs down or in the middle. I was really struck by their approach that looks simple and yet is incredibly nuanced and carefully planned. Our very brave volunteer passed the interview!!

There was also a presentation from a peer group for people with multiple complex needs. What was great was seeing the growth right there in the room. The pride, the being together, learning and sharing to

offer peer support but also some reflections on what makes it difficult for people to access mainstream support. This highlights the need to co-produce everything. There is still so much wrong with the prescriptive, organisationally focused delivery of some services.

This then led on to some activities to define for ourselves what we understand with words. Bringing together our understanding in collective thoughts and ideas to produce sentences that make sense to us all. Again, the richness of thinking and conversations was fantastic. The programme closed with the most popular definitions as voted for by all in the room. People really liked the simple, as do I.

So, for me it’s the next steps and momentum that is important. The network building and consensus. As the Systems Change Lead how do I weave this in with other pieces of work to ensure that as a system on the three key layers, individual, organisation and system that we are paying attention to co-production? How are we able to support co-production in a financially squeezed system?

What is so obvious to me is that not paying attention to co-production is perilous and has been for all the time I have worked in systems. If you aren’t doing and developing things with people, it will go wrong, it will not fit. It will continue to under deliver and over promise and have really costly outcomes in experience as well as financially. But the system continues to fail to pay the right type of attention and resource in the right way to the right people to enable, celebrate and measure successful Co-Production.

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