Let’s work together to empower and transform

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Ioften hear the term co-production talked about as a way we are or should be working, but do we really embrace it or is it just another buzzword? The reality is that co-production has numerous economic and social benefits, it can spark innovation and holds the key to the transformational change we often seek but fail to realise.

There are various definitions of co-production, although it was perhaps most eloquently described by Sir Harry Burns as “the process of active dialogue and engagement between people who use services and those who provide them”. Perhaps surprisingly for a “buzzword” the term was coined over four decades ago within the social sciences field and therefore the concept is not actually new. Edgar S Cahn, distinguished professor and critical friend of the Health and Social Care Alliance Scotland, pioneered the use of co-production within public services in the 1990s, through an innovative youth justice programme in the USA.

Since 2013 the Health and Social Care Alliance Scotland’s People Powered Health and Wellbeing (PPHW) programme, supported by a Reference Group of people who use services and carers, has been working alongside partners within the Third Sector to create the conditions for change to happen with people who are accessing support and services firmly at the centre. As Scotland finds itself in a landscape of fast-paced change, a new-look second phase of PPHW will focus on making co-production a reality across health and social care integration. This work follows on from the development of “Gaun Yersel”, the Self Management Strategy for Scotland, authored in 2008 by the ALLIANCE with people living with long-term conditions, which set a precedent for co-production in Scotland.

The appetite for change is here and there is fertile ground for innovation. We must pool our resources to further the co-production movement which began several years ago, not least by working closely with others including Nesta, the Scottish Co-Production Network, SCIE, Governance International and Healthcare Improvement Scotland.

People’s experiences have the power to transform health and social care services, as people bring a wide spectrum of experience, skills and knowledge. It is widely acknowledged that the current health and social care system can’t be sustained. Utilising people’s experiences is essential to ensuring our health and social care system remains fit for purpose. This shift will require everyone – policymakers, commissioners, health and care professionals and patients – to change.

Recent Scottish Government publications, such as Realistic Medicine and the National Clinical Strategy, have made reference to the importance of co-production. The Community Empowerment Act and The Public Bodies (Joint Working) (Scotland) Act both have co-production as a key theme. However, one of the reasons that co-production remains way down the agenda is that there is no national strategy which sets it apart.

Those who have seen real co-production in action will testify to the significant social benefits of involving people in the design and delivery of their care. The economic benefits are complex and tricky to evaluate as the financial savings can spread much wider than just the health system. Co-produced services can incur costs in one area, but produce results in others, which has in some cases been a disincentive for commissioners. Nesta have pointed to evidence that could mean savings to the health budget of between 7 per cent and 20 per cent and the savings to the wider economy are, as yet, unquantifiable.

At a recent Open Space event in Glasgow, hosted and organised by PPHW and the ALLIANCE’s Health and Social Care Academy, more than 100 participants from the new Health and Social Care Partnerships across Scotland came together to discuss co-production within health and social care. At a time when public services are facing budget constraints it’s more important than ever to invest in community assets and give people who access support and services a greater say in their health and social care. In this landscape of integration, this means empowering Health and Social Care Partnerships to be able to co-produce in order to support better outcomes for health, wellbeing and integration.

The argument for change is clear, however – we must work together to overcome the cultural and structural barriers to co-production on health and social care services.

The image co-production conjures up for me and many others is one of empowerment and transformation, but for some it remains an image of political jargon. By developing a National Strategy for Co-Production in Health and Social Care, as well as investing in capacity building 
programmes such as PPHW we can allow people to see the positives for themselves.

Once you have seen the tangible benefits of real co-production, it becomes very difficult to work in any other way. We simply can’t afford for co-production to appear as a buzzword any longer.

Gavin Paterson, Programme 
Officer, People Powered Health and Wellbeing, the ALLIANCE, www.alliance-scotland.org.uk