This is ‘Co-production Week’. The word ‘co-production’ might sound like film industry slang for collaborative film making between two production companies – well, actually it is – but it’s also a newish buzzword in health and social care which essentially means ‘involving the people that matter, in all stages of decisions and design of services that affect their lives’.
It really isn’t rocket science, and it’s already mirrored in various fields, like in the arts and crafts or the disability rights movement, the community and voluntary sector, and it’s likely there are communities around the world that could put claim to a focus on collaboration over hierarchy.
Approaches continue to spring up which get packaged up as models (with facilitators you can hire) to implement inside organisations or communities. All of them though, have the same (or similar) basic principles, and therefore achieve relatively the same aim as co-production; to change systems of being, relating and working (organisational and individual), to affect a change of culture that is built on trust, respect, equity, and strengths.
The Care Act (2014) is driving the change in Health & Social Care by formalising the requirement to co-produce in its statutory guidance, which – albeit gradually and in some cases reluctantly – pushes authorities to consider adopting this way of working.
This means they can’t really evade it, and so the pressure is building to do co-production. The problem is nobody quite knows how – yet.
So why is knowing ‘how’ to do co-production the major stumbling block nationally?
Because we keep describing the ‘how’ as working together, treating each other as equal, sharing power, and so on. But this doesn’t even get us close to the practicality of how.
Instead, this merely describes some of the outcomes you get when you have a certain set of knowledge and skills, and know how to – and get the opportunity to – employ those in an expert way.
Co-production has a strong national presence now on social media, and the level of adoption is increasing across health, social care, universities, and communities. But the misleading optimism played out by influencers and advocates, with a false promise of how effortless it might be – if only people would try – if anything, could be setting people up to fail, or risk burning not building bridges, if we continue to be so lopsided about the reality of ‘how’ to do co-production.
It is a hazardous misnomer to say doing co-production will be easy, and we would do better to start looking at the reality of what it takes to do co-production, and do it well.
Just understanding the principles is not enough. Take a look at any examples of where co-production has happened well, and you will find one thing for sure: one, or a small handful of exceptionally talented and passionate individuals who were committed to make it work, and put in the effort to make it happen, often with little resource.
And what do those individuals have in common? A complex set of skills that are not learnt in a one-day workshop. These people have skills like humility and self-awareness, they’re reflective practitioners, with growth mindsets, skilled facilitators and mediators, they understand the needs of a group, are compassionate and unafraid to show their vulnerabilities.
They’re also skilled communicators, network builders, organisers, and experienced at managing conflict and people’s expectations, aware of their unconscious biases, and above all, they are passionate about doing the right thing – knowing everyone actually is equal and deserves to be treated as such!
Co-production practitioners are a new breed of profession. They are highly skilled and work across boundaries, knitting individual and organisation together through honest, real, being and relating. So, can anyone learn these skills? Of course, if they are willing to look honestly at themselves, change their mindsets and practice, but skills like these take years to develop well.
Then there is the question of organisations. Are they genuinely willing to work differently, is that what they really want, or is something else driving their actions to ‘do co-production’?
If the former is true, then organisations need to ask themselves how they can go about changing their culture, and how do they employ more people who have these skills, whilst upskilling their current workforce to adopt, what is effective, a whole new narrative.
On the practical ‘how’ – as in ‘how do we get from A to B’, or what does the journey of co-production look like? – In truth, there is no model for co-production. It is a complicated bespoke problem-solving exercise every time, involving numerous individuals coming together and co-operating to achieve an agreed goal.
Models are useful to help us along when we are stuck, or implementing a specific piece of work, but really models only go so far in helping out, because they don’t necessarily address the underlying issues as to why we’re not already co-producing – because our cultural narrative, and our organisations’ systems and processes, in truth, do not support co-production.
Using a pre-defined model, or doing a ‘bit’ of co-production, will be like forcing a square peg into a round hole. Some of it will get squashed in, but bits will break off, and the hole will still be round.
So, for co-production to truly work and not just be another bit of jargon that people tried out for a bit before moving onto the next fad, people need to change how they behave and relate, people need upskilling, and systems need radically overhauling.
For the culture to shift, a small earthquake needs to happen which people get shook by, and look up from their screens for a moment and ask themselves, do we really have what it takes?
Come along to the Oxfordshire Co-production Festival today if you can!
nigel hunter says
To me these ‘skills’ can come with experience and with other like people co-operating to achieve their aims . Yes it does need a radical thinking of how the old ways can be enabled to blend with the new. If the talents of people can be found early enough perhaps with education a system could be evolved for the idea to function. Education of the right sort can work wonders
Completely agree Nigel. David Boyle and I were discussing this just recently, and you can see our conversation soon here on Radix, where we discuss in more depth the skills needed. We totally agree they are basic human skills, that need nurturing through school and in workplaces, unfortunately the system isn’t set up that way currently, and instead tends to favour knowledge and practical skills over (and I hate this term) ‘soft’ skills!
Fotis Papadopoulos says
I think aiming for equality in our daily lives, in an active, conscious manner, can be releasing and transforming for those experiencing us, propelling them to do the same (a bit like the driving culture, on the whole, in the UK). Power asymmetries, informed by a psychic deficit, can also, of course, act as self-fulfilling prophecies. The choice is ours, between virtuous versus vicious cycles.
If I understand what you’re saying, Fotis, sounds like you’re in favour of co-production, and hopeful that if we role model positive behaviours, others will follow suit. We try to promote ‘easy speak’ in the co-pro world, so that we all understand what is being said, and don’t use any special or scholarly languages which might exlude others, perhaps less well educated (see the other comments about the problem with the education system). In that vein, would you please explain what a ‘psychic deficit’ is? 🙂
Fotis Papadopoulos says
Hi Danie, yes, my apologies for writing compactly. I often wonder about the psycological profile of those occupying top job positions because of the allure of power. It would appear there is often a deficit of power early in their lives, they try to compensate for. I imagine, co-production is highly threatening as they have to give up a lot of the power they hold, and with that, part of the identity they have constructed, being left with their fragility. How can they then bring their “whole self” to the process of co-production? All this is to be contrasted with those whose power stems from a secure base, and they are ready to share because they have nothing to lose in the process, rather, gain in the knowledge they further others and, ultimately, themselves.
Thank you for clarifying Fotis. Bringing one’s ‘whole self’ is something encouraged in order to co-produce. I totally agree that this is threatening to some people, but not just people in positions of power. The cultural set-up we currently have still frowns upon vulnerability and sharing of feelings, and as such is one of the barriers to true collaboration, where individuals and communities are better able to support each other.
Gordon Lishman says
Co-production requires skills, habits and techniques which have been crowded out in many parts of society. The idea of community politics is crucially about how to help people to learn and practice those skills, habits and techniques. The underlying need therefore goes beyond the areas of work and the co-production of services which are the main focus of current approaches. It’s part of the way forward, but needs to be viewed more widely.
David Boyle says
I v much agree, Gordon!