Principle 1: Co-production activities with people and communities must be adequately resourced.
Effective co-production requires good planning. Think about the capacity of the group to deliver the co-production, how long it may take and what funding is required to support the activity. For smaller projects and 121 co-production the focus will be more on the logistics, to ensure there is time to do the co-production and arrange support such as advocates or interpreters. Without this initial work the co-production effectiveness will be hindered.
Ways to adequately resource co-production activities with people and communities:
- Commissioners need to consider engagement funding at a programmes’ inception, with contingency, to provide capacity to respond to changes in the engagement/co-production project.
- Co-production projects should consider participatory budgeting to support community and voluntary sector shaping co-production activities within a project.
- For individual co-production planning with the individual (and unpaid carer) the co-production process needs to focus on the time and capacity for the person (and their unpaid carer) to be effectively involved in the co-production
Principle 2: Power should be shared amongst all partners
People want meaningful engagement with people and communities, feeling connected to services. Therefore, people who use services must be the starting point for any service improvement. If this did not happen there would be a continuation of a ‘top-down’ approach, which is ineffective and undermines co-production; it is important to work inclusively with people who use services.
Ways to share power:
- At the start of the project ensure strong representation of people who use services in the project group.
- If working with an individual (and their unpaid carer), spend time working out how they are meaningful involved in the co-production throughout the activity. Discuss things such as their vision and understanding of the piece of work, preferred level of involvement, preferred method of correspondence, do they need additional tools or support to enhance communication?
- Explore with all involved the level of commitment required with the explicit aim of seeking stability in the relationship. This includes operating in a culturally appropriate and fully inclusive manner for all those involved in the activity.
- Discuss with the group/individual how to run the activity/project. Have open discussions about how best to run meetings, who and how it is led/chaired, what is the best format and location for meetings. Keep this under review throughout the project.
- Consider support and training for people to effectively take part in the work.
- Recognising the complexity of people’s lives means staff need to be flexible to be inclusive. I.e. staff should be available to speak to people outside scheduled events/meetings to ensure they feel involved and understand how the work is proceeding.
Principle 3: Embrace perspectives and skills of others and ensure these are represented whether working with a individual or in the project
Effective co-production happens when all voices who have an interest are heard. How this can happen should be creatively developed within a project or work with an individual (and their unpaid carer). The important point is an ability of a piece of work to create a space(s) for all voices to be heard. Value and include voices from people who use services and frontline staff.
Ways to hear all voices:
- At the start of a piece of work ensure it represents all perspectives to allow the it to fully understand the view of all those involved (working in, funding or using) in a piece of work or intervention.
- If working with an individual (and unpaid carer) explore with them how their perspective is fully reflected in the activity.
- Keep this under review;
For groups, you may need to recruit if the project does not reflect the full range of perspectives or people move on and you need to replace them.
For individuals (and their unpaid carer) you should check in regularly if they feel their perspective is reflected in the work.
Principle 4: Respect and value the ‘lived experience’ and how different forms of knowledge can be expressed and transmitted
Value ‘lived experience’ and looks for creative ways for knowledge to be shared and expressed. ‘Lived experience’ is a core driver and starting point for any project. Openness and use of ‘lived experience’ and other forms of knowledge are a way to build trust with individuals and communities to ensure best individual outcomes and/or service improvement.
Ways to value different means of creating understanding and knowledge:
- Whether working with an individual (and the unpaid carer) or a group ensure your practice is trauma informed [insert link to trauma informed] as sharing ‘lived experience’ if not carefully handled can retraumatise people.
Working with individuals
- ‘Lived experience’ of an individual (and an unpaid carer) reflect the effectiveness of the support they receive, and to gain their confidence in co-production it is important you place emphasis of the importance of their ‘voice’.
- Take a strengths-based approach and focus on individuals’ strengths (including personal strengths and social and community networks) and not on their deficits. This approach is holistic and multidisciplinary and works with the individual to promote their wellbeing
- Perspectives of an individual and unpaid carers can differ. Explore appropriately and transparently how such differences are incorporated in the co-production. This can be challenging were differences are stark; seek management support and explore this with individual and unpaid carer.
Working with groups
- A co-production project should scope with its members the range of knowledge it can access (lived experience, service data etc)
- In this process explore how this knowledge is accessible and valued; seek to be explicit not to overvalue some data (e.g. institutional data) over other sources of data (e.g. lived experience)
- Discuss with the group the resources and techniques to develop ‘undervalued’ knowledge like lived experience; art-based methods are increasingly seen as a useful technique for people to share knowledge and understanding.
- Check with those producing ‘undervalued’ knowledge if they feel it is being used effectively
Principle 5: Ensure there are benefits for all parties involved in the co-production activities.
Effective co-production happens when everyone can see the benefit from their involvement in co-production. There can be wider gains when all parties benefit, as this builds trust that individuals (including unpaid carers) and communities are listened to, and can see actions as a result of their involvement.
Reward and recognition are important in supporting people and the voluntary and community sector to have the time and space to be involved the co-production.
Ways to ensure everyone benefits from co-production:
- Have an open and clear discussion on the benefits of the co-production, the timescales of the project and potential impact of the work; check in throughout the project to help everyone have a clear sense of what the project can (and cannot) achieve.
- Ensure reward and recognition is budgeted on the project plan and all parties understand its use.
- At the end of the project discuss legacy of the work; are there opportunities where the community could be supported to continue this work independently, this could involve signposting community groups to funding opportunities to take forward the project legacy.
- Ensure the personalised care package or treatment plan is co-produced and agreed with the individual (and their unpaid carer)
- Explore how an individual (and their unpaid carer) can build on person’s existing abilities and networks to better support their independence; this can benefit an unpaid carer by giving them space for respite.
Principle 6: Meet people and communities where they are: do not expect them to come to you.
Effective co-production requires individual and community involvement and helps people feel connected to the services there to support them. It is important there is time allocated in the co-production to build individual (and unpaid carer) and community confidence in engagement so they see it as genuine and meaningful; invest time in gaining people and community confidence.
Ways to build connections:
- Work with Voluntary and Community sector and community leaders to identify routes into communities who use a service and have a specific condition.
- When you reach into communities be clear with them about why you are doing this and the benefits to them – do not be vague.
- Think about holding listening events in the community; let people tell you their story in their place in their time.
- Think about what is the best place to work with an individual, it could be their home, an outside safe place such as on office etc.
- Where an unpaid carer is involved think about if there are differences of ‘voice’ between and individual and their unpaid carers; where this is challenging seek management support and explore this with individual and unpaid carer.
Principle 7: Work Flexibly
It is important everyone working in a co-production activity agrees the pace of the work. Everyone has other commitments; think about how organisational requirements, such as reporting cycles, support this rather than limit flexibility.
Co-production is an evolving process of discovery that can change as the activity is carried out. Being rigid because organisational requirements can undermine both the co-production and people’s trust that their concerns are being addressed appropriately.
Ways to ensure flexible working:
- At the start of a project spend time exploring how you will work together; be explicit on issues like timescale, resources, costs etc so such issues are collectively understood.
- Keep flexible working under review; co-production activities can change over time, and you may need to re-flex to ensure everyone feels included throughout the activity.
- See co-production as a multi-tool; it is a flexible concept that will help you work others to agree collective solutions
- For individuals (and their unpaid carer) their lives can be complex and unpredictable resulting in challenges to keeping to an agreed plan. Be flexible with the plan and aim to fit into the person’s life – this builds their confidence in the process and demonstrates your recognition of their individual needs.
Principle 8: Avoid jargon and ensure people and communities have access to the right information at the right time
The use of jargon is a key barrier to building effective and enduring relationships between staff and people. Language used needs to be inclusive.
Staff presentation of information needs to be inclusive. For people, struggling or not understanding information, can make them disconnect and undermine their willingness to take part (or fully engage).
Ways to avoid jargon and ensure individuals and communities have access to the right information at the right time:
- Do not use jargon or acronyms, do use plain English and ask people to review information produced
- Consider the need for translations, interpreters and Easy Read to facilitate involvement.
- Tower Hamlets has diverse communities, work with Voluntary and Community Sector, including faith leaders and groups, to create links to individuals and communities
- Design information and co-production activities for relevant community languages, work with those communities to do this.
- A co-production group should understand the ways a community communicates, such as Whats App, Next Door, and identify the ways it can link into such social media activity.
Principle 9: Relationships with individuals and communities should be built for the long-term and not for the short-term.
It is important people do not feel the relationship with services and providers is transactional. Statutory organisations can struggle to build long-term trusted relationships with individuals and communities.
Voluntary and community sector organisations., including faith leaders and groups, can help build trust with individuals and communities.
Individuals (their unpaid carers) and communities are active partners, rather than passive providers of information. Where people help services, services need to feedback to them about how their information had impact.
Ways to build relationships with the community long-term:
- Take time to build the relations with the individual and/or community
- The voluntary and community sector, including faith leaders and groups, are key partners in helping connect to individuals and communities. Therefore, it is important to build a strong trusting relationship with this sector.
- Think about how to feedback to individuals and communities throughout a co-production project. Agree within the person (and their unpaid carer) or project how and when to feedback.
- The co-production project should consider as part of its legacy the long-term service communications with those individuals and communities involved in the engagement/co-production.
Examples of co-production in practice
Jon Williams, Engagement Lead - NHS North East London, embedded in Tower Hamlets Together
Sarah Murphy, Anne Page, Lauren Osborn - London Borough Tower Hamlets Adult Social Care
Joe Ellis - CREATE community hub (Learning Disability Service)
Millie Smith and PPL - East London Foundation Trust
Ellen Kennedy - REAL (disability organisation)
Stef Abrar, Angela Burns, Sue Denning - London Borough Tower Hamlets Public Health
Jamie Bird, Akbal Ahmed - London Borough Tower Hamlets Integrated Commissioning
Alison Robert - Tower Hamlets Council for Voluntary Service