To mark National Co-Production Week from 5th to 9th July, Natalie Davies discusses what co-production is, and what it looks like in practice. More articles will follow on the SSA website throughout the month of July, exploring some of the central issues and barriers to co-production as well as highlighting some innovative projects and research in this area.
In the same way that medicine has traditionally been practiced and laws have been created, research has tended to be a ‘top-down’ process – being ‘done to’ and ‘done on behalf of’ certain groups of people. In 2021, this is more problematic than it perhaps would have seemed 50 years ago, because we have learned that working only in this way ignores the expertise of people with lived experience, and can perpetuate social inequalities – particularly when there is a lack of diversity and representation of marginalised groups among people in positions of power and influence.
Challenging ‘top-down’ traditions
According to the Cambridge Dictionary, the term ‘top-down’ is “used to refer to a situation in which decisions are made by a few people in authority rather than by the people who are affected by the decisions”.
The term ‘co-production’ can be applied in a range of different contexts; policies can be co-produced, research can be co-produced, and interventions can be co-produced. To ‘co-produce’ something is to redistribute power and influence, so that the people who stand to receive, benefit from, or deliver a provision or service (including service users and practitioners), are involved in its development or implementation as equal partners. Adding more detail to this description, Dr. Catherine Needham and Dr. Sarah Carr write that:
“Co-production emphasises that people are not passive recipients of services and have assets and expertise which can help improve services.”
“Co-production is a potentially transformative way of thinking about power, resources, partnerships, risks and outcomes, not an off-the-shelf model of service provision or a single magic solution.”
Co-production can be implemented with different levels of intensity and different degrees of change in mind. For example, co-production can be delivered with the aim of improving research or services, which requires a greater recognition, involvement, and understanding of ‘seldom-heard from’ stakeholders. Another example, which is a step-up from this, is to hold co-production as a way of transforming research and services. This requires “a relocation of power and control, through the development of new user-led mechanisms of planning, delivery, management and governance [and…] involves new structures of delivery to entrench co-production, rather than simply ad hoc opportunities for collaboration”.
Embracing principles of co-production
The Social Care Institute for Excellence (SCIE) suggests a list of principles for organisations wanting to pursue co-production:
- Equality: Co-production starts from the idea that everyone is equal, and everyone has assets (e.g. skills, abilities, time and other qualities) to bring to the process, including people who use services, workers, practitioners, and managers. This strengths-based approach is different from approaches that focus on people’s problems and what they cannot do.
- Diversity: Co-production projects should be pro-active about diversity, which means seeking out groups which are typically under-represented or excluded from such work, including: people from Black and minority ethnic communities; people from lesbian, gay, bisexual and transgender communities; people who communicate differently; people with dementia; older people who need a high level of support; and people who are not affiliated to any organised group or community.
- Accessibility: Accessibility is about ensuring that everyone has the same opportunity to take part in an activity, in the way that suits them best. This applies to physical access, the time and timing of projects, and information-sharing.
- Reciprocity: A key concept in co-production is ‘reciprocity’ – ensuring that people get something back when they put something in. The word itself may seem like jargon, but there is no other word that fully captures what it means.
Equality, diversity, accessibility and reciprocity seem like principles we should all/always be striving for, but the need to point them out, and put them under this umbrella of co-production, suggests that we are not all/always following them. In this context, co-production may be a useful signpost for improving (and potentially transforming) research and services.
The SSA’s reading lists provide a starting point for people interested in reading up on a specific area. View the collection on co-production.
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