Suffolk & North East Essex Integrated Care System

Co-production

Suffolk and North East Essex ICS – the need to co-produce our services and expectations

Co-production creates services that help people stay well: Involving people in service design ensures the services are what people really want and will produce better health and wellbeing outcomes for them and other local people. If we get care and support right, especially preventative services, we can reduce demand for urgent and long- term services.

The vision for the Suffolk and North East Essex ICS is that all services shall be co-produced.  We live in the real world, and recognise that when developing a service it may not always be possible to co-produce everything.

However, the Suffolk and North East Essex ICS expect all development work to consider and share what elements can be co-produced, and the approach be taken, and to explain when and why it isn’t practical to be applying co-production.  To apply co-production purposefully, to be involving service users and /or carers in first identifying the need and the approach, and  then in gathering of intelligence, through to making decisions, from start to finish, requires from Providers resources and commitments.

Therefore, the Suffolk and North East Essex ICS recognise that the availability of resources and time factors may necessitate concentrating on co-producing a part(s) of a service development rather than the whole.

A Suffolk and North East Essex ICS Co-Production Leads workshop in August 2019 identified good co-production as changing the way we think and act. It:
  • Stops health and care services doing things ‘for’ people, and means they start doing things ‘with’ people.
  • Stops seeing people as ‘problems’ and starts seeing their strengths and resilience.
  • Values people’s lived experiences.
  • Recognises people are experts in their own lives.
  • Increases people’s control over their lives.
  • Enables people to have direct input into their care and support.
  • Contributes to better care and support for everyone.
  • Involves honesty, being open when resources are limited and realistic about expectations.
What is co-production?

Co-production is not just a word, it’s not just a concept, it is a meeting of minds coming together to find a shared solution. In practice, it involves people who use services being consulted, included and working together from the start to the end of any project that affects them.

Source: National Co-production Advisory Group www.thinklocalactpersonal.org.uk

Co-production is people, carers and professionals working together as equal partners to: design, develop, commission, deliver and review services, information and advice.

Source: Suffolk Health and Wellbeing Board definition of co-production for Suffolk

Healthwatch Suffolk and Healthwatch Essex are committed to supporting co-production. Healthwatch Essex and Healthwatch Suffolk work in close partnership with voluntary and statutory services, they and their partners have strong links with service users and carers, as individuals and in community groups.

Healthwatch Suffolk shares resources online through The Co-production Hub on the Healthwatch Suffolk website and can provide support by their dedicated co- production and community team. Healthwatch Suffolk is leading a conversation with people in their communities about the meaning of, and best ways to approach, co- production, to develop a shared understanding.

Healthwatch Essex has a creative and flexible approach to co-producing services, removing barriers to participation and enabling wider groups of people to be involved in co-producing services. The contribution by Healthwatch Essex Mental Health Ambassadors towards co-producing the first pan Essex Mental Health and Wellbeing Strategy has been widely recognised and a grant awarded by NHS England has funded the creation of a short film ‘Co-production at its best’. The film is available to organisations, to help promote good practice in co-production.

Equality:

everyone has assets; Co-production starts from the idea that no one group, or person is more important than anyone else and everyone has skills, abilities and time to contribute.

Diversity:

Co-production should be as inclusive and diverse as possible. Particular efforts may be needed to ensure that seldom heard groups are included.

Accessibility:

Making everything accessible is the way to ensure that everyone has an equal opportunity to participate fully in an activity in the way that suits them best.

Reciprocity:

Reciprocity means people get something back for putting something in.

Social Care Institute of Excellence
We want our systems, alliances and citizens to work together going forward, to achieve this, we need to:
  • Change the starting point from ‘the service’ to ‘the person’. We start with what people value, and what people care about.
  • Change cultures in systems and organisations, from holding power to sharing power with the people who they serve.
  • Hear all voices, not only those people who are like us, or who we usually ask. This includes seldom heard groups and younger people.
  • Recognise and value each other’s diversity, and the variety of people’s lived experience.
  • Be honest and transparent with each other, and always try to resolve any disagreements.
  • Recognise that people’s stories are not about a single organisation or locality but involve experiences that cross artificial boundaries such as these.
  • Ensure people have the right support to be able to co-produce, so that everyone has equality of opportunity to be involved.
We will:
  • Draw on the expertise and evidence gathered by the voluntary and statutory sector organisations who are most closely engaging with service users and carers, including those who have a legal duty to ask local people their views, such as Healthwatch.
  • Train and prepare health and care staff to co-produce, so they demonstrate the values of co-production in everything they do.
  • Avoid over-consulting groups of people, making people repeat their stories, or duplicating co-production efforts unnecessarily. We can achieve this by co-ordinating our co-production activities and sharing the outcomes with partners.
  • Be flexible, as co-production may not lead us in the direction we expect. Be prepared to follow co-production wherever it takes us, to the right solution and the right transformation.
  • Share the outcomes of co-production, so that the people who were involved know how they made a difference, and so that everyone is assured that local health and wellbeing care and support is based on what local people want.
  • Learn from people who have achieved positive change, to identify what helped them reach their goals.
  • Recognise and share learning from co-production successes and when things go wrong, to encourage best practice.

Essex County Council have been re-thinking how best to engage and work more collaboratively with adults with an experience of disability, so that collectively we can do better to ensure genuine co- production is happening across the system. Beginning in 2017, staff from Essex County Council came together with a small group of people comprised of adults with an experience of disability, to form a project team, thereby including user involvement from the outset. Healthwatch Essex are applying their co-production experience to facilitate a Forum to help enable adults with disabilities to have their voices heard, including by those who have senior, influential, positions.

Suffolk’s five year transformation plan sets out how it would improve children and young people’s (0-25) emotional wellbeing and mental health by transforming services, changing thelandscape in which services operate and upskilling the workforce.

‘Under-pinning the delivery of the children’s emotional health and wellbeing plan is our work with our partners, which includes representation from across our Alliance (Ipswich & East Suffolk and West Suffolk CCGs, Ipswich Hospital NHS Foundation Trust, West Suffolk Foundation Trust, Norfolk & Suffolk NHS Foundation Trust and Suffolk County Council: Children and Young People CYP Services), young people, Suffolk Parent Carer Network (SPCN), Schools, Voluntary sector organisations and Healthwatch Suffolk. Young people have also formed a separate group called CAT (Children & young people, Action and Transformation). Our partners are also represented on the Children’s Emotional Wellbeing Group (CEWG).’

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