Anthony Pickup, Involvement and Inclusion Manager at MEAM, looks at coproduction and how it can help improve services and change lives.
The word coproduction often worries people, particularly those who are responsible for designing and delivering services that have to work, and be seen to be working. It’s often seen as a risky and burdensome practice when compared to the traditional way of designing services, which despite having faults, is seen as tried-and-tested and above all predictable. It has been my job for 6 years now to help people overcome this fear and to embrace the concept of coproduction, and I try to do this by not only explaining the concept but by showing examples of where it has worked and the transformational effect that it can have on services and individual lives.
The fundamental concept follows the definition of the prefix ‘co’, which is ‘together, partnership, equally or jointly’. If you approach work with these words in mind you can’t go far wrong.
In the last few years I have been involved in many projects incorporating all levels of user involvement and coproduction. Almost all of these projects, and their success, shared an emphasis on what I always saw as my core activity – building relationships. Not only with clients but also with frontline workers and senior leaders. In the years before Covid, when I worked for Porchlight in Kent, I achieved this through visits to all of our residential and outreach projects, getting to know key-workers and attending team meetings. Some days it felt like I walked across half of Kent just chatting to people and at the time it often felt like I hadn’t achieved anything, but as relationships developed so did opportunities for involvement and gradually a network emerged. By being visible, dependable and consistent both clients and staff came to trust me.
Taking part in house meetings, focus groups, consultations and other regular activities such as mystery shopping and interview panels also helped clients develop a structure in their lives that had been lacking. The improvement of self-esteem amongst people with lived experience, and a dawning realisation of their own abilities and assets, often occurred alongside the other interventions in their lives to help them turn a corner in their own multiple disadvantage. In my experience, this is the successful impact of involvement and coproduced work.
I believe there are two distinct benefits of involvement, inclusion and coproduction:
- By engaging with the expert voice our understanding of systems, and people’s place within those systems, is increased. By tapping into subjective experience we learn the real effect of the services we provide and can then re-think those services to be their most effective. We all have seen countless examples of this and although there is still some resistance, buy-in to the ideal of coproduction is growing sector-wide.
- The other hugely beneficial aspect to involvement is the direct therapeutic benefit to those involved on an individual level. As we value people’s experience, time and contribution it creates a positive self-esteem feedback loop. As each opportunity gives experience and self-worth it leads, if managed well, onto the next opportunity and so on until eventually you can find you’ve covered a huge amount of ground. We’ve seen it in the experts that work with MEAM and many cases right across the sector. This is what I’ve tried to express as transformative practice.
In my own experience it was the acknowledgement that my contribution was valuable that was key. A life of experiencing multiple disadvantage can often feel like a wasted life, and coming to understand that all those experiences can actually be seen as an asset, such as allowing insight that others lack was fundamental to the development of my self-worth. This then allowed for growth in many other areas of my life.
A couple of years ago I was asked to deliver a speech to an NHS conference on Adverse Childhood Experience. Below, I summarise my key conclusions and considerations for best practice as I think they resonate with the creation of good coproduction. Adverse childhood experiences and multiple disadvantage are often interlinked and it seems obvious that addressing them is linked too. For those wishing to work on coproduction, whoever they are, these things feel relevant:
- It takes time. Constantin Stanislavski said “Time is a great filter for our remembered feelings. Besides, it is a great artist. It not only purifies it transmutes even painfully realistic memories into poetry.” I’ve found this to be true.
- It requires reflection and the development of self-knowledge
- It requires resilience
- It’s almost impossible in isolation – you have to let other people in. Positive relationships with services and individuals are vital.
- It’s a process – each activity adds a little over time and it is the accumulation of these things that enables recovery.
- You have to learn Positive Self Regard and experience positive regard from others, which, after years of guilt, low self-esteem and self-blame is a difficult thing to cultivate but transformative when it happens.
If we can incorporate these into coproduced service design and delivery we are well on our way. When the individual experts grow and develop so does the work that they are engaged in and vice versa.
In my first six months at MEAM I have worked on expanding the expert network, providing support for MEAM Approach areas wishing to develop coproduction, creating training and workshop resources, and developing a best practice library and an accessible Co-design toolkit. I hope to expand all these activities in the coming months to benefit more areas in the MEAM network.
Anthony Pickup is MEAM’s Involvement and Inclusion Manager. For further advice and support regarding coproduction, please contact Anthony.email@example.com