Co-Production - Find out how you can be involved

Whether you are a patient, clinician, Carer, statutory, voluntary or community sector, everyone has something to bring to the table. Everyone can help co-produce services by working together.

This section is for people to share stories, experiences, ideas and opinions about what changes we could make to work towards co-production. If you are already working together to co- produce and have already learnt from this experience please tell us about it and we will include it here

Watch this film clip if you want an easy way of understanding what co-production means for all of us. 
 

Try this quick and easy quiz to do using real life examples. It scores out of 5 – what did you get? Think Local Act Personal have kindly given permission for the Trust to use this quiz.  

3 Conversation Model developed by Worcestershire County Council – Listen and Connect, Work Intensively with People in Crisis, Build a Good Life.

 

Helpful Checklists for Co-production

This is a young person’s perspective but could apply to any member of the public or staff.
 

• An acknowledgement that it is a partnership, that we must all take responsibility and we each have an expertise (for example, we are the experts in ourselves but may need help in knowing how to manage our health)
• It is a shared responsibility
• Not one person is more important, or at a higher level than another
• Not looking down at someone, or assuming that they don’t know something purely because they are young
• Using simple language or terminology that everyone can understand so that they can work together (no jargon)
• Making sure your body language is welcoming, that you don’t appear indifferent to the younger person (give them the same level of respect you would give another adult or another professional)
• Respecting other people opinions (e.g. just because someone is young, does not make their opinion any less valid or important)
• Being able to disagree or object to something said without feeling afraid (having the confidence to do so and knowing that what your going to say will be heard)

Checklist for co-production (and younger people) by Katie Conway Youth Consulter. 

Training

We are currently developing training materials and piloted these recently on one of our teams within Worcestershire Health and Care Trust. We would like to share these materials with our partners and hope that some of our knowledge and ideas are helpful to you as you also, like us, aim to embed co-production into your everyday practice. 

CoProduction Presentation [pdf] 1MB

This section is about gathering your ideas, questions and experiences and sharing them with others across the system. You may have a question about how to go about co-producing, or an idea for a co-production approach or have learned some things from a piece of work that you have been doing. If so please complete the form below or email: Mandi Bishop: mandi.bishop@nhs.net and we will post it here

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Your Experience(s):

Worcestershire Health and Care Trust held a system wide event on 16^th July 2018 at the Bankhouse Hotel, Bransford, Worcester. We invited our STP partners to showcase the work they have been doing around co-production and to start a conversation about how people felt about the approach and how we can all work towards embedding co-production.  It was a fantastic opportunity to network and identify creative ways of working.

In this section we will be showcasing your achievements. So whether you work at a community centre, or are a patient, carer or a matron of a community hospital, let us know what you are doing and achieving. You might be the person who has driven co- production and changes within an organisation and have been the catalyst for change. Not only is it good for you and your organisation to showcase your achievements, it also enables other individuals and organisations to become inspired and start co-producing.

We know that this will be driven by people from lots of different backgrounds. It would be great to learn about the variety of approaches that is co-production. This could include a different approach to a clinical conversation right through to; role play, drama, art, creative writing and patient stories. We can all learn from each-other.

Volunteering

Volunteering is an important part of co-production. Volunteers in the Worcestershire Health and Care NHS Trust help support patients/carers on their health journey and make their experience of being in hospital more friendly and comfortable at an often difficult time.

Although our volunteers are not involved directly with patient care, they all offer their services by doing a wide variety of roles and help provide extra support to patients.

Our volunteers come from all walks of life and backgrounds. We don’t ask for qualifications; all we ask is that applicants have a genuine interest in helping others and are fit and well to fulfill the role. It is a real advantage too if a volunteer has their own ‘lived experience’.

The benefits of volunteering are:

• Gives people an opportunity to help their community
• Volunteering has an important role in improving skills and therefore can lead to paid employment if this is what someone wants
• It can help people gain confidence
• It can be sociable and helps people meet and integrate with others
• Can help reduce loneliness, and can help improve mental health.
• Above all it’s about contribution and being part of the community.

As staff can be so busy with clinical aspects of their role, volunteers can add much value by spending more time with the patient, providing activities/support that are so important but which staff don’t always have the time for, but do recognise the value of.

• Volunteers who have a lived experience help staff by giving them a resource for ongoing dialogue to help improve services as little things can make the biggest difference
• Volunteering has continued to develop in our Trust and in the last few years, we have seen a substantial increase in the numbers of volunteers supporting various activities throughout the Trust. This has resulted in considerable benefits to the Trust, individuals and the community in Worcestershire.

Diane Payne -  Patient Activity Companion 
Monica Whitmore - Housekeeping 
Jess Galbraith - Patient Companion 
Katie Conway - Community Engagement Team 
Alan Sanson - Tai Chi instructor

CAMHS App

Co-producing a Gaming App for Child and Adolescent Mental Health Services (CAMHS) – Young People are Equal Partners. This will be an app for children and young people to access interactive support and guidance around mental health.

These pictures depict Youth Consulters and Youth Ambassadors from Worcestershire Health and Care Trust working with web designers and clinicians to develop an app for CAMHS. This is a really exciting venture where all involved have benefited from working together and sharing ideas and perspectives. The app will start to go live later in the year and has the potential to support many young people with their mental health in a truly interactive way! This could not have been achieved without the “buy in” from the Trust in terms of co-production. 

Chelsea James, age 18, Youth Consulter(Worcestershire Health and Care Trust).

“I felt very honoured to be part of something that could potentially be very popular in the future and help a lot of young people get back on track. I think it was great to have people from a variety of ages and backgrounds all bouncing ideas and encouragement, off one another at the meeting. It was a nice relaxed atmosphere and together - youth consulters/ambassadors, clinicians and IT technicians - I think we made a success of it.”

System-wide Co-Production Event

Partners from across Herefordshire and Worcestershire came together at this event to hear about lots of different examples of co-production from clinical interaction
right through to the development or redesign of services.

Things That People Found Useful from our Event . . .

• People enjoyed the time to reflect and discussion time after the workshops. For many, this is where the real learning opportunities are. Many reported an increased motivation to explore co-production within their service. “How can we make these ideas work in our setting?”
• The actual co-production exercises and the group involvement which provided real examples of power sharing.
• Many appreciated the time to network with people and organisations that otherwise, they would not meet. There was particular value placed on the interest in working with Carers.
• There was a recognition of the diversity of the attendees – a cross section of patients, Carers, staff, statutory, voluntary, community sectors.
• Attendees related to the inspirational patient experiences and stories and again, this encourages reflection and learning.
• Opportunities to share practice and experience was valued.
• There was appreciation of the role Youth Board played in their workshop and the use of role play to deliver a message to the audience.
• The way the day was organised and planned and the enthusiasm of those involved was acknowledged!
• The strategy workshop was really useful in terms of informing people of what is currently going on. People left with a greater understanding of the “bigger picture” of how we all could work together and work towards co-producing.
• The range of workshops and staff involved provided an inspiring learning environment.
• Previous to the event, many had little awareness of the term “co-production” so they appreciated learning about it and the value of co-production in all areas.
• Many appreciated the key note speech by our Chief Exec Sarah Dugan. The fact that Sarah is such an advocate of co-production was inspiring to many: “It is reassuring that co-production is here to stay and grow”. 

• Keynote Speakers from the Event and Contributions:

• Sass Freeman - Stroke Survivor 
  “Think about empowering us to put more effort into our recovery. This can be done by simply pointing out what we can do, rather than what we cannot.”
• Gordon Prescott - Diabetes (My Friend and Me) 
  “I made and took positive decisions to liaise in a meaningful way with healthcare professionals including the pharmacist, family and friends to enlist their support on my journey.”

Building Health Partnerships

Building Health Partnerships. On the 28th of June 2018, the Herefordshire and Worcestershire BHP 'think carer' group met for the last time as part of the funded Building Health Partnerships Programme (BHP). Here's the Think Carer Partnership Presentation for information and you can also find out more on the IVAR website about the Building Health Programme more broadly and how we can enable a new and fresh dialogue between statutory organisations/services and the voluntary and community sector.

Blogs and films are a great way for people who are passionate to air their views, tell us about their experience and give great advice and support to others who would like to do the same. 

Volunteer and stroke survivor, Sas Freeman on co-production. The language often used with stroke survivors is negative and this impacts on their progress and recovery. “ Would it be possible to use different language?”  How do we include children affected by stroke? “Take the time to take children in the family aside and explain what to expect”.

Here are some tips which might be helpful if you want to write a Blog:  

• Blogs are successful because they are specific and written with passion.
• They often highlight a single focus on a topic you enjoy or really care about. The best way to put this across is to “put a bit of yourself into it”.
• Make it condensed and concise so readers get a lot of information in a small amount of time. 
• Stand out, be different – be honest.
• Connect with the reader and encourage them to interact and comment.

CAMHS App

See how one of our Youth Consulters from Worcestershire Health and Care Trust  has enjoyed experiencing co-production first hand working with young people, clinicians and designers to design an app for CAMHS; “Being part of this project has been highly inspiring and motivating; it has showed me how I can use my voice to actually make a difference to someone’s life”

Blogs Workhop Speakers and Presentations [pdf] 183KB

What is Co-Production?

By Katie Conway, Youth Consulter(Worcestershire Health and Care Trust)

• In its simplest terms, to me co-production means working in partnership with people and taking a shared responsibility on something. For example, we are all responsible for our own health and so working in partnership with your GP, your pharmacist or whoever can help you manage your own health and assist you in taking responsibility equals co-production at its finest.
• However, co-production does not just mean working together. For co-production to be effective and to truly understand what it means, everyone must be at an equal standing; professionals, patients and the public. It means acknowledging and accepting that everyone brings a particular strength and knowledge that others may not have, working so that not one person is considered more important than another or that one person is seen as knowing less in a way that their opinion and knowledge may be slightly disregarded.
• Youth Board is a perfect example of co-production as it is a group of young people sat together with staff and also patients, where no one feels as though their opinion isn’t heard and we all have an equal part to play. We all come together to share our knowledge, experience and opinions and respect that these may differ between us, but this also creates an effective group dynamic, with everyone putting in an equal amount of effort and work (from both the young people and the staff members).

How I have experienced co-production in helping to design a Camh’s App…how I can use my voice to actually make a difference

By Ellie Duncan Youth Consulter.(Worcestershire Health and Care Trust)

• I have loved being part of the production process for the CAMHS app project. Over the past 6 months I have been involved in roughly 4 meetings along with a range of other young people, clinicians and IT professionals. It has been such a great to experience for us members from the Trusts Youth Board to intertwine our ideas with healthcare professional and it has also helped me to gain a further insight and understanding of a range of mental health issues.
• Throughout the meetings, we spent different proportions of time focusing on various aspects of the app. This was really eye opening as it helped reveal how, what we thought would be a simple task, such as personalisation would in fact in fact require great thought and intricate detail.  As a whole,  the aim was to be able to produce an app that would be able to give CAMHs patients a safe and positive environment to aid them.
• Being part of this project has been highly inspiring and motivating; it has shown me how I can use my voice to actually make a difference to someone’s life but how it’s important to focus on a wide range of aspects in lots of detail and how something that may seem small can have a big effect and impact. It has also been a great experience to be able to experience the definition of co-production and to be able to integrate with health care professionals and to be able to share our ideas and be guided by their knowledge.
• Overall it’s been amazing to watch our ideas and visions slowly come to life and to be part of such an amazing project and to be able to really make a difference. I really hope I will be able to participate in more projects like this in the future!
   

Katie Conway and Ellie Duncan - Members of our Youth Board.(Worcestershire Health and Care Trust) 

Giving young people a voice by One of Our Youth Consulters: “Youth Board is a great way to get your Voice and Opinions Heard to Influence Service…….” (anonymous)

I’m a sixteen year old who is a unique mixture of nerd and chatterbox. I live with my family and my dog in the Worcestershire countryside. I went to a local school and that’s where my story begins. I didn’t really fit in to the ‘popular’ crowd when I first started at my high school. I was a victim of bullying- every little thing I did picked apart and taken the mickey out of. I ended up spending time by myself avoiding others for fear of judgement. I didn’t tell anyone about what was happening to me- I couldn’t wait to leave school and be at home where I was free to be me without the bully’s judgement. This constant state of trying to get the most out of school but being put down by people who thought they were better than me left me suffering from anxiety and had bad implications on my controlled OCD. The effects of that time at the beginning of school still affect me in some way today.

However, I survived - I came out the other end knowing that people who bully are the ones in the wrong. That’s why I want to use my newfound confidence to empower others to get involved with sharing their story and making a difference. Youth board is a great way to get your voice and opinions heard to influence services that directly affect you or your peers- that’s why I wanted to become involved in schemes that allow me to do so. The NHS in Worcestershire has many different services set up to help young people in many areas of their health, from mental to physical. Mental health awareness in young people is very important in an age where everything we do is filtered through the internet and often easily judged by our peers on social media for example. Young people very often experience some form of negative interaction aided by the Internet or solidified by stereotypes in society and this has serious implications on mental health. These implications lead to many people not seeking a way to revive help to assist them in thei lives. The NHS, as well as many other organisations that work with the NHS, recognise and completely understand that everyone needs specific help or advice to prevent any more serious issues from occurring. These health organisations try their hardest to use years of research and experience to assemble these avenues of services for young people; they more than often have great success with helping people find the right help and guidance but not everyone feels that way. That’s where youth board comes in! Youth board is run by NHS youth engagement teams that work hard to give young people, age fourteen to thirty, a platform and save space where their views on their own experience of services can be heard and direct action taken to implement new ideas or amendments. This format is such a unique environment: a diverse discussion between direct recipients, observers or people who work for organisations that manage services, that are consulted on a monthly basis. Youth board discusses new services aimed at young people as well as currently existing services to ensure that the investments into young people’s health are worthwhile.

One of the unique ways that youth board work is through coproduction; working together to produce something. In this case, we work together with the people that matter to create new opportunities and be involved in reforming existing ones. This way of being involved has given me a great opportunity to have my opinions shared and taken on board as well getting to see real impacts of services that I help to shape. (anonymous)

The challenges of co-production- A Peer Support Workers Perspective 

It’s really important that we as service users and patients can talk about service experiences, share common ground and negotiate service improvements together. This to me is the essence of co-production. Making meaningful change together. However, to do this well takes time and effort all round.

 Co-production isn’t, or at least shouldn’t be, a tick box exercise and whilst it may add more time onto a project, the outcomes of a better fit for purpose service are worth the effort.

Often there is a lack of time for people implementing new changes to circulate information about involvement opportunities. True Co-production takes time, detailed conversations, time to ‘think’ (often left out of NHS change projects) and just general involvement and communication.

I believe that many people do want to involve patients and service users however it can sometimes appear tokenistic – usually due to lack of time. For my own experiences I feel fortunate to have been involved fully in several changes that have taken place in the trust, however I know there is always more to do.

I sit on the community engagement panel and have seen first-hand how our involvement has given fresh thinking and ideas to upcoming projects. Our ‘fresh pair of eyes’ often uncover things that haven’t been thought about which clearly help bring about more robust, patient focussed changes.

Co-production will be on the NHS’s agenda more and more and will become ‘business as usual’ but until then, we need to think clearly about involving those whom the service directly affects – ‘no decision about me, without me.’

Clare Knighton

Strategic Vision

Since our STP co-production event in July the energy around this approach has continued to gain momentum and we felt it would be useful to share some of the conversations and commitments both locally and nationally. Firstly though I would like to thank all of the people who attended the event in July because it highlighted yet again the passion we have across Herefordshire and Worcestershire for working together whether this is clinicians, patients and carers or across teams and organisations – the commitment was clear and great to be part of. What people who attended did feedback was that they wanted to be able to access materials, updates and like minded individuals so we have created this co-production space on our STP website and I hope to continue to keep you posted with what is happening in our STP and in particular how we looking to embed co-production in our planning, developments and delivery – all ideas welcome! I will be inviting other colleagues to pick up the blog too with their thoughts and reflections so if you are interested in doing so, please let me know.

I think the timing around launching this “co-pro space” is really helpful too as nationally we are expecting the NHS 10 year plan in the next month or so and whilst it will set out national priorities we will need to work together to deliver these locally. There is also going to be a period of engagement post national publication and again it provides a great opportunity to get more people involved in shaping what this could mean across Herefordshire and Worcestershire. Key aspects of our local plan will undoubtedly  continue, for example increasing our focus on prevention and care outside of hospital and improving access to mental health support, but how we scale up the impact of these will need to be shaped and owned by us all. For me, co-production on every level will be fundamental in achieving this – embracing and nurturing collaboration, partnerships, relationships as being central to the way we work together.

So on a more practical note, we will be looking to follow up on the commitments from the co-pro session in July and many of the outcomes of the day itself have been channelled into key forums/discussions, for example co-pro being central to system wide OD programmes for all staff and widening relationships at a Neighbourhood / Locality level to include voluntary and community sector, housing and other key partners (e.g the fire service) to help people live as independently as possible in their home. I have been talking to Heatlhwatch colleagues about how we can widen our conversations with our communities, especially in relation to self care and I have also met with the University of Worcester to plan a debate that would look to focus on the personal responsibility for our health – not to provide answers but to start us all thinking about the role of the NHS in the 21^st century.

So I would really appreciate feedback on the co-pro space and what else you would like to see here in the future, including what would be useful to hear from myself and others in terms of system wide updates. Thanks again for your interest and please continue to spread the word!

Sue Harris

If you want to contact us about this website or co-production and the STP please email: whcnhs.yourconversationhw@nhs.net