Why we need to consolidate investment in co-production

Gerry considers the case for a strategic hub for co-production.

It’s now 18 months since the legislation seeking to integrate Scotland’s NHS and council care services came into force. This transformation, heralded by the Scottish Government as the ‘… single biggest reform to the way health and social care is delivered in Scotland since the creation of the NHS…’ is in part a response to the 2011 Christie Commission report which called for a ‘radical new collaborative culture’ to counteract the continuing growth in demand and financial pressure within our Public Services. So a year and half later how are we faring on the journey towards this co-operative vision?

In fairness it’s still relatively early days given the enormity of the task at hand. However whilst the integration of statutory health and social care services will undoubtedly bring benefits in the quality and consistency of services, true change, as stated in the Scottish Government’s policy memorandum 2013 will only be realised through ‘the utilisation of the talents, capacities and potential of all of Scotland‘s people and communities in designing and delivering health and social services’. This emphasises the importance of co-production as a cornerstone in the reform of health and social care by seeking to develop and utilise the nation’s mutual and complimentary capabilities and resources in achieving our common goal of improving Scotland’s health and wellbeing.

In her vision for ‘Realistic Medicine’ Dr Catherine Calderwood, Chief Medical Officer for Scotland, stressed the need for system and organisational change to promote the required attitudes, roles and skills which will enable practitioners and patients to combine their differing expertise and experience in sharing power and decision making. This echoes Malby and Turbitt’s view described in my last viewpoint that those working in the NHS (and other public services for that matter) need a mature relationship with citizens who are supported to acquire a well-developed understanding of their shared responsibility for their own as well as others health and wellbeing. As recommended by the Auditor General in October 2016 (6) achieving this requires that the Scottish Government, NHS Boards and Integration Authorities enter into a conversation with citizens about realistic expectations for future service provision; a conversation primarily based on the principles of co-production.

There has been an encouraging increase in the understanding and practice of co-production since the publication of ‘Christie’ however this is not the universal position across our health and social care system. Whilst progress remains slow there is also a sense we are edging towards a tipping point where the principles of co-production will make even more sense within the context of increasingly tighter supply/demand economics. In driving forward the transformation of our health and social care services we cannot therefore afford to take our foot off the co-production pedal if we are to have services which meet our future needs.

We now have a strong legislative and policy framework that encourages and promotes co-production. Given its importance in achieving the aspirations for health and social care reform however the level and focus of available funding is meagre given the size of the transformation task.

A cursory scan of the co-production ‘landscape’ across Scotland demonstrates the existence of a significant number of innovative but uncoordinated and diverse projects spanning activities from education and training, service delivery, strategic commissioning and the development of an evidence base. Given the overall paucity of investment it is argued there is potential to achieve greater traction by better marshalling these disparate resources around a central rallying point or hub which would provide more cohesiveness and drive in embedding co-production in all aspects of health and social care.

The creation of a Strategic Hub would provide a central connecting point joining up the broader network of co-production and self-management activities. Curating information from multiple sources and making it available to multiple recipients would provide economies of scale by increasing the speed and effectiveness of communication, facilitating learning exchange and giving organisations and practitioner’s access to wider audiences. As such it would focus resources and streamline the availability of information and dissemination of knowledge on co-production.

There are a significant number of organisations and departments across central/local government and within the wider statutory, non-statutory and independent sectors who are engaged in a variety of activities aimed at promoting, incorporating and evidencing the use of co-production and self-management as viable concepts in reforming the provision of public services. A Strategic Co-production and Self-management Hub will enhance rather than duplicate the work of these participants by consolidating collective knowledge and scare resources.

The ALLIANCE with its extensive links across the Third Sector and experience in hosting the Self-Management Network and national co-production programmes therefore calls upon likeminded organisations, planners and practitioners to join with us in making a Strategic Co-production and Self-Management Hub a reality.

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