A view from practice and experience Dr Ruth Allen

 Thanks to colleagues, people using services and their families in SW London

 ‘ Professionalism’ should be about standards not status

  ‘People do not realise they are looking through different lenses. i.e. service users, staff and carers, friends and families’

  ‘expertise’ – & deficits in expertise - lie in different parts of the system  there is different benefit from different types of expertise  different parts of the system have different access to power and resources and also different accountabilities and responsibilities  changes in one part create change or resistance in other parts Co-production means systemic change

  Co-production is about enabling the different parts of the system to work together differently  To build new connections and networks  To redistribute power and resources  To prevent responsibility and accountability from being so fixed they get in the way of creativity and alternatives  E.g from procedural risk averse safeguarding to making safeguarding personal…... Co-production means systemic change

  A ‘role is just a half-assed relationship’  Gregory Bateson in excerpt from ‘An ecology of mind’ 2011 Film by Nora Bateson Everything is in relationship to everything else….. From role to relationship

  Co-production will not grow if it is understood as an intermittent ‘ferry’ between two worlds  It has to be a permanent, free flowing, open all hours set of multiple connections  It must become a way of life for professionals and the communities they work with

  ‘Professionalism is the ability to work across cultures, be culturally competent’

  Professional as person  The professional/person encounter  The organisations and models of service Levels of co-production

  I create my professionalism from my own personal experience and my professional learning  An internal co-production. Both professional and personal contributions  Does the discourse of co-production need to pay attention to our relationship with parts of ourselves as professionals as well as relationships with people using services, families and wider community? The professional as person

  The real challenge is the human interaction. Being reflective, being patient…….Social skills and interaction are just as important as technical knowledge……. The professional/person encounter

  ‘Experiencing ‘unprofessional’ behaviour is ‘painful and disappointing’  ‘Professional boundaries are a matter of human rights’

 Some questions managers should be asking:  Where is the evidence of co-production / collaboration /shared decision making?  Are we training staff to be aware of ‘Micro aggressions and enablers’  Are the tools for collaboration adequate?  ‘Care planning’ or ‘support planning’ or ……. ?  Is feedback on practice routine? The professional/person encounter

  A true professional is confident and not afraid of challenge

 Social work for better mental health – Making the difference together 2016 ….. (encourages) practitioners and supervisors to work with service users and carers to develop a local methodology to hold collaborative conversations to explore and capture the experience of social work services from the service user or carer perspective. This is a simple thing to describe and quite a hard thing to do…….

  Service users and carers may (at least initially) also find a collaborative conversation approach unwelcome and/or exposing – and crucially may fear the experience will re-play power differentials with professionals rather than providing a safe and equitable space for a truly collaborative exploration. Service users and carers may also fear criticism will negatively impact on their care and support in the future and considerable assurance is required in order for this fear to be allayed. Social work for better mental health – Making the difference together (2016)

  ‘Some professionals are ‘untouchable’. There must be good structures to raise complaints well…..people fear being labelled and the impact on care’

  ‘Involvement’ can feel like a hidden experiment…… professionals often do not know what they want from service users/carers, friends and families’ Organisations and models of service

  Complicated and culturally institutionalised pre- existing service designs confound co-production  Co-production processes often attempted within complex and fast changing contexts -> unsatisfying and rushed  Tempting to ‘wipe slate clean’ -> add more complexity?  Commissioner led or whole system led? (many leaders) Organisations and models of service

  Commissioners as ‘hosts’?  Systemic change needed  Don’t underestimate resistance  Don’t avoid thorny professional responsibilities eg towards the public  Need multiple braveries  Value the smart and innovative  Use the research and evidence  Deal with ‘professional’ issues competently  What are the capabilities/expertise the system needs?  What are short and longer term workforce planning and development issues? Organisations and models of service

  Need systemic redesign and change process  IMRoC programme within Trusts  Recovery Colleges  Peer support: taken seriously  Community, service user and citizen leadership partnerships Organisations and models of service

  ‘Need to improve the conditions for professionalism’  ‘Professionals need rewards too!’

  Train for co-production  Enable professionalism in all parts of the system  Make standards and codes of conduct for professionals transparent  Co-produce local standards of professionalism and the role of the professions Reimagining professionalism