CO-PRODUCTION TOOLKIT: AN APPROACH TO UNDERPIN EFFECTIVE INTEGRATED WORKING Gerry Power Joint Improvement Team

Christie Commission on the Future Delivery of Public Services 2011 “ … pressure on budgets is intense and public spending is not expected to return to 2010 levels in real terms for 16 years. In addition, new demographic and social pressures will entail a huge increase in the demand for public services. The economic downturn will also intensify and prolong demand … unless Scotland embraces a radical new collaborative culture throughout our public services, both budgets and provision will buckle under the strain…”

Co-production Enabling People to influence their own health and wellbeing by contributing to the design, delivery and improvement of services … by harnessing the mutual strengths, capacities and potential of people, communities, organisations and sectors working in partnership to make better use of each others assets in order to achieve positive change.

Commissioning for Joint Outcomes Self-directed support Market Facilitation Co-production Service User Engagement Joint commissioning for better outcomes

Your views on co-production Let’s look at your responses to the ‘Dots’ exercise:  Areas of agreement  Areas of disagreement 5

Potential benefits of co-production For Users  Improved outcomes and quality of life.  Higher quality, more realistic and sustainable public services as a result of bringing in the expertise of users and their networks. For Citizens  Increasing social capital and social cohesion.  Offering reassurance about availability and quality of services for the future. For Frontline Staff  More responsibility and job satisfaction from working with satisfied service users. For Top Managers  Limiting demands on the services.  Making services more efficient. For Politicians  More votes through more satisfied service users.  Less need for public funding and therefore lower taxes.

Potential limitations  Not everyone WANTS to co-produce, not everyone CAN co-produce – we need a variety of service models.  Co-production may bring some risks – although it might also DECREASE some risks.  Co-production is generally not ‘free’ – it requires resources and investment for its full potential to be realised.

How co-production works in practice: the Four Co’s of the Co-Production Star

Co-commission: Participatory Budgeting in Berlin-Lichtenberg, Germany Objectives:  Priorisation of public services in austerity  Strengthen social capital. Co-production Approach: Citizens are invited to suggest public service improvements & to prioritise suggestions. Results:  Direct dialogue between citizens & councillors improves accountability & trust  Engagement of citizens in neighbourhood projects supported through 13 citizen-led innovation funds (7000 Euros each) Source: Governance International

Co-design: The Esther approach in healthcare in Sweden Objectives: To shift from a provider focus to network support for the patient’s journey to care. Co-production Approach: Redesign of processes through ‘customer journey mapping’, Esther coaches, virtual good practice hub and patient charters. Results:  20% reduction in hospital admissions within 5 years  Number of unnecessary days in hospital decreased from 1113 in 1999 to 62 in 2011 Source: Governance International

Co-deliver: The Environment Champions Scheme of Solihull Council Objectives:  Improve environment and reduce anti-social behaviour  Strengthen social capital Co-production Approach: The local council provides Health & Safety Training and support to volunteers. Results:  370 volunteers now active  100 projects (large scale projects – Gardeners World + Community Hub)  Projects have produced an added value of over £500,000 Source: Governance International

Co-assess: Citizen inspectors in West Lothian Council Objective: To empower local people to inspect and improve public services. Co-production Approach: Local council recruited & trained 2 inspection teams of 4 local people to carry out service reviews. Results:  Improvements to winter maintenance and pupil placement services.  Change of perspective of staff engaged in service review with citizen inspectors. Source: Governance International

FIVE STEPS TO CO-PRODUCTION Step 1: Map it!  Action: mapping of existing co-production activities with public and third sector partners  Looking at what initiatives are already making use of co-production o What is happening? o What is working well? o What has not worked well? o What could be improved?

FIVE STEPS TO CO-PRODUCTION Step 2: Focus it!  Action: Identifying the activities where there are likely to be big savings and/or service quality improvements in areas which are organisational priorities  Tool: Priority Maps  Tool: Scenario Building – helping participants to identify the benefits to them (and to others) of co-production – how will it achieve the specific outcomes they want?

FIVE STEPS TO CO-PRODUCTION Step 2: Focus it!  Action: Identifying the activities where there are likely to be big savings and/or service quality improvements in areas which are organisational priorities  Tool: Priority Maps  Tool: Scenario Building – helping participants to identify the benefits to them (and to others) of co-production – how will it achieve the specific outcomes they want?

Step 4: Market it!  Action: Encouraging behaviour change by people who use services, other citizens and by provider staff  Tool: Co-design a co-production charter for the service, setting out the roles, responsibilities and incentives for people who use services, other citizens, frontline staff and managers  Tool: Public campaigns, focusing on 'nudges' and positive and negative incentives (to users, other citizens and staff)

Step 5: Grow it!  Action: scaling up the co-production activities that work, including spreading good practice to other services and other organisations  Tool: Service reviews - annual reviews with staff and service users to learn lessons from existing co-production initiatives and to identify quick wins and potential large wins  Tool: Recruit Co-production Champions to convince others to join in the co-production activities – people who will talk to citizens in places where they already are (“fish where the fish are, not in the pool beside you”)

Step 6: JUST START!

Co–Production of Health and Wellbeing in Scotland

Contact Details Gerry Power National Lead for Co-production and Community Capacity Building