Co ProductionWorking with patients

as partners

Co Production

What do you understand by the term?

A Continuum of Co Production

Partnership

Patient Voice/influence

Passive Patient

Mindsets not models

We are at a turning point in health policy: the nature of 21st century health, changes in society and technology call for a radical change of mindset and a reorganisation of how we govern health in the 21st century.

This changes the role of the health sector, of health professionals, of patients and of citizens – and of other sectors and societal actors including the private sector.WHO 2020 Framework

Current healthcare system boundaries are limited by a professional-knows-best mindset which can be blind to the powerful actions and forces that shape health outside of the boundaries of the healthcare systemBatalden 2015

FIVE YEAR FORWARD VIEW

A new relationship with patients and communities

We have not fully harnessed the renewable energy represented by patients and communities

But collectively and cumulatively (these initiatives) and others like them will help shift power to patients and citizens,

Patients are impatient of being treated like chipped flowerpots in for repairGerda Cohen

Self government by the patients must involve pretence because as soon as they encroach on real power they are brought up short Gerda Cohen

Who Am I?

STAGE ONE – PASSIVE PATIENT

FREQUENT FLYER MILES15 stays in psychiatric unitsOne year trapped on MH ward “delayed discharge due to housing”2 residential rehabs1 therapeutic community1 Social Services hostelOver 100 acute hospital admissions18 months in supported housing2 substance misuse day programmes2 dual diagnosis day programmes

Frozen Assets

Stage Two - Patient Voice

CONSULTATION FATIGUE

Beyond Involvement to Co-production

STAGE THREE PARTNERSHIP

I didn’t like feeling useless. My idea of who I was - the ‘me’ that I valued – was someone who could be special for others, who could do something they needed and here I was, a passive recipient of everyone’s helpEdgar Cahn

Co-production means delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change NEF/NESTA 2009

CORE PRINCIPLES Assets: Transforming the perception of people from passive recipients to equal partners. Capabilities: Building on what people can do and supporting them to put this to work. Mutuality: Reciprocal relationships with mutual responsibilities and expectations. Networks: Engaging a range of networks, inside and outside ‘services’ including peer support, to transfer knowledge. Blur roles: Removing tightly defined boundaries between professionals and recipients to enable shared responsibility and control. Catalysts: Shifting from ‘delivering’ services to supporting things to happen and catalysing other action.

IT’S ABOUT TIME…and value…

• Co-design, including planning of services and commissioning

• Co-decision making in the allocation of resources

• Co-delivery of services, including the role of service users in providing the service

• Co-evaluation of the service

What’s stopping

us?

CAN I COME OUT YET?

The moats we dig between patients and clinicians can drain spirit from both.Don Berwick

In moments of crisis the wise build bridges

The foolish build damsNigerian Proverb

Alison CameronPatient Leader

Kings Fund Associate@allyc375