What are we talking about?

Co-production describes a way of working together in which support providers and those in need of support are recognised as stakeholders and are part of the same decision-making process. The aim of co-production, as laid out in the New Economic Foundation’s Commissioning outcomes and co-production: a practical guide for local authorities, is to create more effective services in partnership with people using those services. 

Meaningful co-production prioritises the inclusion of children, young people and families whose views and ideas have not previously been heard; whose experiences of working with professionals haven’t always been positive; or those for whom services are not easily accessible. Without the inclusion of families whose needs haven’t been met, there is a risk of repeatedly designing services that do not meet the needs of some of the most marginalised families. A commitment to equality, through ongoing training and information sharing on the principles and practice of equity, diversity and inclusion, is key to good co-production. 

Co-production is linked to participation research in many ways. This module highlights Treseder’s degrees of participation model. It builds on the well-known ladders of participation models created by Sally Arnstein and Roger Hart but rearranges the rungs in a non-hierarchical formatrecognises the importance of context, and lays out the degrees to which the voice of the child can be made central.  

Why does it matter to families? 

Working with families is also a method of understanding whether integrated care meets people’s needs. You can read more about the how the lived experience of families is a powerful tool for improving health and other outcomes in the King’s Fund guide, Understanding integration: how to listen to and learn from people and communities. 

Ultimately, co-production is about redistributing power to families and enabling them to make informed choices about their own lives. In the relational practice module (coming soon), you can find out more about how to identify and mitigate power and privilege (implicit in everyday conversations as well as organisational and structural dynamics) in the context of family hubs. 

Why does co-production matter to family hubs implementation? 

The family hub model, like children’s centres, is an integrated service. The model is expected to involve families and communities to build social capital and cohesion, as described in the Early Intervention Foundation’s Planning early childhood services in 2020: learning from practice and research on children’s centres and family hubs. Findings from the report in relation to local community governance and delivery are: 

  • there is limited involvement of parents and carers in the planning and delivery of children’s centre’s and hubs; 
  • there is little service co-design work with parents and carers; and 
  • there has been a decrease in the use of advisory boards or parent forums. 

Co-production can help address these limitations, but context is key. The family hub model is an integrated service model, not a standalone service. Co-production must therefore focus on the journey through the system and not only on individual services such as GPs or social care. You can read more about integration and how to embed good practice in your local area in the integration module. 

Who should be involved in co-production? 

  • Quite simply – families! To create a comfortable environment for families, adaptations may be necessary to accommodate need and age, and to reflect the project focus. 
  • Parent carer forums within your local area and other parent and carer groups, including those for parents and carers of children with special educational needs and disabilities, and panels for those who are pregnant or have a child under the age of two. 
  • Family practitioners. Consider who works with families in the local area, from the public sector, the private sector and voluntary services. 
  • Faith and community groups who may help widen engagement. Pay particular attention to individuals and groups who have not previously accessed services in traditional ways. 
  • Commissioners and commissioned services. Think about how you can engage those who may be commissioned in future, not just those already working with families. 
  • Strategic bodies, for example children’s strategic partnerships and integrated care systems. It’s important to include the voice of families at a strategic and governance level. You can read more about these bodies in the integration module . 
  • National and local charities who can bring an important perspective to local thinking, particularly in relation to protected characteristics. 
  • Education settings, including schools and early years provisions, as universal settings can facilitate access to services. It’s also important to remember who is not accessing education settings, such as children who are electively home educated.

How? Good practice (what are they key ingredients to success?)

Case example 1:

Charlie Waller Trust – Parent and carer peer support workers

Parent and carer peer support workers have experience of mental health problems in their own families and draw on that experience to support others. Families who have been supported by peer workers report that they have been better able to understand their child’s needs and navigate their way to better outcomes for their child in a non-judgemental safe space.  

Peer support workers can: 

  • provide needs-led, inclusive and targeted support to different communities, for example dads, adoptive families and Black and minority ethnic groups, provided by people who are culturally aware of the needs of family members because they have similar experiences and come from similar backgrounds   
  • offer personalised practical advice and support, hope and encouragement to families, and help them identify their own strengths, needs and goals  
  • develop or enhance existing support, such as face-to-face and digital support groups, one-to-one support, support via social media platforms, email, and text-based systems.  
  • support parents and carers to navigate local systems  
  • support and extend the work of professional teams in a setting that is collaborative and non-judgemental   
  • co-deliver training and support sessions within family hubs and other community settings  
  • help families to be directly involved in co-producing local service developments  

The Rollercoaster Family Support Project was co-created by a parent with lived experience in partnership with her local children and young people’s mental health services. The project has grown over the last seven years from a single group into a fully commissioned, family needs-led, trusted partnership. It delivers a range of services including digital, drop-in, training, involvement, and crisis services for parents and carers of children with social, emotional and mental health problems.   

The professionals know the academic side, but they don’t feel the total exhaustion and emotion looking after your amazing children. Finding a parent peer support group is worth its weight in gold. They understand your emotions and how to navigate your way through the system, who you need to speak to and what to ask for. They also give you that bit of hope that things will get better when you are rock bottom. Life savers – no more words to describe the value of parent peer support. A parent of a parent peer support group

The Parent Peer Supporters (PPS) engage parents in a way statutory services cannot. Parents trust their shared experiences. The PPS often discover issues with parents that they are unlikely to disclose to services that are blocking their engagement e.g. literacy problems, previous negative experiences, lack of confidence in working with professionals, feeling unable to speak up and advocate for themselves and their children. PPS often work with complex families a they are the place families go to when they are their most desperate. PPS are very often highly skilled people with a wealth of knowledge about services across the area and how parents can access the help they need. Community Modern Matron Child and Young People’s Service

Family hub leads or interested parents and carers can get advice and support to set up and run their own local project via Charlie Waller Trust PLACE parent and carer network.     

Case example 2:

Stockport Council

Stockport Council recognised the need to develop its approaches to co-production. It worked with parents, carers and young people and education, health and social care professionals to create an agreed definition of co-production:   

Co-production happens when all voices are actively listened to from the start of the planning process. This involves a mutual respect for each other’s views, with an open and honest relationship that is transparent and continually evolving to achieve meaningful and positive outcomes. 

Case example 3:

National Voices

National Voices, a collective of 180 health and social care charities evaluated their extensive community of practice work in Greater Manchester. Their findings include the following: 

  • Co-design is time well spent. 
  • The most successful communities push the boundaries of existing knowledge and expertise. 
  • Having a clearly defined goal in mind, and having team- or organisation-wide commitment to trialling new approaches, makes it more likely that a community of practice member will be able to create change in their organisations. 
  • Great facilitation enables creative thinking and increased confidence.  
  • A careful balance between ‘solving the problem’ and ‘capturing the opportunity’ is needed to generate energy within a community.  
  • Identifying specific expertise within communities of practice leads to inspirational learning in diverse aspects of practice. 
  • Defining the scope of the co-production process is essential (and challenging!). 
  • Involving senior leaders ‘makes space’ for change. 
  • Communities of practice may have a natural time limit.
  • The success of place-based communities depends on them being locally owned and led. 
  • Partnerships which span national and regional interests bring unique vale.  

You can read more details around these points in the National Voices report.

Co-production tips

  • Be relational
    • Find ways to work with, rather than do to, one another. This is in line with a restorative practice approach, as explained in the social discipline window.  
    • Find ways to ‘stand in the shoes of others’ to support shared understanding of reactions, roles and responsibilities. 
    • Practice the skills of courageous conversations – how to respectfully let someone else know you feel uncomfortable with their tone, language, or views etc.  
  • Be accessible
    • Work in partnership with organisations who already have relationships with the people you want to co-produce with, for instance schools, health visitors, libraries and local charities.  
    • Find different ways to reach different people, for example appropriate and safe use of social media, peer support and peer champions. 
    • Use language that everyone can understand and make sure everyone feels able to challenge language they are unsure of or acronyms they’ve never heard before. 
    • Make information accessible, for example try using graphic representation to capture key points or consider graphic facilitation training, e.g., Bigger Picture examples   
    • Consider barriers – for example is there only one way to join in? Do meeting times work for the people who want to be involved? Is childcare needed and available? Is there access for people with disabilities? How can those in rural or remote areas take part? 
  • Be inclusive
    • Work together to become aware of personal bias and assumptions and to take this into account before decision-making. For instance, if there are practitioners who are not familiar with the difference between migrants, refugees and asylum seekers, support them to understand these differences.  
    • Be an ally, i.e., someone who takes action to support underrepresented groups. 
    • Be supportive of those sharing lived experience. This can be challenging and may be a trigger for others present, so additional pastoral or therapeutic support may be needed.  
    • Call people by their name – and if you’re not sure how to pronounce it, ask respectfully. 
    • Recognise the difference between people with lived experience (e.g., a young care leaver with cerebral palsy) and people who represent a group or community (e.g., a representative from young carers charity). Each person brings a unique perspective and can make a valid but different contribution to the process.  
  • Be practical
    • Ensure safeguarding procedures are robust and well-communicated at meetings and events.  
    • Celebrate ‘easy wins’ to build on success for longer term goals. 
    • Be clear about the purpose of engagement with all those involved. For example, responding to a questionnaire is a data collection process that allows someone to share their perspective. On its own, it does not constitute coproduction. Co-production will require additional resource and longer time frames – plan and budget realistically for this.  
    • Consider what support and training is needed to develop confidence and skills for co-production.  
    • Commit to induction, training and skills for those who are involved in co-production – there is a lot to learn and there are fun ways to learn it. 
    • Ensure your promises are realistic – disappointment may stay in community memory longer than success. 
    • Remember to plan and implement consent and data sharing processes. 

Questions for reflections 

  • What narrative does our data tell us about the involvement of families whose needs haven’t been met? 
  • How can we work co-produce from the outset of our project? 
  • What do we need to consider when communicating with our diverse communities? 
  • What are my own biases and assumptions? 
  • How might I stay motivated and motivate others when meaningful co-production gets challenging?  
  • What skills might I need to mediate and balance seemingly contradictory viewpoints or tensions that co-production can raise 

Key deliverables: 

  • A shared commitment to co-produce from all stakeholders. 
  • A shared understanding of what co-production means that is communicated to all stakeholders. 
  • Agreed strategies for co-production layered throughout family hub processes within clear time frames. 
  • Agreed strategies for sustaining methods for co-production, including regular refreshing of community involvement and engagement. 
  • An assigned stakeholder or professional to develop, organise and deliver co-production, and to communicate with and manage service users involved in co-production. 

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