Good commissioning is dependent on co-production – a hypothesis
Ian Kennard, Commissioning Manager at Thurrock Council, de-mystifies the mechanics of co-production in commissioning a service designed to help people choose and utilise a direct payment.
A direct payment allows the council to let go of control, enabling individuals to take responsibility in choosing what they feel is best and best reflects what they need, when they need it. Our council wanted to commission a new support service for direct payments and turned to the Thurrock Centre for Independent Living. As a commissioner, I cannot make personalisation work, nor can any single organisation. It takes the art of co-operation to make this happen for real.
Talk is cheap………so use It
Talking to people is the simplest way of understanding each other. However, starting the conversation can be the hardest and most intimidating step. The little voice in your head asks; How do I start? Will people want to talk? Will they want to listen? Am I a good listener?
To enjoy a productive conversation, we needed to start from a position of mutual respect, speak the same language, listen to and hear each other; checking in to clarify uncertainties. This is not necessarily an easy task in a world of labels and acronyms, but it doesn’t come more person centred when we meet each other as equals, observing the golden ratio of two ears, one mouth to guide us in listening well, to understand.
The more we listened, the more people were willing to give up their time and share their expertise’Commissioning a support service for direct payments
Early on, we engaged Thurrock Centre for Independent Living (opens new window), our User Led Organisation (ULO), to help us speak the same language. The world around us in Thurrock had changed significantly since we last looked at support for direct payments. With the introduction of community led support (where we place Adult Social Care in the heart of the community to help tailor solutions for people), alongside a market bristling with micro providers, we needed to change and renew relationships. This included building relationships with people with lived experience of the local social care system. Growing mutuality enabled local people to have more trust and confidence in the council, generating a very significant increase in demand for support. This was a positive outcome, enabling the council and people to work together much earlier than at the crisis stage, where activity is likely to be less well planned, less well negotiated and costlier in human and financial terms.
Our focus is on intervening earlier to help people sooner and prevent a deterioration in their health and well-being. Co-production has helped unlock the mutual benefits of prevention.
We worked with the disabled people's organisation over six months, talking with individuals and groups about these changes in practice and the things we need to pursue. In return we were told about the things that worked, what didn’t and what people really wanted. We found that the more we listened, the more people were willing to give up their time and share their expertise to help make these changes happen for mutual benefit.
These simple conversations amongst equals, and a few cups of tea and biscuits, defined and tailored the support service we commissioned. It enabled individuals to have a meaningful say in the services sought, reflected their requirements and empowered people to interview prospective provider of the support service. This influenced the outcome of the tender, ensuring that the voice of lived experience secured the personalised support service that we collectively wanted to be available for all local people interested in taking a direct payment.
It is still personal
The conversation didn’t stop when Thurrock awarded the direct payment support contract to Purple (opens new window), nor should it. Purple has joined the ongoing conversation, alongside practitioners, turning up the volume on important discussions including what works, what doesn’t and has enabled:
- a co-produced Direct Payment policy that has collective ownership and is reviewed and updated by all
- a sharing of ideas and issues that shapes practice
- opportunities to resolve issues
- building bridges and understanding between the parties.
These small conversations really can tackle the big issues, building trust, confidence and shared benefit.
It is abundantly clear that we would not we have achieved the same benefits without a commitment to co-production and judge that the investment of time, tea and biscuits has multiplied our impact, quite simply by meeting each other as equals to design solutions that work for everyone.
In this case, the hypothesis that good commissioning is dependent on co-production is proven.
Comment below to tell us about your experience or indeed absence of co-production in public sector commissioning