The language of co-production

This blog is about the language of co-production, so let’s start with the word itself. A lot of people are talking about co-production – it’s in all the big national strategy documents, it’s in the Care Act, it’s in the Care Quality Commission's assessment process. This is great, and long overdue, but lots of people either don’t know what co-production is or think they’re co-producing when they’re actually consulting or engaging with people.  

My advice is to research the many online resources, then co-produce how you will approach it within your own team, group or organisation. Co-production is, most of all, a way of being, thinking and valuing people because you want people to have the best lives they can. It is the most effective way to make the best decisions. I recommend having a look at the Ladder of Co-Production (opens new window).  

The words we choose to use matter. It's not about being pedantic; it's about being respectful and valuing each other as equal human beings.  If we accept that the words we use reflect and reinforce our values, then we must take responsibility for how we say things. This includes challenging other people to think more deeply about language. Organisations should be conscious of the way they speak about people, including on their computer systems, forms and documents. They should be conscientious about adopting respectful language that sees people as unique and valued human beings. On the other hand, good, well-meaning people who ask me ‘What’s wrong with your daughter?’ maybe deserve an explanation to help them think differently, rather than a stone-wall ‘Nothing!’ in reply.  

You said, we did  

Co-production is meant to make a difference, to change things for the better for people who draw on services. It’s not unusual to read reports with the mantra, ‘You said, we did’. This is often an appropriate response to feedback, but it’s more consultation and engagement than co-production. Ask instead what would your organisations have to do to start saying, ‘We said, we did’, as evidence of true co-production?  

Service users and professionals  

Much has been said and written about why the term ‘service users’ should be avoided and the offensiveness of the term to many, so I won’t talk about that here. Instead, I want to highlight how the word ‘professionals’ bothers me, when contrasted with ‘people who draw on care and support’. The term ‘professional’ suggests qualifications, expertise, knowledge, skills and competence. When pitched in contrast to ‘people with lived experience’ or ‘people who draw on services’ it feels imbalanced and implies that people who draw on services lack wider expertise, knowledge, skills and competence. Which, of course, is rubbish. Instead, why not just talk about people who work in services and people who draw on services? Isn’t this more straightforward, clear and equitable?  

Opportunity, increasing confidence and training  

People who draw on services are sometimes offered co-production work as an ‘opportunity’ – an opportunity to contribute, to have your voice heard, to increase your confidence, to learn how to fit into the ‘service land’ world of board meetings, projects, workshops. To be frank, I find this patronising. When we co-produce, we are all working! Co-production gives everyone the space to think from a different perspective, to understand what’s working and not working and then be creative, finding solutions and designing services that will do what actually makes sense to people.  

It can feel patronising to assume that people with lived experience need to be trained to co-produce because they should learn how the health and social care systems work so they can ‘join in’. Co-production can be creative in how people work together and communicate and doesn’t have to be done in council offices! Learning is for everyone and it’s every bit as important for people working in services to understand how to work differently to get the most from co-production.  

Empowerment 

For me, the concept of empowering people who draw on services is good; it’s the right thing to do. But we need to be cautious about using the word. When services talk about empowering people, it recognises that services hold all the power and can choose how much to cede to people who draw on their services; that’s how things are. Drawing attention to it can undermine the value of equality that is at the heart of co-production. It also negates the principle of choice and control and challenges rights-based approaches to social care and health. Better to focus on the positives of working together and joint decision-making. 

Jargon 

Using jargon is only a problem if it excludes some people who don’t understand what others are talking about. It’s important to co-produce the approach to jargon in any particular co-production work. Agree to avoid jargon or agree to the editorial convention of explaining acronyms the first time they’re used. Or give everyone a glossary (opens new window). There are options. Just don’t exclude people, because it creates barriers between ‘us and them’ and is patronising.  

And finally… 

TLAP’s Making it Real, which sets out how to do personalised care and support, has a lot to say about co-production and is worth a read with a co-production hat on. This is my personal Making it Real favourite statement about co-production: 

We work with people as equal partners and combine our respective knowledge and experience to support joint decision-making. 

If you’ve got this far, thank you for reading this and I hope my musings have given you something to think about. 

 

To explore this subject further, you might like to read Bryony Shannon and Glyn Butcher's recent discussion on the language of social care and co-production in their blog Co-production: are we missing the point?