The impact of co-production in policy.

The Impact of Co-production is the theme of SCIE's co-production week this year. It got me thinking about the enduring need for innovation in co-production approaches and how genuine examples of innovation in service creation remain few and far between. So much of TLAP’s work centres on policy, but what happens when we’re asked to feed into policy and co-produce in less-than-ideal circumstances?

Take the short turnaround time to respond to the White Paper on Adult Social Care Reform.  Engagement around the White Paper was about six weeks from start to finish; how would we ensure people who draw on care and support were able to shape it?  What emerged was a collective looking back, working together in the present and developing relationships that laid the foundation for some exciting future work to make our vision of social care reform a reality.

We were asked to comment on a wide range of themes and questions about the how the social care system could and should change. We welcomed the focus on:

• understanding our views on the future for social care  
• what concepts such as choice, control and independence mean to us
• understanding what quality looks and feels like
• the importance of access and fairness in the system.

What did we do?

The fact that co-production shapes how  the TLAP partnership operates meant we didn’t need to start with a blank page. We reviewed ten years of existing TLAP reports, blogs and quotes - and were able to feed ideas and authentic lived experience into roundtables with people who attended advisory groups set up by the Department of Health and Social Care (DHSC).  We asked partners and allies - Social Care Future, Alzheimer’s Society, Shared Lives Plus, Community Catalysts and others to bring their own learning and insights, gathered with people who directly draw on care and support. We held two open sessions with our National Co-production Advisory Group (NCAG), a group of people with lived experience that supports TLAPs work. There we discussed the questions raised by the DHSC and our ideas for future development of co-production opportunities between us.

Our learning from these reviews and discussions were analysed, grouped into themes and summarised in an accessible format to reflect what we heard, evidenced with direct quotes and all mapped to the White Paper headings. We stressed the need to build something new, different, bold and transformative. Words and vision are important, but we have had those now for many years. What we need now is action, accountability, investment, creativity, and commitment to genuine reform.

What difference did this make?

While it felt messy and imperfect, TLAP was able to ensure lived experience played a vital role in shaping the White Paper and the decade of reforms it aims for. The relationships and trust that developed over these short weeks, also led to TLAP supporting regular meetings of a new lived experience group, bringing together the Care Minister and people with lived experience to share ideas, insights and answering her questions; acting as a forum to support the ongoing development of reforms. Rooting our response in co-production gave authenticity and a value that was recognised as the government shaped their white paper - People at the Heart of Care. This has built a platform for this and future work.

The DHSC used TLAP’s ‘Ladder of Co-production (opens new window)’ each rung illustrating the difference between consultation/ engagement, co-design and co-production; ‘doing to, doing for and doing with’ people, encouraging them to reflect on their own practice.

Even in a brief six-week process, we were able to find ways to uphold our values, to work with people with a wealth of insight, knowledge to co-produce ideas and build new relationships. What emerged is an arc of co-production- using evidence from the past to describe the present and shining a light towards the future.

We stressed change will only come with adequate investment, a change in mindsets and cultures, and a willingness on all sides to do things differently. Innovation, in coproduction and with people who themselves draw on care and support, will be key to the transformation we all so desperately want.