Co-production in social care

Introduction 

When the 2014 Care Act was introduced, the inclusion of co-production in its statutory guidance was much-needed – we were starting to see a shift in how service users were involved in shaping their care, but its implementation was patchy and sometimes surface-level. 

The story is very different now, with the mantra, “nothing about us, without us” being more ingrained in health and social care planning. Co-production – an equal relationship between service users and the people that run services – should be used to plan, develop, assess and shape services. 

Ten years on from the Care Act, the sector has embraced the broad definition of co-production in social care and created sophisticated methods to ensure the concept can be properly understood and implemented in a way that leads to improved and higher quality services. 

Here we pull together some useful resources on the best ways to deliver co-production in social care with a focus on improvement.  

1. Social Care Institute for Excellence (SCIE): Co-production; what it is and how to do it

Acknowledging that there is no precise definition for co-production in social care, this helpful guide – which itself was co-produced with service users – lists key features of successful co-production initiatives. They:

• define those who access care and support as people with skills;
• break down the barriers between people who draw on care and support and professionals;
• build on people’s existing capabilities;
• include reciprocity (where people get something back for putting something in) and mutuality (people working together to achieve shared objectives);
• work with peer and personal support networks alongside professional networks; and
• facilitate services by helping organisations to become agents for change rather than just being service providers.

In this comprehensive overview, the SCIE provides guidance on how to implement co-production in social care in a way that considers these areas:

• Culture – the beliefs and values that define an organisation and the way that it works;
• Structure – the way the organisation is arranged and the systems it has set up to conduct its work;
• Practice – how the organisation and the people who work for it conduct their work; and
• Review – monitoring how the work is conducted and the outcomes or impacts that result from the work.

Engaging with frontline staff is a particularly important aspect of understanding the culture and practice areas.

2. The National Co-production Advisory Group

The National Co-production Advisory Group, or NCAG, is a membership body made up of people who draw on care and support. They have produced a handy, concise guide on what co-production is and how to do it. 

Engaging frontline staff is a step that is sometimes overlooked in co-production, as it can be seen as an activity between decision makers and service users. NCAG acknowledges the importance of this group by including in their top ten tips: “in order to achieve meaningful, positive outcomes, everybody involved must have the same vision, from front line staff to management/board members.”

They go on to include in their tips on how to support co-production that teams should: “Ensure frontline staff have everything they need to for co-production, including time and flexibility.”

3. Making it real

Developed by a collaboration between charities and public sector organisations, Making It Real is a set of co-produced statements that describe what good care and support looks like. It was co-produced by people who draw upon care and support and people who work in it and the statements are aligned to the Care Act, and built into the CQC Single Assessment Framework.

Making It Real is a set of statements that describe what good care and support looks like, organised into these six themes. These statements can be used to spark discussions to lead to improved care.

The statements are followed by guidance on how to use them effectively:

4. NHS England

NHS England’s guide to co-production in health and social care gives high-level guidance on how it can be blended with other user involvement activities, summarised by this diagram, which is expanded on in Annex A1. 

Their creative map animation provides guidance on the pitfalls of co-production in social care:

These summaries are particularly helpful for those wanting to sense-check and finalise their plans for co-production in social care. 

5. The King’s Fund: how does the health and care system hear from people and communities?

This King’s Fund report from 2022 gives an overview of the different ways to listen to service users, providing inspiration for a broader approach to co-production in social care. 

They highlight national data sources as important, with surveys being key in measuring the experience of the people (and their carers) using health and care services.

Alongside surveys, they highlight the below as additional resources for hearing users’ voices to improve services:

• The Friends and Family Test
• Patient-reported outcome measures
• Healthwatch 
• Local Government surveys
• Patient Advice and Liaison Service
• Patient participation groups
• Voluntary, community and social enterprise groups
• Complaints and compliments.

Conclusion

While co-production in social care is a statutory requirement, there is room to embrace the concept and implement it in a comprehensive, creative way that engages everyone involved in improving services. 

ImproveWell is a real-time feedback and engagement platform that is improving the quality of health and social care services by gathering ideas and data from frontline staff, expert service users and other stakeholders. By presenting ideas in an accessible and efficient way, feedback can be collated easily to streamline co-production in social care and speed up improvements for its users. 

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