Co-production Narrative as Creative Theatre–based Dialogue for Changing Practices

[Mr Hament Patel]

Co-production as an approach has experienced a massive upswing in interest in the last few years from a range of different stakeholders, with public service organisations playing a vital part. Especially in healthcare, while it is an approach to collaboration which has been met with much interest for many people in such organisations, for others an equal consideration as to what are some of the likely challenges and opportunities in developing such approach, has also been of issue.   

As an ‘asset-based approach’ co-production assumes that we all bring a set of valuable experiences, expertise and skills which can be developed and built upon to help improve our health, and the health of others - So far so good. What is a more difficult step for institutional learning structures is the acceptance that co-production recognises all forms of expertise: including the expertise earned through the experience of living with a health condition or spending time in a neighbourhood, as well as more academic and professional based expertise.

Involve (http://www.involve.org.uk/) has found in wider work around participation and engagement that organisational culture is one of the most common barriers to success. So it is with co-production that more focus is needed on the power of narrative; that is to say the stories that organisations tell themselves about who they are and what is right and wrong. Without a supportive narrative creating meaningful dialogue between people who bring different types of expertise can be all but impossible.

Cultural barriers are not limited to professional institutions; for patients and service users it can be difficult to be asked to become part of systems and processes which are either alien or new to them.

Organisations and communities have personalities in the same way that people do. There are a number of frameworks for exploring this. The UK Government’s science engagement body (which one of this blog post’s authors works part time on) has developed the ‘Departmental Dialogue Index’ which helps organisations indentify and pay attention to their culture. Please look at the following site http://www.digitalengagement.info/2012/03/12/departmental-dialogue-...

If co-production is to be more than just window dressing more attention needs to be paid to the stories we tell ourselves which help or hinder genuine empowerment. Involve recently pulled together a publication ‘From Fairy Tale to Reality’ http://www.involve.org.uk/from-fairy-tale-to-reality/ which looks at common myths that hinder genuine engagement and participation across the public sector. 

More recently in teaming up with the Professional Support Unit and Shared Services in London who are part of Health Education England (North, Central and East London) previously London Deanery, details of website are http://www.londondeanery.ac.uk/, Involve and OCP Ltd (www.ocp-ltd.com)together with a senior patient and public involvement practitioner with expertise in using applied performance theatre and dialogue, have developed a demonstration project. The project looks at ways to improve communication, quality of information and relationships in and beyond health and care services, through the creative use of theatre based dialogue, underpinned by a co-productive learning approach. The project asks how we can make co-production processes engaging and accessible so that everyone can contribute to changing practices in health and also benefit from achieving better health outcomes and relationships. To read more please click here for link to PDF Coproductive%20Learning%20for%20Better%20Health.pdf.

The project is currently operating in East London and is seeking to extend its work and reach to others elsewhere in London, over this coming year and possibly beyond.

The project aims are:

• To establish a wider network of partners interested in co-productive learning approaches to health and social care.
• To work with several active partners to pilot co-productive learning workshops in London.
• To work with the wider network of partners to review and reflect upon emerging evidence and information from workshops, drawing on the work of others.
• To develop an ongoing on-line resources and support for service users, professionals and other practitioners - involving workshop participants and others such as ‘expert patients’ and also health activists including voluntary organisations, in capturing wider ‘community voice.’ 
• To also look at more broadly at ways of supporting strategic health policy and practice through developing and improving approaches to communication and dialogue  in ways that will facilitate professionals, service users and communities to work for better health outcomes and well-being.

To date we have co-designed and co-delivered 3 workshops of both short and long length, with participants from a range of backgrounds and experiences in terms of ethnicity, gender and work in the field of health, care and support services including community development work. This comprised of service users, carers and different health professionals. Some of the things said by participants who had attended included:

“The role-play was helpful. During the feedback we built a model of good communication. We want more health professionals to be like that!”

“It was an important event for creating a space for us to explore coproduction and we look forward to the next stage.” 

“I would promote your event to local people as well as community organisations, as I am sure they will also benefit the learning and the know how of what co-production is.”

We welcome contact with any individual or organisation within London interested in finding out more about developing and using co-productive learning. This could include service users, carers, health professionals, community and voluntary organisations including social enterprises, policy makers, health activists and academics.

Workshops will focus on how service users and the health workforce can communicate effectively about change by challenging existing practices and power imbalances in relationships. Sessions will bring together people from different backgrounds to explore a health issue which is of importance and relevant to them all.

The workshops will use arts based techniques including a simulated performance model whereby a live case study is presented and used as a catalyst for discussion. The content of the case study will be developed together with participants.

Please let us know what you think by posting your comments. To also find out more about our work and how you can get involved, get in touch with either [e-mail] and, or [e-mail].