Cuts and Opportunities

[Julia]

Last week I received a call from a director of services from a large London council. Let’s call him Mr Borough. He had just read our latest report, Public Services Inside Out, which makes the case for people and professionals designing and delivering public services together in equal partnership: what we call ‘co-production’. This innovative approach, we argue, results in much better outcomes, often shifts towards a more preventative model of public services and can lower costs. Mr Borough had also been told that he would need to make a 30 per cent cut to his budget within the next three to five years. But instead of heading straight for the nearest pub to drown his sorrows, he was actually excited by what lay ahead. Mr Borough felt that the current ‘squeeze’ on public services represents the biggest opportunity he had ever faced to radically revisit the shape and style of the support he is able to offer people.

Co-production offers such an alternative, as a wider transformation of our public services by bringing new resources – people’s time, skills and experience – into the system.

Mention “co-production” to someone and the chances are most people won’t know what you’re talking about. But although the vocabulary of co-production isn’t well known, the practice of it is increasingly happening all around us. Almost any service can be co-produced: while the actual process and activities can vary, it almost always looks and feels the same as the principles which underpin the approach are manifested in everyday practices, as well as in strategic level governance.

For example, Learning to Lead is a national programme of self-elected school councils where students establish and run a range of action groups from the food growing team to school improvements and science class advisory groups. Through this model, young people work together to identify their own areas for action, set agendas, run projects, set targets, and are active at the point of delivery. Their action allows them to become, as one student said, ‘the crew and not the passengers’ of their education, and in providing students with the space and responsibility they act into the role, developing valuable skills and – more importantly, a vested interest in their school and education.

At Merevale House, a residential home for people with dementia, residents participate fully in the running of the home: staff and residents cook meals together, garden together and work in partnership to run the centre’s services and activities.

Similarly, Local Area Co-ordination (LAC) a model developed in Australia, demonstrates the fundamental shift from someone having a ‘voice’ in the service to being an active agent in its creation. The model employs a local area co-ordinator within a given area where they are linked to between 50 – 60 individuals with disabilities. Instead of starting with the question ‘what do you need?’ which lends itself to specialist delivery interventions – the co-ordinator asks ‘what kind of life do you want to live?’ The answers to this question are more often, friendships, a job, living independently: things that we value universally and frequently a life free from the components which have traditionally made up disability services. The co-ordinator works with each individual to identify local networks and resources, such as a church group, library or local timebank that they can connect into, integrating the individual into local networks rather than allocating them due to their condition into specialist and disconnected groups and institutions. Funding and support is devolved down to an individual level and attention is paid to existing support structures, such as the family, or friends. The result has been a complete shift away from residential care or ‘drop in’ centres, and towards a more organic public department which has lowered costs, and more sustainable and valuable outcomes for people.

It all sounds simple enough. But all too often this common sense, equitable approach is marginalised in favour of specialist service interventions, shaped by the notion of ‘needs’ rather than capacities and leading to what Ed Miliband has described as ‘a letterbox approach’ to delivering public services.

The front line public (and Third) sector staff who are already experimenting with a co-productive approach all speak of the transformational effect it has had on the service, and the better outcomes for those people who use – or co-produce – services. The theoretical model leans on several principles, some of which are already familiar. However when these principles are combined, as with co-production, they represent a significant difference between co-produced services and our more traditional deficit model.

Co-production looks at people not as passive recipients, but as assets whose knowledge, experience, skills and capabilities are central to achieving more successful and sustainable outcomes. Successful co-production also builds on these assets, to enhance the capacity of the people who are so central to the outcome of the service. There is a strong element of reciprocity within co-production, and we often see mutual roles, responsibilities and expectations between people and professionals. Peer support networks are also central, and have demonstrated beneficial effects of social interaction and relationships on mental and physical well-being.

Once these elements are in place the division between professional and user often begins to erode as the delivery of the service becomes rooted in a much more organic and equal partnership. These principles are not abstract values, but are rooted in the approach of co-production that we have seen across hundreds of organisations within the UK, and globally.

There is a difference between a model which encourages, even enforces, passive consumption of services, and one which engages and mobilises people as active agents of change – where a service is not delivered in a one way (not to mention unsustainable) fashion, but is co-produced so that people can shape what their outcomes look like and grow their personal confidence and capacity through engaging in this way.

Why is this so important now? Because we are in the midst of one of those decisive moments where the possibility of transformation is in the air. For some the opportunity will result in a retreat to ‘core business’, struggling to deliver the same old services with diminishing budgets and limited impact. It’s at times like this when we need people to dare to be radical and innovative, and engage with the new opportunities that co-production represents. Whatever the political result of the election, we are facing a future where the purse strings of the public sector are significantly tightened. As an election flyer through the door the other day reminded me, ‘You can’t keep doing the same thing and expect a different result’. I couldn’t agree more.