Next week is Scotland’s Co-production Week (19 – 25 November). There is a lot going on across the country to share stories and experiences of co-production.
The word co-production is used regularly in conversations across health and social care in Dumfries and Galloway and in my experience generates a range of different reactions from people. I’ve seen people roll their eyes (in frustration?) “here is another buzz word or management term, ” others grimace (in confusion?) “what is it all about?” Some people shrug and are concerned that this will simply slow down progress and we shouldn’t have to bother, “we just need to get on with change” they say. For some people, myself included, there is a hope that this approach will genuinely make a difference to how we plan and deliver health and social care in the future.
So, what is co-production? Are we doing it? And, does it work?
Co-production is when people with different interests come together as a group to:
- Co-design
- Co-deliver
- Co-commission and
- Co-evaluate
In health and social care, this means the people who use services, professionals, Carers, volunteers, providers and other stakeholders working together to consider how health and social care and support look and are delivered in the future.
Traditionally health and social care services have been designed and delivered by professionals working in partnership within the statutory, third and independent sectors. With co-production the crucial difference is people in communities that receive care and support are involved in all aspects of their design and delivery.
We should already be consulting and engaging widely on any kind of service change. Co-production takes us to the next level of engagement. It’s crucially about doing with and not to people. It’s about recognising that people who use services and their communities know things that we, as professionals, don’t know.
Working in a co-productive way
- can make a service more efficient and effective
- can change peoples behaviours in how they use or deliver services
- can place an emphasis on delivery of outcomes rather than just inputs and activity
100 days of co-production
In the USA there is a real emphasis on what Presidents can achieve in their first 100 days in office. It is amazing what can be achieved in a short period of time. For example, Franklin D. Roosevelt’s presidency began on March 4, 1933. During his first 100 days, a series of initiatives were developed that went on to successfully counter the effects of the Great Depression.
Perhaps a bit ambitious to think that we can counter all the challenges facing health and social care in Dumfries and Galloway in the same time period, however, using the 100 days to focus our efforts will be useful.
We have identified three topics to take into ‘100 day co-production labs.’ Co-production labs are essentially workshops to share experience, explore potential options for change, undertake tests of change, evaluate these and understand how and if they worked. This will help us to decide whether to embed these as part of routine service delivery or to try something else.
The topics for the labs have been identified by communities across Dumfries and Galloway. It is anticipated that a focus on these particular areas of care and support will bring some benefit to design and delivery of health and social care. They will also give us the opportunity to test out our co-production skills to understand what does and doesn’t work for us.
This is an exciting time with an opportunity to try a different approach. It will require hard work and commitment over these 100 days. But we’re all set and raring to go! Watch this space – see you in 100 days!
Viv Gration, Strategic Planning and Commissioning Manager
For more information about the Dumfries and Galloway 100 days co-production labs contact Viv Gration on v.gration@nhs.net
For more information about co-production, including a range of case examples visit www.govint.org
For more information on Scotland’s co-production week visit http://coproductionscotland.org.uk/coproweekscot
When I think about allied health professions it makes me think of an analogy I picked up when working in Vancouver. This visually described the multicultural society present in Canada as a “patchwork quilt”. Canadians aim to preserve their multicultural heritage by valuing the differences in being Chinese Canadian, Italian Canadian, British Canadian and so forth. They become Canadian but keep their root heritage alive, contributing to a rich cultural diversity.
We invite you to reflect on your own “way with words” and use the poster to explore what you tend to say and what you could say to explore how changing our words can help inspire, motivate and bring about positive provocations.
The seven C’s of Caring Conversations
Communication is key; how often do we hear this? The Senses framework is a useful tool to enhance communication and good relationships whether it is personally or professionally.
During my Aspire to lead journey, I used image cards at the beginning and end of a Dafne Pump week long course to capture expectations and experiences of the course. These sessions were always part of the course curriculum and delivered using verbal only methods. I changed this session by inviting participants and facilitators to choose an image that described how they felt about starting the course and how they felt after completion. It is worth noting that people are invited to only share what they feel comfortable with. The sharing generated was much more detailed and allowed emotional connection within the group. All of which influenced discussions and interactions throughout the week and at follow up appointments.
Since ASPIRE, I have been able to use appreciative language to be courageous about how I feel in the moment. I have been able to communicate my goals in my career, and my needs as a person at home in a clearer way. I am now in a Trainee Improvement Advisor, undertaking the Scottish Improvement Leaders (ScIL) course. ASPIRE gave me the tools to compromise and collaborate with people in situations I previously would not have had the self confidence to try.
Aspire to lead has provided me with many valuable tools that I use daily in my professional and personal life. Using these skills I have been able to be more courageous. I have recently started a secondment with the patient safety and improvement team out with my clinical speciality. During this time I have been involved in several improvement projects all of which I have continued to notch up my skills from Aspire by working collaboratively with others and also celebrating achievements. Probably the biggest challenge for me which I am still working on from the 7 C’s is sharing with people ‘how did that make me feel’, rather than what I think about the situation
Since Aspire I have become more conscious of my language and using the different Aspire tools have made a significant difference both in my personal and professional life. It has enabled me to be more courageous and become the STL for Ophthalmology. It has helped me to connect emotionally to team members and consider other perspectives while agreeing on different working arrangements. Following Aspire I have also completed the SIS Course at QI Hub and designed and led a major Service Development Project. Using appreciative inquiry has helped me to collaborate with all the major stakeholders. Using the 7 C’s of Caring Conversations has also helped me to enable the team to work together harmoniously towards achieving the aim of the project, which is ultimately to make our patients happier by seeing them closer to their home address in the West of D&G. Finally I got accepted unto and started in September 2018 Cohort 11 of the Scottish Quality and Safety Fellowship! I am excited about this amazing opportunity and I am curious about the work of other fellows. I feel the next step for me is to encourage the team(s) I am working with to celebrate more our successes and achievements!
We have recently welcomed many new trainee doctors to our beloved Dumfries and Galloway. The first week in August always brings back memories of my own first job..known then as “house job”, when change-over day was 1st of August, whatever day of the week that may be. In 1982 that was a Sunday. I arrived eagerly to Heathfield Hospital, Ayr on the Saturday, expecting to be able to find my way around and meet the staff prior to fully starting on the Monday (no induction or shadowing), having been informed that the “local boy” who knew the hospital would cover Sunday. However a last minute change of plan and alarming phone call informed me that I was to start on Sunday morning, be on call for medicine and was the CCU team with 2nd on call at home a few miles away. Thankfully a Registrar who stayed in residencies helped on his day off and I will never forget his kindness to reduce my terror.
Shadowing and induction programmes have improved the starting process hugely but do we do enough to welcome our new colleagues and do we all always remember how scarey this process is? Many of us have worked here for many years and it is easy to take for granted our familiarity with the place, people, who to ask, geography, processes but for our trainees everything and everyone is new.
All sorts of issues are covered and many resolved; issues that are causing stress or reducing enjoyment of the job and many good ideas for improvement are implemented. We are all busy but half an hour per week that can make such a difference must be worth while!
Second is a scavenger hunt, the brainwave of Dr Dutton. We live in a stunning, fascinating area yet we weren’t convinced that our trainees always got to explore and realise the beauty of the region. Our game enthusiastic trainees have gone out exploring following clues to places of interest. Selfies are required to confirm that they have successfully solved the clue.
Of course this applies to all trainees and new starters, not just medical staff. The focus on trainee doctors is simply because August sees the biggest change in staff in the whole year, but whenever someone new joins us, we should welcome them, put ourselves in their shoes, be inclusive, be creative, and be kind!
