2.11 Co-production and self-directed support
Scotland’s National Strategy for Self-directed Support was developed to take forward the personalisation of health and social care in Scotland. The strategy describes co-production as being ‘at the heart of self-directed support theory and practice’ (Scottish Government, 2010, p. 48). This implies, then, that co-production is fundamental to the provision of personalised services through self-directed support.
The Scottish Parliament has described the relationship between co-production, personalisation and self-directed support (SDS) in this way:
SDS can be seen as a method of pursuing the agenda of increased ‘personalisation’ in service delivery. Personalisation envisages a shift in the culture of public bodies and professionals from viewing service users as passive recipients of care to genuine partners in making decisions over the services they need. SDS is the means which individuals and families can have informed choice and greater control about the way support is provided to them. The type and level of support should then be decided upon through a process of ‘co-production’ i.e. ‘support that is designed and delivered in equal partnership between people and professionals’.
You will notice that this is a rather narrower definition of co-production than some of those discussed earlier in this section, since it focuses mainly on the relationship between service users and those who are care providers, such as social workers, support workers and nurses, rather than wider issues relating to community capacity, and how services are commissioned and designed. Sang (2009, p.32), has identified the need to make a choice:
... between a highly individualised approach to ‘personalisation and choice’ where the consumer is also, potentially, an isolated ‘claimant’, and … creating a collective approach grounded in the values of active citizenship and community engagement.
Some examples of more community-based and inclusive approaches to co-producing self-directed support are now beginning to lead the way in Scotland, as the next set of activities demonstrate. There is a choice of activities, depending on whether you are particularly interested in co-production in relation to adults or to children.
Activity 2.9: Co-producing self-directed support with children
Listen to Mamta Kanabar, a Barnardo's Children Services Manager identify two examples of co-production she has experienced in her work with children with disabilities and their families.
Then use your learning log to answer the following questions:
- What benefits does of working in a co-productive way does Mamta identify?
- Do you think that this approach would work well when developing self-directed support with other groups of children and families (e.g. children who have offended, or looked-after children)? Would it work in different parts of Scotland, or in different services? (You may well want to think about the services and areas you are most familiar with when you answer this question.)
You have probably been able to identify a range of benefits. In the case of the summer play scheme, for example there was a very obvious positive outcome – that the play scheme, that so many families valued, was able to take place that summer. But there also seemed to be other, less tangible, benefits, such as the development of more collaborative working relationships between carers and staff, and the participation of service users in the marathon event. You may have conjectured that the success of this venture might have longer-term benefits, for example in increasing the carers' confidence that they can make a difference to services, and increasing capacity of the carers' group to take action in the future.
The notes about applying this approach to your personal and professional context will be different for every learner, but it is important not to see the examples given in the podcasts as 'one-offs'. Elements of the approach could be applied in many different places and with different people with different needs.
Activity 2.10: Co-producing self-directed support with adults
The Institute for Research and Innovation in Social Services (IRISS) is, through its Pilotlight scheme, working with teams of people who use and deliver services across Scotland to design pathways to self-directed support. Listen to this 'Pilotlight' IRISS FM episode about their work in Moray Council with people with mental health needs. Make notes in your learning log to answer these questions:
- What benefits are identified of working in a co-productive way?
- Do you think that this approach would work well when developing self-directed support with other groups of service users (e.g. children, people with physical disabilities)? In different parts of Scotland? In different services? (you may well want to think about the services and area(s) you are most familiar with when you answer this question).
You have probably been able to identify a range of benefits for different people. For example, one service user describes how important it was to her that everyone's opinion is valued equally, whilst others talked of increased self-confidence and esteem. This was a two-way process, with practitioners and managers talking about the new insight a co-productive approach has given them to what really matters to service users. There have been a number of concrete outcomes, including new ways of approaching assessments and information-sharing, as well as significant relationship building between professionals, service users and carers. The process was not always easy – as one participant says, there have been no short cuts to co-production.
The notes you make about applying this approach to your personal and professional context will be different for every learner, but it is important not to see the work in Moray as a 'one off' pilot. Elements of this approach could equally be applied in many different places and with different people with different needs.