Co-production in perspective

Decision-maker or Solution-builder?

We enter 2018 with co-production hitting an all-time high in the popularity stakes. It seems to capture the mood of the moment, harnessing community assets to make better use of diminishing resources, particularly in the fields of health and social care. Institute members report positive experiences – well beyond these subjects, and Government Ministers increasingly find ways to encourage the practice in speeches and policy initiatives. No-one argues against co-production, but its relationship with public and stakeholder consultation might benefit from greater clarity.

Obviously, the very act of involving service users in designing new services can amount to being consulted. But for some people, co-production can be a much wider concept, and can even alter the balance of power in organisations. According to TLAP’s (Think Local Act Personal) Ladder of Participation co-production can mean sharing strategic decision-making about policies as well as decisions. In short, the decision-making is sub-contracted to those who co-produce.

Now that’s okay in the sense that Councils, Health Trusts, Police Forces or even Government Ministries should surely be able to delegate difficult problems to a subsidiary body or committee if they wish. But can they delegate the accountability? Is it open for a Council to entrust service design and delivery to a third party based around a co-production project? This is unlikely to be an issue if everything goes well, but where there are challenges and problems, can that Council escape ultimate responsibility? If whole services are to be co-delivered, there has to be clarity and legal accountability for the outcomes. In most cases, therefore, effective as co-development or co-design may have been, full-blown co-production may have to be commissioned by someone with the legal obligation to provide.

Anything less than fully delegating authority and accountability makes co-production primarily a form of influencing the decision-maker. Technically that’s a form of consultation, but where the credibility of the exercise is much enhanced if it results in a bi-partisan consensus or solutions which everyone thinks amount to the right answers. As a way of arriving at new approaches to persistent problems or new innovative working methods, having a wider talent pool with equal status to the old-style professional experts is a tremendous advantage. Indeed what better way can there be to devise and assess a range of future options? Surely, a no-brainer?

At the Consultation Institute, we acknowledge all these strengths, and our new Courses and Workshops will help members and supporters deploy the best co-production methods possible in practice. But we also need to highlight and consider the critical challenges inherent in co-production?

Who is In the Room?

So much depends upon the choice of participants. And who gets to select them? On complex issues, there are a host of individuals and interests who might legitimately participate, and the profile of those who become involved can have a bearing upon its consensus … assuming there is one.

Single solution or a range of options?

There is righteous scepticism of any single solution to a complex problem, and the Courts have signalled their reluctance to endorse such an approach. Yet much co-production literature assumes that the simple expedient of bringing all parties together eliminates disagreement. One ‘Top Tip’ states that ‘in order to achieve meaningful and positive outcomes, everybody involved must have the same vision,’ That’s a little optimistic. Yet when expert professionals promote single options, there is serious criticism. Ideally, co-production should identify a range of proposals.

When should consultation happen?

Answer – when proposals need to be considered by a wider group than those who devised them in the first place. Forecast Impacts are best assessed by stakeholders who will be affected, and not just by those who develop the proposals.

In the ideal world, the fact that options have been devised through co-production should greatly strengthen their appeal, enhance their credibility and improve confidence that they have been thought through by people who understand the subject. But they are not a magic bullet. Right now, there are politicians who earnestly hope that if clinicians and patients only work together to co-produce enough consensus, there are ways of delivering cheaper services without making them worse. Ditto for schools, public transport, environmental protection, social security and a thousand other public goods and services. Occasionally it happens, but in the phrase of the month, it is ‘not a given’. It is still necessary to test these ideas against the opinions of a wider public. That’s why we consult.

TRIGGER POINTS

1. Has your organisation explored the opportunity to use co-production? Are you investing sufficiently in understanding the concept? Can you delegate so as to fully co-produce?
2. Do you clarify the difference between co-production for decision-making and for solutions-development?
3. The Think Local Act Personal website has much useful material
4. Consider attending the Institute’s new Workshop Co-Production in Public Engagement and consultation or explore in-house delivery by Institute specialists

This is the 333rd Tuesday Topic; a full list of subjects covered is available for Institute members and is a valuable resource covering so many aspects of consultation and engagement.