Co-production

Below, we have set out two co-production tools that have been used within IMPACT projects to help stakeholders understand a change and discuss how best to take forward their collaboration: the Ladder of Co-production and co-production workshops.

Ladder of Co-production

The Ladder of Co-production is a tool for understanding the stages on the journey of co-production. It describes the different steps of engaging with people and aids understanding of how to move up the ladder to meaningful co-production.

True co-production describes an approach where people who draw on care and support and carers work with professionals in equal partnerships towards shared goals. We also refer to ‘professionals’ as ‘people with learnt experience’: this means people who are there primarily because of their job and professional or academic experience. They may also have lived experience of a topic in their personal life, but they are there in a professional capacity. It is important to have a clear understanding of where you are on the co-production ladder; co-production is the goal, but if you are only able to ‘consult’ or ‘engage; then be transparent and don’t call it co-production.

The Ladder of Co-production was developed by Think Local Act Personal’s National Co-Production Advisory Group, drawing inspiration from Shelly Arnstein’s Ladder of Citizen Participation but adapted to a UK social care context.

The key characteristics of good co-production are:

Equal Partnership: Everyone involved has the same level of influence and decision-making power.
From the Start: People with lived experience are engaged in all stages of service design, development, and evaluation.
Inclusivity and accessibility: adaptations are made to ensure everyone can participate in a way that works for them and their needs.
Valued Contributions: All voices and perspectives are respected and valued.
Focus on Outcomes: The goal is to improve processes, services and outcomes for everyone involved.

Here are some examples of what each level of the ladder could look like in practice:

Co-production: Residents in a supported living setting are part of a monthly meeting where decisions about the building are made, tenants can have their say, and staff can understand their views. During this meeting, residents raise that many people living there can’t enjoy the outdoor space as it is inaccessible, so ask for it to be renovated. They are involved throughout the process of the renovation, and can make decisions on how the garden is renovated, engage with other residents to ensure everyone has a voice, and have a say on decisions made at each stage of the renovation. Their voice has equal status in decisions as staff.
Co-design: The housing provider of a supported living accommodation decides to renovate its outdoor space. It brings together a group of residents to design the garden renovation, asking them for their preferences and involving them in decisions. Once the garden renovation is complete, they no longer have a forum to meet and share their views.
Engagement: Residents of a supported living accommodation are asked what changes they would like to see in their outdoor space. There is a survey as well as a focus group to ask people for their ideas about the garden. Some of these ideas are taken on board, whereas others aren’t considered. The residents don’t have ownership of the project or any of the ideas.
Consultation: The outdoor space of a supported accommodation setting is being renovated. Two options are presented to the residents, and they are asked to fill out a survey to say which of the two options they prefer. Their preferences may or may not be considered, and they don’t have the choice to give other ideas or make more decisions about how the outdoor space is renovated.
Informing: Residents of a supported living accommodation are given flyers informing them that their outdoor space is being renovated and turned into a garden. They have no opportunity to share their views on how the outdoor space should be used, so concerns about accessibility are not addressed.
Educating: Residents are informed in a meeting about the plan to renovate their outdoor space and turn it into a garden. They are told how the decision has been made and what the timescales will be, but don’t have the opportunity to share their views.
Coercion: The outdoor space of a supported accommodation building is turned into a garden without informing any of the residents. It is inaccessible and is not used.

How can you use the Ladder of Co-production to make change?

The Ladder of Co-production can be used to reflect on and review your approach to engaging with people with lived experience. Once organisations truly understand which level of the co-production ladder they are working at, they can reflect on and take action to move their work up to the next level, and come closer to working in a co-productive way. The benefits of working in co-production are:

Improved Services: Services are more likely to work well for the people who use them.
Increased Empowerment: People are valued, gain skills, and have a greater sense of control over their lives.
Better Outcomes: Services are more likely to lead to positive outcomes for people and the community.
Stronger Community: Co-production fosters a sense of belonging and shared responsibility.
Builds Trust: Co-production can build trust between individuals and services, leading to better relationships.

Co-production workshops

Bringing together people with lived experience and learnt experience for collaborative co-production workshops is an essential tool when aiming to make change in adult social care. Workshops can be an effective tool for use in different stages of co-production, including building an understanding of a problem, gathering insights on a topic from a range of people, co-creating ideas and solutions, or evaluating a process. Workshops are a collaborative and equal space where a range of stakeholders can share power and move co-production forwards.

Facilitating creative, engaging, and accessible spaces is key to carrying out meaningful co-production where people can be truly included. It is essential to understand the multiple access barriers faced by people with lived experience of accessing adult social care, and to take the steps to overcome these. Facilitating good co-production involves understanding the barriers to participation faced by the communities we work with and taking steps to include them through accessible facilitation.

Things to consider

Balance of attendees with lived and learnt experience
Ensuring a diverse range of attendees
Accessible and inclusive activities
Use creative approaches
Include warmups and ice breakers to build relationships
Provide multiple ways to participate to ensure everyone has a voice

Some facilitation tools:

1-2-4-All: Attendees are asked a question about a particular problem or topic, for example ‘what action should we take next?’. They are given 1 minute for individual reflection on this question, then 2 minutes to share and generate ideas in pairs, then 4 minutes to share and develop ideas in foursomes, then 5 minutes for each group to share their best idea. This works well to ensure quieter voices are heard and for generating a variety of ideas.
Storyboarding: Storyboarding can help diverse stakeholders to visualise a journey – such as using a service – from beginning to end. It centres lived experiences and enables people to see a service from a person-centred perspective. Storyboarding can aid people to better understand the challenges of a current experience, or imagine a better future. Attendees are given a large piece of paper, and in small groups asked to draw or write each step in a journey. They should think about what’s happening, who is involved, opportunities, barriers, and how the person feels. Groups can then share and reflect on the stories and use these as the foundation for co-produced change.
Dotmocracy: After brainstorming ideas, all options are displayed on post it notes or pieces of paper. Each attendee gets a set of sticky dots and are invited to stick a dot on the ideas they think are the most important. This activity can be adapted for online workshops using digital tools such as Miro. It enables the narrowing down of ideas after larger idea generation sessions.

Liberating structures

Spotlight on facilitation — Scottish Co-production Network

Making events/meetings accessible – SCIE

Dotmocracy

Lived experience panels

Lived experience panels are small, dedicated groups of people who bring personal experience of a specific issue – such as being neurodivergent, drawing on care and support, or living with mental ill health – to influence decision-making in social care.

They meet regularly to offer insights that inform:

Policymaking
Service design
Organisational strategy and culture

Members of these panels should be valued as long-term, trusted partners, not temporary consultation groups.

Key Principles for Doing It Well

Power and Influence: Panels must have decision-making power, not just offer feedback. This moves them up the co-production ladder from “consultation” to true co-production.
Investment: Members should be paid for their time and offered benefits such as training, networking opportunities, and personal development.
Backed by Leadership: Their work must be supported and respected by those with learnt experience (staff and professionals).
Trauma-Informed Practice: Facilitation should minimise the risk of retraumatisation and support safe sharing.

Steps for Setting Up a Lived Experience Panel

Recruitment

Identify who you want to involve and what type of experience they need.

Prioritise diversity, including race, gender, disability, sexuality, and socio-economic background.

Publicise the opportunity through trusted community networks and use accessible formats.

Clear Role Description

Be transparent about the purpose, frequency of meetings, expected time commitment, and payment.

Explain the application process and support offered.

Define the Panel’s Scope

Clarify what the panel will influence and how their insights will be used.

Set realistic expectations about what is within their control.

Access and Inclusion

Ask about access needs from the start (e.g. digital access, literacy, mobility, sensory needs).

Make reasonable adjustments so all members can participate equally.

Relationship Building

Facilitate time for members to build trust and understanding.

Co-create a group agreement or shared values document to guide how the panel works together.

Meeting Schedule and Communication

Set dates with flexibility for people’s availability and needs.

Share agendas, notes, and updates in plain language and accessible formats.

Support Structures

Provide a named point of contact for queries and ongoing support.

Ensure that wellbeing is considered and that members know how to raise concerns.

When done well, lived experience panels:

Create more equitable systems by redistributing power.
Ensure services are grounded in real-life experiences.
Build skills, capacity, and confidence in members.
Strengthen trust and accountability between communities and organisations.

They are a cornerstone of meaningful, inclusive co-production, and essential to changing how adult social care is designed, delivered, and experienced.

Helpful tools to support evidence-based change in social care – Co-production