co-production

Relationships and meetings of the mind

IMPACT and The Health Foundation logos

Earlier this year, IMPACT’s Co-production Advisory Group had the pleasure of meeting and engaging with The Health Foundation Inclusion Panel. This created an opportunity for IMPACT to focus on building relationships between organisations. Early in the process we agreed this would be a two-way engagement and we would focus on the theme of co-production. The detail of what that would look like took a little longer to decide.

Co-producing an event

We agreed to co-produce the preparation and delivery of our co-production themed event, involving two members of each group plus the coordinator of each group. Narrowing down such a big topic is challenging – it can be time consuming and a little messy, but this is time well spent. As co-production means different things to different people, it involves accommodation and relationship building, seeing things from alternative perspectives and not being prescriptive. Not being prescriptive means that it can take time to tease out the theme and agree on questions to address and perhaps working in a way that’s different from what we are used to.

Happy to say I’m quite reassured it’s come a long way. I didn’t think you would get there, well done guys!  Testament to real coproduction in action.

Isaac Samuels, member of the Co-production Advisory Group

Building relationships for a successful approach

Cohesiveness, trust, and building relationships takes time for groups. This applies internally to groups and in external engagement. This is an ongoing challenge when time to co-produce, plan and deliver is limited or restricted by the reality of projects and work programmes.

A takeaway for me was the importance of building relationships to ensure effective co-production.

Ann Marie Penman, member of the Co-production Advisory Group

As a fledgling group meeting, engaging, sharing and learning with an established group was insightful. We are at different points in our journeys – we are starting out on our journey and the Health Foundation Inclusion Panel is working out its path for a sustainable and productive future. The experience of meeting a more established group reinforced the point that relationships, group trust and dynamic takes time to build. The sense of family and community from the well-established Health Foundation Inclusion Panel was palpable. This was inspiring and settled us as a group that we are right to spend time on building relationships and trust within our group.

In the practical sense, the process of co-producing the joint event has prompted us to try this approach in our preparation and meeting delivery. Until this point, we were somewhat self-critical of our own approach – a ‘knowing’ that we weren’t quite there but not quite sure how to get where we want to be.

Reflections

I am very proud of our work as the Co-production Advisory Group in 2022, particularly our ability and willingness as a group to be flexible, listen to each other, to feedback and most importantly to act upon it. Building relationships involves building trust and confidence. This takes time. A key takeaway from this meeting is co-producing the preparation, delivery and follow up. We are implementing this approach in our workplan for 2023.

Karen McCormick, Lived Experience Engagement Lead 

My own reflections were about how important it is to consider the whole process in effective co-production. That is, thinking about before, during and after i.e. how do we make sure we give the opportunity of involvement to everyone, how do we bring people together in a suitable space (physical and otherwise) and how are people kept involved and updated afterwards? A lot of our discussions focused on the being together part, but I think it’s important not to lose site of the ‘before’ and ‘after’.

Ann Marie Penman, member of the Co-production Advisory Group 

Relationship building extends beyond the relationship between two groups. Bringing in another group can somewhat shift the dynamic within our own groups. Sharing lived experiences and a passion for co-production with another group was empowering for members of IMPACT’s Co-production Advisory Group, a sense of shared purpose, a healthy respect and acknowledgement of the perspective of others.

Reflections on Co-production

Zoom screenshot of Co-production Advisory Group meeting

We asked members of the Co-production Advisory Group, to reflect on the year, and the work of the group so far. Scroll through to read reflections from Karen McCormick (Lived Experience Engagement Lead), and Ann Marie Penman who co-designed and co-facilitated the last Co-production Advisory Group meeting of 2022.

Karen McCormick’s Reflections

Our Co-production Advisory Group has been given the freedom this year to co-design and co-develop our way of working (Charter), our workplan and how we will meet strategic objectives. This approach has been a breath of fresh air. However, it is not without challenge. There is a fine line between coordinating, supporting, and delivering for the group and the project but in a way that is not prescriptive.

We created a reflections document, which collates the sentiments, thoughts, and ideas of group members. Starting from “you said”, we move towards the outcomes we want to achieve and some actions that we can either take as a group or put forward to other team members in IMPACT that may be helpful in delivering the outcomes.

We have a number of priorities for 2023, including: establishing and embedding two-way communications with and across IMPACT, continuing to identify the skills and assets of the group and expand our engagement offering, and establishing a feedback loop.

Thoughts from Ann Marie Penman

It seems to me that we’ve come a really long way. We’ve come together from across four nations, with different backgrounds, experiences, skills, and opinions but with a shared belief in the value of co-production to make things better.

It’s been a really steep learning curve, in terms of getting to know each other, the wider work of IMPACT and what our role is and might be.

Our remit is very broad, but there are three key aspects:

  • develop, support, monitor and review IMPACT’s co-production activity
  • produce an annual report
  • identify areas of good practice and areas for development

In our first year, it feels like we’ve had an inward focus, quite rightly looking at us as a group and what we bring, our strengths and our assets. As well as that, we’ve been exploring and gathering more information on the wider work of IMPACT.

Each time we’ve met, we have raised questions, made observations, picked up issues and contributed comments – and it’s all of these that have been gathered together into our reflections document. Essentially, it’s giving us a direction for our second year. It’s clear in these recommendations that it’s still important that we continue getting to know each other better but there’s also now an increased emphasis on our personal development, for each one of us. What is the benefit for any one of us in being part of this group?

And there is a clearer balance now in terms of what we want to be bringing to the wider work of IMPACT – what difference do we make, what value do we add and how are things better because of us, the Co-production Advisory Group?

The reflections document is our own development plan. It’s what we’ve come up with ourselves in terms of what is important for us but also recommendations for the IMPACT Leadership Team, for all the different IMPACT projects and the whole organisation.

I think it’s important to remember this is a living document. It will grow and develop each time we meet as we go through the next year. We can add to it, change it and further develop it but also what we want to do is think about, for each recommendation, what is the outcome that we want to put forward as the Co-Production Advisory Group, what will be better and specifically what is the benefit and for who?

Working with the NIHR Delivery Research Programme

A paper setting out a framework for collaboration between NIHR Health and Social Care Delivery Research (HSDR) and IMPACT was discussed at the HSDR Programme Oversight Committee in April 2022. The principles for closer working to promote and enhance social care research were welcomed by the HSDR Programme Director and committee. The Committee endorsed the approach, setting out how this informal collaboration might work and key touchpoints where there would be mutual benefit in close working to maximise HSDR outputs and reach wider social care audiences. This was seen as an exciting opportunity for the Programme.

It was agreed that information on current studies in the pipeline could be shared regularly with Jon Glasby and staff at IMPACT, perhaps on a quarterly basis. It was suggested that pilot work would be done with early engagement with teams and projects on linked studies on family group conferencing and support for people with learning disabilities/autism leaving long-stay hospitals which are likely to be of great interest to social care practitioners and service users. 

Jon Glasby is also linked into other parts of NIHR, including the School for Social Care Research, Research for Social Care programme and the NIHR Centre for Engagement and Dissemination. Developing ways of working with HSDR programme may be a useful pilot arrangement which could be the model for other parts of NIHR.

This paper was then discussed at the IMPACT Leadership Team meeting in June 2022.  With a few minor changes in wording or emphasis, IMPACT would be keen to pursue all the opportunities below as a way of supporting NIHR as it extends its social care expertise and presence, and as a way of supporting a number of IMPACT’s key objectives.

Frameworks for working with NIHR

Background

IMPACT is the UK centre funded by the ESRC and Health Foundation to implement evidence in adult social care.  Following a scoping phase with surveys and Assemblies to identify pressing topics and ways of working, the new centre will enter a steady state for five years from 2023-27. After this, the aspiration is that the centre, or key elements of its work, becomes a more permanent feature of the social care landscape (future business model tbc).

NIHR Health and Social Care Delivery Research (HSDR) Programme is a national funding programme awarding more than £20m a year for research on the quality and organisation of services in health and social care. Projects relevant to social care range from evidence synthesis on strengths-based approaches to social work to ambitious evaluations of family group conferences for vulnerable adults. 

Suggested areas for joint working and synergy

  • Anticipating research pipeline and maximising funded outputs

HSDR has a number of projects underway in the area of adult social care. This includes £7m+ investment in local adult social care research partnerships around the country, projects on self-neglect, care workforce and support for older carers. In the first instance, this could be a pilot for one or two research teams and projects to work with IMPACT, with IMPACT delivery staff working to implement findings from these studies. This would need to depend on their being an appropriate ‘fit’ between forthcoming research and IMPACT’s priorities for 2023-25 (to be submitted to IMPACT’s funders in September 2022). NIHR studies would also need to be working with a similar definition of evidence (which IMPACT defines in terms of insights from different types of research, the lived experience of people drawing on care and support and carers, and the practice knowledge of social care staff).

  • Identifying gaps/research needs

IMPACT’s broad and deep engagement will help to identify priority areas for future research. This is already evident from outputs from the survey/Assemblies which highlighted the importance of research in areas like prevention and wellbeing, asset-based approaches, carers’ health and wellbeing, and support for people who work in social care. Having chosen a series of key topics for its forthcoming work programme, IMPACT also goes through a ‘triage’ process to make sure that there is enough evidence with which to work, and checking for gaps – in either research, lived experience or practice knowledge. HSDR could work with IMPACT and constituent partners to work up briefs in priority areas, identifying important areas of research interest and important gaps in knowledge and framing calls in ways that will resonate with social care researchers and communities. 

  • Building capacity and sharing expertise

Consider opportunities to develop and strengthen capacity and community in adult social care research. Some approaches for embedded research and capacity building are being tested in the new HSDR adult social care partnership research awards, as well as particular opportunities through NIHR Academy Incubator for Social Care. There may be other opportunities – for instance, shadowing or sharing resources around review and research methods through the rapid evaluation and synthesis centres. This is a key priority for IMPACT as one of its four objectives is around building capacity in the workforce, and there may be scope to explore for IMPACT to support the local stakeholders with whom it is working on the ground to encourage stronger applications for existing NIHR capacity building schemes and helping to create a pipeline of credible candidates for these opportunities.

HSDR would also benefit from the expertise and networks of IMPACT to strengthen funding committee and reviewer base to make the right decisions with the right expertise for new projects.

Next steps

  • IMPACT and HSDR Programme staff to meet to take forward above areas for development – with quarterly meetings suggested going forwards
  • There is a particular opportunity to build in 1-2 topics from current NIHR projects into the draft work programme which IMPACT submits to funders in September 2022
  • IMPACT and HSDR to explore scope to publish a statement about this relationship/ways of working
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