Co-production

“Out beyond ideas of wrongdoing and right doing, there is a field, I will meet you there”  ~ Rumi

I met Neil last year, as part of our Future Leaders course. I immediately sensed that here was someone who I could learn from and with, and who would challenge my thinking around co-production. A few months ago I asked Neil to be one of my Co-Production Partners around families and young people, and was delighted that he agreed. Here is his first blog with us, and you can see why I am excited to learn together.

Since being involved in Co-production, I have come across two types of ‘elephants’ that occupy meeting rooms. The small ones that run around causing havoc-  these ‘elephants’ are easy to identify and each participant in the meeting,  if they had a mind, could call them out. The larger ‘elephants’ on the other hand, require the vantage point of everyone in the room to describe them. 

The little ‘elephants’, figuratively speaking, are the tokenistic acts of people that use Co-production meetings for their own agenda, or to tick a box on their job description. In both cases, such people seem to operate without really understanding, or perhaps deeply caring about the purpose of Co-production. Sometimes, people in Co-production meetings have competing priorities that simply outweigh the virtues of collaboration. 

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Due to the stature of the bigger ‘elephants’, it requires everyone in the room to give their unique perspective, and for the sake of accuracy, these descriptions need to be from an equitable position. It is critical that common ground is established in Co-production meetings, wherein Health and Social Care ‘Professionals’ are able to meet and talk to those with ‘Lived Experience’ on an equal footing. Only then are we able to see what good Co-production looks like.

However, there is an inherent division of power that means that whilst people with Lived Experience are treated equally, there are not treated with equity. People with Lived Experience, by necessity, have to continuously reveal aspects  of their private lives in order to make Co-production happen. Parent carers have to talk about the indignity of changing their disabled child on the floor of public toilets- wheelchair users have to share with the room what sitting in a wheelchair over several hours does to their body.  When do the ‘professionals’ in the room display this kind of vulnerability?

If we were to sincerely answer this question, we would have to say rarely, and yet  you cannot Co-produce when there is inequity in the room. This means that if genuine Co-production is to happen, then Health and Social Care professionals are going to have to figure out how to be vulnerable and to stop, albeit unconsciously, using their ‘professional boundaries’ as a shield. 

It feels as if the Self Management approach developed by the Wellbeing Teams addresses this issue and is the key reason I accepted Helen’s offer to be Coproduction Partner for families.  Wellbeing Team members are empowered to bring their whole selves to work and to share aspects of their personal lives with those they have the privilege to support. 

As Helen remarked at a recent presentation on Wellbeing Teams “…we also talk a lot about love”. If I had one aspiration for this partnership, it would be to join that conversation, because I feel that it is only through love can we are genuinely vulnerable and only then can we authentically Co-produce.

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Working out how to measure the right things can be difficult. It’s easy to fall into the trap of counting what’s easy and missing what matters. That seems to be especially true when it comes to measuring outcomes, where whatever we measure usually feels like it only gives a glimpse of what’s important but not enough to know that we’ve actually met our  purpose.

In the work I’ve been doing recently to create new Wellbeing Teams, I’ve been  focussed on finding a way past this problem. I want the information we use in these teams and in support of them, to help us pay attention to the right things in ways that are open and collaborative. Ideally, I want to find ways to do this that are simple and engaging too. Working with Andy from Easier Inc, one of the ways I’ve been exploring how to do this has led to a very unusual use of the word ‘clean’.

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“What would Wellbeing Teams and self-management look like in mental health?”

Carey Bamber is my asked me to think about this, and to share ideas through a webinar. Carey is  the Policy Adviser and Member Support with the Association of Mental Health Providers. A couple of months later we were sat together in my office managing technical challenges in delivering a webinar on the subject. I shared how Wellbeing Teams were working to support older people at home, and we talked about some potential implications for mental health support.

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I am learning about new models and ways to deliver support to people at home. Over the last few weeks I have been learning about co-operatives and employee ownership and what this could mean for Wellbeing Teams. Wellbeing Teams are a social enterprise, which is a “business that has primarily social objectives whose surpluses are principally reinvested for that purpose in the business or in the community, rather than being driven by the need to maximise profit for shareholders and owners”.

This week I am looking at community ownership and community businesses, so naturally the first place I looked was Power to Change’s website. The website says that there are four features to a community business. They are locally rooted, trading for the benefit of the community, accountable to the community, and have broad community impact.  Here are some ways that I can see how these could apply to Wellbeing Teams.

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Co-operatives have been around since the 19th Century, and still feel relevant today. I am interested in them because of my work with Wellbeing Teams: both share a common thread of self-management.

There are some exciting co-ops emerging in health and care, and there are three examples that colleagues of mine have established. Neatly, we also think there are three reasons to take a closer look at both co-operatives and Wellbeing Teams.

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Yesterday I met with colleagues from Macmillann, to share how Wellbeing Teams are working, and what could be possible in relation to people experiencing cancer. I am excited that the next two Wellbeing Teams are getting started within GP practices. We think there are five ways that Community Circles and Wellbeing Teams can support people to come home from hospital or to avoid hospital admission. Here is a summary of the approaches, and what we have tried so far.

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This morning I read ‘How we can start a social care revolution in seven easy steps’ by Katie Johnson, KPMG, in the Guardian Social Care Network. I agree with her ideas, but not that it is easy. If it was easy, it would have been done by now. I am one of the many, many people who want to see this change, and be part of this change. Here I want to share what I am see my colleagues doing to actually move towards the steps she describes. I want to call out the people who are making it happen, and what else we need – some of the detail to deliver the big ideas.

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Last week I saw a post on Facebook about how a Google coach @Jenny_Blake created a mindmap of what we she wanted to achieve in 2017.

It seemed like a great way to get my thoughts organised, and inspired me to do my own. I love planning for a new year, and I liked how she balanced work with other areas in her life. Because I love my work so much I need to have an equally strong focus and intention on other areas of my life, so creating a mind map that covers all areas of my life felt right for me. I also wanted to make sure that I was paying attention to my overall wellbeing, so I used the Five Ways to Wellbeing to structure this.

Watch the video below or read the rest of the post to see what came out of this exercise as my areas of focus for 2017.

 

 

At work

I chose to explore three work areas as my focus for 2017.

Wellbeing Teams

My biggest priority is moving forward with Wellbeing Teams, my new model for living well at home.

We have four getting started at the beginning of the year, across Devon, Doncaster and Dumfries (two teams). By the end of 2017, I want to have learned from these and extended the number to at least 10 teams. Our fabulous partners in Devon, Love2Care, want to get to 12 teams by the end of the year as well, and if they achieve that (and I am confident they will!), this alone would take the total to 16. We have teams starting in Scotland and England, and it would be brilliant to have teams in Wales too.

The numbers matter because my aspiration is to demonstrate that Wellbeing Teams can happen at scale across the UK. Demonstrating a different way of supporting people at home is key, but making an impact nationally is really important to me too, so we can show that it is possible to improve more people’s lives, more of the time. I am looking at social franchising as a possible way to do this.

 

Hospitals

We are just waiting for the final sign-off on an opportunity to work with patients and staff across several hospitals in one area, as the lead organisation for improving the patient and staff experience.

We will be working to make sure that both patients and staff feel known as individuals and that their voices are listened to, through embedding one-page profiles and Working Together for Change. This is a great opportunity to build on the work we have been doing in two hospitals in 2016.

 

Care homes

I was delighted that our work with Landermeads Care Home was cited by CQC in their report that rated them as Outstanding. It said “the provider had worked with an internationally-renowned external service to produce one-page profiles for both people who use the service and staff. People who use the service, relatives and staff we spoke with told us they found the profiles helpful.”

In 2017 I want to build on this with Ros and her team, and see if we can take some of the concepts from self-managed Wellbeing Teams into a care home environment. I am also working with a leading thinker in dementia care to develop a new way of supporting other registered managers in care homes to keep developing and improving how they support people and staff.

 

My wellbeing

Using the Five Ways to Wellbeing in my mind map helped me to move into 2017 thinking about how to do more of what matters to me, and what I need to do to stay healthy and well. Here are some examples of what I want to do:

Connect

My Dad died when I was 21 and I always wanted to know more about his life, and have a record of this to share with my children.

 

I spent Christmas with my ‘big family’, my mum and sisters and our families. We are going to work on capturing Mum and Dad’s life histories this year, and some of our own as well, as a family project.

Keep learning

I love learning, and last year I started two courses that I did not finish and want to go back and complete them this year – podcasting and Theory U. I am also halfway through e-learning on Compassionate Communication too, which I find really useful both for my personal and professional lives.

Take notice

I have been reading Thich Nhat Hanh’s book ‘Savor – Mindful Eating, Mindful Life’. This year instead of my usual resolution to eat and drink less, I am going to try to eat and drink mindfully.

Be active

I started Parkruns this year – 5k runs that take place at local parks every Saturday morning. I want to go from doing them on an ad-hoc basis to including them as part of my typical week. I did well with my yoga practice in 2016, but this dropped off in November, so getting back to weekly yoga is important to me this year too.

Contribute

I volunteer through Community Circles, both as a Community Circle facilitator, and chair of the trustees. I want to help the organisation to scale up – for us to build internationally and to find funding for over 20 Connectors in the UK in 2017. If you’re looking for a way to contribute in 2017, get in touch – we are always looking to hear from people who would like to join us!

 

 

It’s exciting to have ideas about what I want to experience, achieve, and new habits to build, but staying focused right through to December 2017 is much more of a challenge for me. Over the last year I have updated a ‘Now page‘ on my blog site, that describes what I am currently doing or working on. I will post a monthly update on my Now page sharing how I am getting on. Going public with the areas I want to focus on makes me feel more committed and determined, and a bit vulnerable too. I hope that your plans for 2017 are exciting, and that we can stick at them together!

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Carol works in the care sector visiting clients in their own homes for which she receives the National Minimum Wage and 7p a mile mileage. She has been doing it for three years, but says she is increasingly thinking of leaving because in her view the industry is getting worse. She says that the central frustration in her working life is not the pay, but that her employer schedules three half-hour visits every hour, meaning she is constantly late for each appointment and feels that she is short-changing the clients. This blog describes how Wellbeing Teams are trying to change Carol’s experience.

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