We have continuously collected feedback from lay partners on their involvement in the process, and from other programme partners on how this has worked.
I am one of the people who continue to push for the vision when the arguments for a pragmatic approach overwhelm. That said, I think I have learned to be more pragmatic myself and more open to unexpressed quiet compromise – learning to have battles another day! I have learned from observing other group members. So I want to add that the learning here is a two way thing.
Lay Partner
We have not always got it right, but we have learned a lot, and we are making steps towards improvement all the time.
We have found that it is essential to recognise that it is always a case of starting where you are – but the point is to do just that: roll your sleeves up and get on with it. This is exactly what we have done with Embedding Partnerships and we believe that the result has been significant in terms of impact and breadth. At times, it has been a rocky road of compromise, negotiation and acceptance; but part of the real value in what we have attempted to do, has been the opportunity for everyone to grow and learn together.
We consider self-reflection to be an important evaluative tool in relation to new ways of working, and an excellent way to measure self-development as well as changing attitudes.
To implement a co-productive approach you will need to plan for and complete the following:
- Service user leaders from among patient participation groups, service user and carer groups, local voluntary groups and others should be participants in the thinking and planning from the start.
- Clearly demonstrate in an accessible way what you are trying to achieve and how this fits with previous work that these individuals may have been involved in (see Supporting Material C: Embedding Partnerships Supplement).
- With service user leaders, co-design a plan for recruiting the lay partners who will work with you to develop joined-up care to meet the needs of individuals, looking for a mix of people who have capability and commitment.
- Identify the skills and assets required and develop a role profile.
- Be clear about the time commitment expected and whether expenses will be paid or remuneration offered.
- Offer interested people the opportunity to learn more about the roles and discuss their potential contribution, possibly by organising an event (see Supporting Material C: Embedding Partnerships Supplement).
- Ensure that lay partners (ideally two or three) are present as full members from the very first planning meetings.
- Provide lay partners with support for meetings in the form of briefings and debriefings and the opportunity to meet with each other and discuss progress.
- Provide training for the other members of meetings so that they understand the principles of coproduction and that lay partners are equal partners. Incorporate learning and feedback from training sessions into the co-design of future training opportunities.
- Consider appointing lay partners as chairs or co-chairs of committees or working groups.
- Provide frequent opportunities for lay partners to feedback on whether the behaviours in the coproduction touchstone are being mirrored in reality.
I suspect that sustainability is an issue. At the recent Integration Board where we discussed early adopters, you could see that there was anxiety when I suggested that there needed to be pre-existing user groups for the early adopters we proposed, or else co-design to such a tight schedule would not be possible. I was certainly listened to. I think the place we ended up at, with a suggestion about coordinated care in nursing homes, probably delivers it. But we will need to be vigilant.
Lay Partner