Co-production
Toolkit
Co, prex. Jointly, together, mutually.
+
Production, noun. Things produced.
=
Co-production, Producing things together
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www.iasbolton.com
This toolkit has been created in co-production between Bolton CCG & NHS,
Bolton Parent Carers, Bolton Information Advisory Service and Bolton Council.
With thanks to:
Jenny Wilkinson - Designated Clinical Ofcer for SEND
Nan Cooper - Chairperson, Bolton Parent Carers
Cheryl Wyatt - Head of Service, Bolton Information Advisory Service
Christine Williams - Bolton Educational Psychology Service
Introduction
what is co-production and why is it important?
In Bolton, we recognise the need to co-produce services and how they run, in order to have
successful outcomes for those who use them.
We have developed this toolkit with partners from health, educational psychology, Bolton
Parent Carer Forum and Bolton Information and Advisory Service to help services across Bolton,
that work with 0-25's with SEND, to embed co-production as part of routine good practice.
Please watch our video below, by clickiing on the image, or using the web address, before you
continue with the rest of the toolkit.
www.sho.co/embed/1DGE6
The Core Principles of Co-Production
The core principles of co-production as described by the Social Care
Institute for Excellence.
1. Equality – co-production starts from the idea that no one group or person is more important
than any other group or person. So everyone is equal and everyone has assets to bring to the
process.
2. Diversity – diversity and inclusion are important values in co-production. This can be
challenging but it is important that co-production
projects are pro-active about diversity.
3. Accessibility – access needs to be recognised as a “Co-production must start as
fundamental principle of co-production as the early as possible in any
process needs to be accessible if everyone is going given process, with
to take part on an equal basis. Accessibility is about
ensuring that everyone has the same opportunity to everybody involved having
take part in an activity fully, in the way that suits them an equal say.”
best.
4. Reciprocity – ‘reciprocity’ is a key concept in co-
production. It has been dened as ensuring that people receive something back for putting
something in, and building on people’s desire to feel needed and valued.
Legislation
what are your duties to co-produce?
Duties for participation are embedded in the NHS Constitution and for wider partners, detailed
in the SEND Code of Practice, with key points detailed below. For all references, see the
appendices.
“Remember, it's the people who use your services/ processes that
truly know what works- you can't get it right without them.”
“At a strategic level, partners must “Effective participation should lead to a
engage children and young people with better t between families' needs and the
SEN and disabilities and children's parents services provided, higher satisfaction with
in commissioning decisions, to give useful services, reduced costs (as long-term
insights into how to improve services and benets emerge) and better value for
outcomes. money. Effective participation happens
when:
Local Authorities, CCGs and NHS England
must develop effective ways of Ÿ It is recognised, valued, planned and
harnessing the views of their local resourced
communities so that commissioning
decisions on services for those with SEN Ÿ It is evident at all stages in the planning,
and disabilities are shaped by users' delivery and monitoring of services
experiences, ambitions and expectations.
Ÿ There are clearly described roles for
To do this, local authorities and CCGs children, young people, and parents
should engage with local Healthwatch
organisations, patient representative Ÿ There are strong feedback mechanisms
groups, Parent Carer Forums, groups to ensure that children, young people,
representing young people with SEN and and parents understand the impact
disabilities and other local voluntary their participation is making.”
organisations and community groups.”
1.12 Code of Practice 2015
3.18 Code of Practice 2015
Participation helps us to understand people’s needs, and to prioritise those people who
experience the poorest health outcomes – enabling us to improve access and reduce
health inequalities. Participation provides opportunities to see things differently and to be
innovative, leading to a better use of our limited resources.
NHS Annual Reporting on the Legal Duty to Involve Patients and the Public in Commissioning
“Co-production is not a 'task'.
It should be a tool used to help you make- sure you are providing the right service
or process, in the right way, and ultimately, make things easier for everyone.
Decision Tree
when should I co-produce?
Use the decision tree to understand when you should be considering co-production with children
and young people with SEND and their parents and carers.
Is your service No Is your service making
introducing something changes to something current?
brand new? Ÿ change of personnel?
Ÿ change to pathway?
Ÿ a new guide? Ÿ new criteria?....
Ÿ a new role?
Ÿ a new provider? Yes No
Ÿ new guidance?...
Yes
Will it impact the No You should continue to to consider
experience of children or the role of co-production when
young people, 0-25, and
designing and reviewing services.
their families? In the meantime continue
If you aren’t sure, ask Bolton gathering feedback from your
Parent Carers service users.
Yes
Continue reading for
þ Process
þ A checklist for genuine co-production
þ Resources to help you co-production project
“Its ok to start small and build Don't come to the table with an agenda,
up to your bigger build it with people who use the service
or process that you are developing
co-production efforts.”
Process
how to plan and deliver your co-production
Service user input, and the impact of using their knowledge and experience to inform your
service delivery and development, should be evaluated and evidenced throughout all stages
of the co- production process. The process below will offer guidance on how to utilise service
user expertise at all stages of co-producing, and support you as to how to record and monitor
the process.
Planning
è Come to the table with a blank agenda and build it with your service users. Monitor how this
agenda develops and record any changes/ adaptations, so that it is clear how service user
views have shaped the direction of the project
è Before starting a piece of work, develop a Co-production Plan to identify all opportunities for
service users to be involved in shaping and inuencing the work you plan to develop
è Use the checklist in this toolkit when planning any co-production activity to check all key
principles are being met and to identify any gaps in your planned engagement methods.
The checklist can also be used to review each stage of a project and identify further
opportunities for co-production moving forward.
è Professionals should ensure all service users involved in co-production understand the desired
outcomes from the start to ensure all parties are working towards the agreed goals
Delivery “It’s not your
responsibility to solve
è Throughout the course of co-producing, no one every problem, allow
should take sole responsibility for solving every
problem on their own. You should allow the whole the group to nd
group to nd solutions together, and record decisions collective solutions
on the Co-production Plan to show joint decision-
making. together.”
è Record your 'lessons learned' from co-production
activity on your Co-Production Plan. These can be
used to reect both successes, and areas for
improvement. Use these to inform any future co-
production, and evaluate the impact of your chosen
engagement methods.
Review
è Clearly evidence how service user input has been used, for example, by sharing something
like a 'You Said, We Did', showing new or updated policies, a case study or annual report.
è Make a request for feedback following the process of co-production to record service user
views on their involvement and capture suggestions for improvement. Questions could
include: 'what difference do you feel you have made?', 'what were the benets of
participating in the co-production activity for you? What were the challenges?'
Cycle of co-production
how to plan and deliver your co-production
Co-production is a cycle that should be revisited whenever your service undergoes any
changes, as covered in the decision tree.
1 2
Use decision tree Identify
to identify duty to your service
co-produce
users
Identify possible
3
7 outcomes for
your Use the
service checklist
and get
started
Feedback to Co-production 4
participants activity
6
Evaluation and
review
5
“Everybody involved must have the same vision, from front line staff to
management/ governance members, or it won't be meaningful.”
Using the term Co-production
“Co-production is called for when solutions need to be found that rely on knowledge from
multiple sources, where each member of the co-production team has a skill or knowledge that
the other team members need in order to nd solutions.” Durose, 2017
This is where the knowledge of those that are using, or have used, your service has such an
impact. Only these people can truly explain to you what it is like access or use your service, how
changes would impact them and how things could be improved. This is where working in
coproduction from the very beginning of a project, or making changes, works.
Coproduction is a specic process, and the term should be used with consideration.
Co-production isn’t asking for feedback
Co-production isn’t holding a consultation
Co-production isn’t sharing information
Not all work with service users requires full a full coproduction project. In some cases, specic
feedback is needed, sometimes a formal consultation is required and often, it is necessary to
share information with service users, however, none of these should be described as co-
production. The co-production process is described on the previous pages and describes a
journey from a blank page, to post-project review.
Engagement tools - pro’s & cons
A few things to bear in mind when considering the tools of co-production at your disposal.
These are just a couple of ways to engage with service users, with the aim to provide some
pointers of where they can be used well, and also their drawbacks.
Surveys & Questionnaires Focus Groups Utilise other organisations Informal Feedback
Pro’s C Easy to circulate C You can be more C Using groups that C Using ongoing
digitally exible with the support/work with opportunities to talk to
conversation and families and young service users gives
C Not time intensive unpick ideas people can provide a current experiences
C Data is gathered in a wealth of information
C Service Users may feel C Can include
structured format C Trends and themes can
more engaged experiences over broad
be identied time period
C Groups can be
identied to represent
breadth of experience
Con’s D Reliant on service users D Not everyone feels D Individuals may not feel D Difcult to formalise
having online presence comfortable in groups represented by the the experiences into
organisation used data
D Misses out on input from D potential for only those
D Needs to evidence the D Needs to be used
those who with EAL. with a condent ‘voice’
will volunteer way in which the sensitively if the service
D Writing surveys that organisation gathers user isn’t aware their
D Location can be hard experiences experience has been
gather good, useful ‘captured.’
to source
feedback is a skill
When using a combination of tools, throughout the co-production project, you can ensure you
are gathering a wealth of information.
One of the key points of the ethos of co-production is that those involved in the journey
understand where their input ts in and that they can see their contribution within the project.
Ladder of Co-production
The ladder of co-production provides a visual example of when working with your service users
becomes co-production
Co-production Parents & carers, young people and children and professionals
work together from design to delivery. They are involved in all,
Develop, design, do together or, almost all of the decisions.
Participation Parents & carers, young people and childrenand professionals Increased service user satisfaction
work together and are involved in designing services and
Decide together inuence decisions along the way.
Consultation Parents & carers, young people and children are invited to have
a say in proposals and offer their opinions. Professionals make all
Offered choice, you decide the decisions.
Education Parents & carers, young people and children are provided with
information and explained how things work. Sometimes
You tell us explaining why decisions have been made.
Info-Sharing Parents & carers, young people and children are provided with
information about services, including when changes happen,
Change happens, no participation with no consultation
No-engagement Parents & carers, young people and children are service users
Checklist
questions to ask yourself
When working with children, young people and their parents, consider the “I statements”
below, then consider the checklist points that will evidence the statements.
“I am an equal partner .” c Are decisions made by the majority?
c Are professionals and service users equally represented in the
group?
c Is everyone clear on their role and responsibility?
“I have opportunities to c What opportunities have you identied for co-design?
participate in all stages of the c What opportunities have you identied for co-delivery
process” c How do you seek views about what things may need to be co-
produced in the future?
“I can see my views and c What do your service users know about the current need for co-
experiences are represented” producing?
c In what ways will their expertise help shape what you are doing?
c What methods have you used?
c Have you sought the views of a diverse cross section?
“I try different approaches c What engagement methods might you use?
and am prepared to work in c How successful were they/ have they been?
different ways to achieve the c Have you developed a co-production plan to run throughout the
desired outcome.”
process?
c Have you consulted with service users about the best way to
communicate with them/ work round their needs/ commitments?
“I receive information that is c Have you asked people how they would prefer to be contacted?
clear and timely, in a way that c Do you have accessible versions of the information?
is accessible for me.” c Would service users know how to contact them?
c Do participants know how to contact you if they need you?
“I can readily participate in c Preferred meeting times/ frequencies?
meetings and other events.” c Alternatives to formal meetings? For example, to better engage
children and young people
“My contribution is valued.” c Serious question… is this a tick box job, or will the time and
knowledge these service users offer you, be for genuine
change? If you can't evidence genuine change, don't
continue.
“I am supported and c Provide paper copies of documents where possible
encouraged to be fully c Can travel expenses be paid to those attending face to face
engaged throughout this
process.” meetings
c Are you making yourself available if people want to speak to you?
Case Study
from Bolton Parent Carers
When services are genuinely co-produced they work better, because they make the most of
the shared expertise of the professionals who work there and the people who have experience
of using them.
At the heart of the work of parent carer forums is gathering
parent carer experiences and ensuring they
are shared at a strategic level with our
partners in the local authority, education,
health and social care. Bolton Parent
Carers does this in a variety of ways, from
workshops, to surveys, to our sessions with
local leaders (pictured.) We sit at a strategic level and ensure
that when SEND services are being designed, developed and
reviewed, parent carer views are incorporated.
SEN Support Co-Production
The development of the SEN Support chapter
of the 2020 SEND Handbook is an ideal case
study of local co-production with parent
carers.
A task group was co-ordinated in 2019 to
look at how SEN Support is delivered in
schools in Bolton. The task group was multi
agency with educational psychology,
SENCO’s, specialist teachers and support staff. Part of the task group from the very beginning
were also 2 parent representatives with experience of the
SEN Support framework and how it is delivered locally.
Hearing how it can be difcult to understand the SEN
Support framework and what provision looks like in the
classroom strongly inuenced the design of a visual
representation of the graduated approach; and showing
this in waves to differentiate the difference between SEN
Support and the level of need where an EHC Plan may be
considered.
The end result, is a tool for schools, that will also enable a
clearer understanding of the framework for parents.
By having parents ‘around the table’ and starting with a
blank sheet the end product is something that will be
valued by professionals and parents alike.
Resources
to support you with co-production
The following resources are example we think may be useful. You may very well have your own
ideas too.
Engagement with children & young people
www.leapfrog.tools has some excellent resources for co-production with children and
young people. Click on the boxes below to be directed to the highlighted suggestions,
or visit the website to take a look at what’s on offer.
The Valuing Voices toolbox aims to Young people can use the storyboard
support care professionals to conduct to bring their experiences and ideas
person centred evaluation that goes to life and use it to help them have a
beyond just tick boxes discussion about improving meetings
www.leapfrog.tools www.leapfrog.tools
Word Play uses the same origami as Make co-production
a tool for people to make, share and accessible for people in
exchange with others. whatever way they feel they
can best contribute. Think
www.leapfrog.tools outside of the box to ensure
everyone has had an
opportunity to contribute
equally, including children
and young people with SEND
The Right Ideas is a collection of tools Target Control helps young people to
including The Right Words, The Right think about how much control they
Opinions and The Big Idea to help have over each of their problems and
young people nd the right words to it challenges them to think about
express their opinions solutions
www.leapfrog.tools www.leapfrog.tools
Resources
to support you with co-production
Iriss.org.uk has a range of downloadable resources to support with co-production projects:
https://www.iriss.org.uk/sites/default/les/2018-05/iriss- https://www.iriss.org.uk/sites/default/les/2018-
coproduction-project-planner-guide.pdf 05/iriss-coproduction-project-planner-workbook.pdf
https://www.iriss.org.uk/sites/default/les/2018-05/iriss- https://www.iriss.org.uk/sites/default/les/2019-
coproduction-project-planner-tools.pdf 03/project_spring_board.pdf
NHS Resources:
https://www.england.nhs.uk/wp- https://www.england.nhs.uk/wp-
content/uploads/2014/03/bs-guide-plann-part1.pdf content/uploads/2016/07/bitesize-
guide-focus-groups.pdf
“Acknowledge that a
range of skills are needed
for co-production and
recruit the right people to
support the process.”
Links
The SEND Code of Practice 2015
https://www.gov.uk/government/publications/send-code-of-practice-0-to-25
NHS Annual Reporting on the Legal Duty to Involve Patients and the Public in Commissioning
https://www.england.nhs.uk/wp-content/uploads/2016/07/guid-annual-reprting-legal-duty-july16.pdf
The NHS has a range of policies, guidance and documents which may be useful to you in
developing your plans for patient and public participation.
https://www.england.nhs.uk/participation/resources/docs/
Transforming Participation in Health and Care, Guidance for Commissioners
https://www.england.nhs.uk/2013/09/trans-part/
Patient and public participation in commissioning health and care:
https://www.england.nhs.uk/wp-content/uploads/2017/05/patient-and-public-participation-guidance.pdf
Bolton Parent Carers - the Parent Carer Forum for Bolton
www.boltonparents.org.uk
National Network of Parent Carer Forum - See how Bolton Parent Carers link to co-produce
nationally
www.nnpcf.org.uk
Bolton’s co-production tooklit video
www.sho.co/embed/1DGE6
“Make co-production accessible for
people. Think outside of the box to
ensure everyone has had an opportunity to
contribute equally, including children and
young people with SEND.”