Co-production Toolkit - FIRST FULL DRAFT

DRAFT - NOT TO BE SHAREDCo-production
Toolkit

Co, prex. Jointly, together, mutually.

+

Production, noun. Things produced.

=

Co-production, Producing things together

IAnSdfeovrrivsmiocaretyion
www.iasbolton.com

This toolkit has been created in co-production between Bolton CCG & NHS,DRAFT - NOT TO BE SHARED
Bolton Parent Carers, Bolton Information Advisory Service and Bolton Council.

With thanks to:

Jenny Wilkinson - Designated Clinical Ofcer 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.
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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 dened 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.”
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“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 benets 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.
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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 inuencing 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
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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 reect 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 benets 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.
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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.”

Ladder ofDCo-productionThe ladder of co-production provides a visual example of when working with your service users
Rbecomes co-production
ACo-production
FDevelop, design, do together Parents & carers, young people and children and professionals
work together from design to delivery. They are involved in all,
or, almost all of the decisions.
T -Participation
NDecide together
Parents & carers, young people and childrenand professionals Increased service user satisfaction
work together and are involved in designing services and
inuence decisions along the way.
OTConsultation
TOOffered choice, you decide
Parents & carers, young people and children are invited to have
a say in proposals and offer their opinions. Professionals make all
the decisions.

Education Parents & carers, young people and children are provided with
information and explained how things work. Sometimes
You tell us
Bexplaining why decisions have been made.
Info-Sharing EParents & carers, young people and children are provided with
Sinformation about services, including when changes happen,
Change happens, no participation
with no consultation
No-engagement
HAREDParents & 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.
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“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 identied for co-design?
participate in all stages of the c What opportunities have you identied 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?

Resources

to support you with coproduction

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.
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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

DRAFT - NOT TO BE SHAREDResources

to support you with co-production

Iriss.org.uk has a range of downloadable resources to support
with coproduction projects:
https://www.iriss.org.uk/resources/tools/co-production-
project-planner

NHS Resources:

“Acknowledge that a
range of skills are needed
for co-production and
recruit the right people to

support the process.”

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 difcult to understand the SEN
Support framework and what provision looks like in the
classroom strongly inuenced 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.

DRAFT - NOT TO BE SHAREDLinks

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.”