Co-production approaches to reducing
health inequalities
Catriona Ness
NHS Tayside
Poverty and Health
Stress
Lack of Direction
Loss of Hope
Learned Helplessness
Health tends to decline in communities where levels of
interaction are low and where people feel insecure
(Smith Institute – 2008)
Changing roles:
Traditional service delivery model
• Planners specify what the services will look like, procure
them and then monitor the services using targets
• Practitioners assess need, ration resources and deliver
services to passive recipients
• Users and communities are defined by what they lack
and receive care based on how needy they are
perceived to be
Changing roles:
Co-production model
Planners, Practitioners, Users/Communities
• All three have a role in assessing needs, mapping assets,
agreeing outcome targets, planning allocation of resources,
designing and delivering services, monitoring and evaluating
impact
• Professional and experiential knowledge are valued and
combined, everyone’s capacity is developed.
• Minimises waste by developing solutions with users
• Can often reduce costs by focusing on person-led communityinvolved services, relieving pressure on expensive specialist
services
Health Equity Strategy
“Communities in Control”
“This is primarily a strategy for investing in community resilience,
investing time and effort in promoting social capital and
community enablement. We will primarily do this by offering
social responses to social problems. In particular we will support
co-production: helping people to plan services and to take back
elements of services which do not need to be delivered by health
professionals so that in total, services are co-produced by
communities and the NHS. This promotes social capital - the
importance of a connected and caring society - over institutions.
In short we will ensure that our services promote more patient
and community enablement, not more dependency on the NHS.”
Health Equity Strategy
“Communities in Control”
“The challenge is to work with
communities, not to find out
what they want and then
provide it, but to enable them to
take control and provide their
own solutions. Communities
need to be involved in the
delivery of services, behaviour
change initiatives and
solutions, as well as in their
design”.
NHS Tayside Health Equity Strategy
“Communities in Control”
• Contributing to Health Equity within a
generation”
• NHS will utilise co-production as a means to
build social capital
• Focus energy and resources on early years
• Focus greater effort on behavioural change
• Improve service access to areas of greatest
need but ensure that this builds social capital not
dependency
• Agree, with partners, measures of progress
• Build co-ordinated health intelligence
Local experience/examples
include
• Dundee Healthy Living Initiative
• Healthy Communities Collaborative P&K
- Older People/Teenage Pregnancy
• Healthy Happy Communities Angus
- Focus on Alcohol
- Young Families/Healthy Eating
• Time banking - Angus, Perth, Dundee
• Connecting Communities
• Equally Well -Social Prescribing
Project Example:
The Family Nurse Partnership (FNP)
Changing the World One Baby at a Time
Remit
•To share talents and skills in a mutually beneficial way.
•To make a positive difference in the local area.
•To promote community spirit.
•To establish and strengthen neighbourliness.
•To build bridges across social groups.
•To build trust in the community.
P&K Healthy Communities
Collaborative -Community-led
Health
Equal and reciprocal partnership
comprising local people and
professionals to effect changes in
communities and improve health care
and well-being
The Benefits of Co-Production to
the Healthy Communities Initiative
• shares skills and workload
Community
Social
Engagement
Capital
• builds community capacity
• promotes community led development
Improvement
Methodology
• reduces costs
• maximises efficiency
Leading by Example
Cash4Communities Innovation Fund
•£2 million from Endowment
Funds
•Community led initiatives
•Enhanced social capital
•Innovative
•Direct or indirect impact on
wellbeing
•£1k to £100k awarded.
Enablers of Innovation & Opportunity
• Top level support, strategic ‘buy in’
but light touch
• Passionate, enthusiastic people good at
communicating and inspiring
• Start with local people, develop trust &
respect
• Agility and ability to work around
bureaucratic obstacles
Challenges
• Culture Change our biggest challenge for
NHS and throughout the public sector
• Time to build relationships –learn together,
plan together, deliver together
• Short term funding –pilot-itis
• Courage-Public service leadership needs
to learn to ‘let go’ and build co-production
into existing services
•
Chaired jointly by NHS Tayside and Scottish Community Development
Centre (SCDC), and funded by Joint Improvement Team
•
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Aims to be:
A locus for building on existing co-production activity
A space for learning, debate and development of ideas and
approaches around co-production
A forum for practice exchange, and sharing of information and
resources
And to supporting dialogue around emerging policy on delivering public
services differently and advancing co-production approaches in Scotland
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•
Members’ meetings; learning events; national conference with JIT;
website with publications, resources, networking forum
Sign up now! www.coproductionscotland.org.uk
Any Questions