What is co-production?
Co-production describes how people work collaboratively together to create, improve and develop services and policy that continue to reflect the issues that are important to older people.
The focus is on recognising that people have relevant expertise through their lived experience, not just through traditional professional, career or educational pathways.
By working alongside each other to gather knowledge, make decisions and problem solve we can create meaningful, relevant and quality services and policy that continue to reflect the issues that are important to older people. This means involving people who have accessed our services, people in the community who could access our services, carers, family or friends.
Everyone engaged in co-production can deepen their understanding, grow their skills and be recognised for their involvement.
The ladder of engagement
Often co-production is described through the ladder of engagement and this can be a valuable tool to help us describe what we are doing. Here’s an example from Think Local Act Personal:
Our co-production principles
Here are Independent Age's core co-production principles:
How and where have we used co-production?
A case study of our work, and a great example of co-production, is the creation of our 'Living well with long-term health conditions' guide.
We wanted to involve older people from the start, to make sure we were creating information that would be valuable to them and address the questions they really cared about. We know that many of our service users are living with long-term health conditions: long-term conditions are more common in older people and they are more likely to be living with more than one long-term condition. However, as we are not a charity with a medical focus, these issues aren’t necessarily raised on our Helpline. This meant we did not have a clear view of which issues were having the biggest impact on people, or of their expectations of the type of help Independent Age would be best-placed to offer.
As some of the issues are potentially sensitive, we also felt it was critical to hear people describe their experiences in their own words to ensure we used the right tone and language to resonate with readers.
We also wanted to involve healthcare professionals, including GPs, as well as our in-house-technical advisers. This would give insight into how people can get the most out of their GP appointments and other interactions with health professionals. Healthcare professionals were also identified as a key audience to market to, as they are well-placed to get information to people at the time when it is most relevant to them. It was therefore important to consider their needs and views when creating the information.
By co-designing with a broad range of people, we were able to draw upon the variety of expertise and experience the different groups could bring. This ensured that our end product was useful and relevant.
What did we do?
We wanted to involve users early on in the development process. This differed to our approach with previous guides, where we had produced a draft guide and then asked focus groups to provide feedback on it. Before creating a detailed plan for what information we would include, we ran three focus groups in different parts of England with over-60s living with one or more long-term health conditions. We asked them about:
- What they found particularly challenging about living with a long-term condition
- What help they had been offered to cope with these challenges
- Whether they felt well-informed about their condition and what information they had been given
- What their main sources of information were
- Whether they had researched their condition themselves and what methods they had used for that
- Anything they wished they had known when they were first diagnosed
- Their preferences for printed or digital information.
Once we had created draft information shaped by feedback from the focus groups, we carried out two rounds of surveys with our Readers’ Panel – one to review the draft content and one to choose a title.
The Readers’ Panel is a group of people who volunteer to review our draft information via email and post. Over 600 people have signed up.
We asked them for their views on:
- the tone and language
- how useful the information was and whether they had learnt anything from it
- whether they’d use self-help elements, such as the medical appointment planner.
They also chose the title of the guide.
To ensure accuracy and understand the perspective of healthcare professionals, draft content was reviewed by two GPs and the Patient Information Forum’s Sounding Board (a panel of health information professionals), as well as our in-house-technical advisers.
These professionals peer-reviewed the guide for us. We also asked them specifically about:
- how patients can get the best from their GP appointments
- what supplementary content patients might find helpful alongside the guide, e.g. downloadable appointment planners to fill in.
How do we support involvement and what are the benefits of being involved?
We feed back to the Readers’ Panel on how their comments have been used, by sending a follow-up message thanking them for their involvement and summarising what we have changed. We have had feedback from Readers’ Panel members (not specifically in relation to this project) that they value seeing how their work has made a difference.
When reviewing the draft guide, Readers’ Panel members also commented that they had learnt information relevant to them by participating.
We use a third party to recruit for focus groups and did not collect contact details for participants from them. For future projects we would consider asking participants if they would like to be re-contacted to hear how their feedback has been used. We have used this approach for a recent evaluation project.
Several participants in the focus groups commented that they had enjoyed the experience of taking part in the panel and found it a valuable experience in itself.
Focus groups took place in the late morning or early afternoon, to avoid times when older people might be collecting grandchildren from school. Avoiding early morning also allowed reasonable travel time for participants coming from further away. The recruiter also booked venues with disabled access and checked whether adjustments would be required by participants to enable them to take part.
What we've learned
Running focus groups at an early stage in our development process really helps us to gauge the issues of greatest importance to people. It also helps us identify areas where we can provide a valuable service - because people may not getting the information they needed, or are not getting information in the best form or at the best time.
As we continue to work together, please watch this space for upcoming example of how co-production guides our work.
If you’d like to join our Readers’ Panel, find out more here or by clicking on the link below.