Damian Brady's latest Blog tackles the topical and often misunderstood subject of Co-production
In recent months Co-production has become something that is being talked up by Tower Hamlets Council, the CCG and not for profit sector. There is clearly a rising tide of policy and interest behind this which is great news but past experience shows that real co-production is something that many claim to do but not that many actually do in practice. It is exactly this gap between Co-production rhetoric and Co-production in practice that has slowed and compromised the development of Co-production for years. In fact some of the things done under the banner of Co-production have at times brought the term to the brink of disrepute.
The public and not for profit sector intellectually and emotionally embrace Co-production as it is something that aligns with their moral compass and their aspirations for the services they are responsible for. Co-production represents the ‘apple pie and motherhood’ approach to commissioning as it offers so much to everyone involved. However, we never actually see that much properly baked ‘apple pie’ in the end because the essence of co-production is that it requires commissioners, service providers and their respective staff to transfer a significant portion of their ‘power’ to shape, deliver, and evaluate services to the people who use them.
In Tower Hamlets this transfer of power, and the control that flows from power, is something that feels pretty risky given the borough history of what can happen in the absence of proper governance and control. In addition, following the Lutfur Rahman years, there has been a pendulum swing in the culture in the public sector in the borough which means that being risk averse is now hard wired in our DNA. This culture has even permeated the not for profit sector which to me represents clear evidence that the risk management pendulum now needs to swing back from attempts to eliminate risk (which is never possible anyway) and instead back towards proportionate measures to mitigate risk.
You may say that it is right that, given our history, the public sector and not for profit sectors are very alert to risk as the avoidance of risk is a good thing. Yes, it is when exercised with a view to the proportionate managing of risk. That is not the current position as was highlighted in the recent Local Government Association review of the Council. Nevertheless, there are examples already of excellent Co production in pockets throughout the borough as evidenced by the CCG’s work with Inspire around mental health services and the Council through its work with carers’ services. However, these are as yet isolated examples and have prospered through resolute sponsorship from individuals despite the prevailing environment.
That needs to change as a risk averse culture stifles innovation and prevents the realisation of good Co-production. The desire to retain power is sometimes about control and risk management but also about the desire to ‘fix’ people or improve lives. Good hearted staff often feel that they should be making the decisions as they are best placed to make these decisions and know what’s best for people. That approach is fine if you are a specialist like a surgeon as Co-producing brain surgery while under anaesthetic would be an interesting experience to undergo before it killed you! Yes, sometimes it is appropriate for health and care professionals (public and not for profit) to make necessary decisions, but in most cases decisions could and should be shared but are not. The immediate challenge is most often ‘but then who decides’. My response is that if you need to ask then you don’t understand what Co-production means, what empowerment means and what residents and people who use services really want or need.
Just a one last thing, can I ask that if you work for a not for profit organisation in Tower Hamlets that you complete our ‘State of the Sector’ survey. This is invaluable to the CVS as it provides crucial intelligence about the not for profit sector that informs the service we will offer you and the issues we need to represent your views on to the powers that be. The survey represents a chance to anonymously tell us how things are and feel to your organisation and to have your voice added to others to influence policy, commissioning and much more. Please take the 10 minutes needed to fill in the survey…It is worth it (and you could win a tablet for your organisation)
Damian Brady (Interim CEO)