Co-production, hammers and nails

We have been facilitating co-production for several years.  In public services this is where the people providing the service and those receiving it work together on equal terms.  We’ve worked with citizens and service providers to improve health and other services.

A speech by Mark Brown to a ‘Fulfilling Lives’ event sponsored by the Big Lottery here in the UK reflects on his experiences and thoughts about coproduction.  It’s strongly expressed and compelling.

There’s a saying that if you have a hammer everything looks like a nail.  As a facilitator I tend to think ‘all you need is good facilitation’ when any group wants to get something done.

Mark’s speech included one nail I wanted to hammer.  He said ‘In reality, co-production isn’t magic: it’s people and processes’.  ‘People and processes’ perfectly summarises what facilitators do.  We get people together and take them through a process that helps them achieve their goals.

So I wanted to reflect on three things we have learned about facilitating co-production over more than five years.

  1. It’s a culture shock – both ways

Of course it’s challenging for organisations to open up to citizens.  But it’s also challenging for citizens to shift focus from ‘they’ to ‘we’. A key moment for us was when a patient said to a consultant ‘It’s easy for you.  You can do what you want.’  She was shocked by the response from the consultant who felt that every move  he took was hedged around by restrictions and rules.  This helped them both understand how the voice of the patient / citizen could add power to clinicians wanting to change the system.

  1. Investing the time up front is key to success

Preparing to co-produce can be arduous.  We have learned that you can never start too early and that co-production needs to run through the whole process like letters in a stick of rock.  Simply holding co-production workshops in the middle of a project risks a disconnect and can be tokenism.  So we advocate co-proucing an evaluation framework at the outset so all parties agree on the outcomes they are seeking to achieve and how they will be measured.  This takes time and energy but avoids that conversation where the partners look at each other and say ‘oh, I thought we were trying to…’

  1. It’s a challenge to our ideas of independence and neutrality.

As facilitators, our commitment to independence and neutrality is ingrained.  But generally we are paid by one of the partners: the commissioner or service provider.  We stand our ground in that neutral space when another partner challenges or criticises and make sure that voices have equal weight.  But I also wonder if we should be challenging ourselves to co-produce facilitation.  What if for every assignment we committed to build community capacity to self-facilitate or to facilitate others’ coproductions?  Sure, this is a challenge to a purist view of neutrality and independence but if coproduction is such a good idea, why should facilitators be immune?

New types of nail mean we may need to redesign the hammer.