For an event on co-production with cares run for Carers Week 2015, this slideshow gives an overview of issues in making co-production work from a Public Health perspective

1. Co Production some work and some
opportunities for Herts
10th
June 2015
Carers Week
Jim McManus,
DPH, Hertfordshire County Council

2. What does it mean - SCIE
• Co-production is a potentially transformative way of thinking about
power, resources, partnerships, risks and outcomes,
• ‘Co-production means involving citizens in collaborative
relationships with more empowered frontline staff who are able
and confident to share power and accept user expertise.
• Staff should be trained in the benefits of co-production, supported
in positive risk-taking and encouraged to identify new
opportunities for collaboration with people who use services.
• The creation of new structures, regulatory and commissioning
practices and financial streams is necessary to embed co-
production as a long-term rather than ad hoc solution.

4. Herts Network on LinkedIn
• http://uk.linkedin.com/grp/home?gid=5181118

5. Any examples, however early days?
• Caritas Older People
• South Oxhey
• Co-Production Training
• Co Production Network
• Infection Control in Care Homes
• Sexual Health Service Re-procurement
• Workplace Health Programme
• CAMHS Review
• Primary Care Heart Services (Previous work)

6. Why is it necessary?
• Economic reasons
• Diversity of Outcome Reasons
• Intrapersonal reasons
• Interpersonal Reasons
• Outcomes – control, self-efficacy and
empowerment
– Better implementation (org psychology)
– Better and healthier living (health psychology)

7. Why hasn’t it happened?
• Hard work in a very busy workload
• Users “It’s your job, why should we tell you?”
• Professionalisms
• Risk
• Cost
• Time
• Willingness
• Commissioner timeframes – 1 year

8. How could it work or more reasons
why it hasn’t happened?
Collaborative
Economy
Co-produce
JSNA
Co-produce
commissioning
intentions
Co-produce
Pathways
Co-produce
Standards
Co-produce
Training
Co-assess
4Es
Co- implement
Co-determine
Outcomes

9. Getting to making it happen
role distinction - Public Health Roles
Macro Meso Micro
What are our priorities
for older people in
Hertfordshire?
What do we do about
older people at higher
risk of seasonal death?
How does Mrs X
choose and buy her
care packages?
Accessible information
presented with clear
priorities
Evidence of what works
Case finding
Information to users
about choosing their
care

10. How can we change things?
• What outcomes do you want? We want
to consider where we can contribute
• We think co-production could result in
– Better pathways for x….
– Less costs for y….
– Better outcomes in this area……
• Can we explore together how existing
resources and systems can be aligned
to achieve this?

11. Starting Again
Obstacles
• Workload in NHS
Commissioners
• Commissioning
Structures and Systems
• Professionalisation
• Complexity
Confused structures and
pathways to commission
• Styles of working
Opportunities
• GP Localities
• New Outcomes
Framework
• Interface Work
• Culture change at small
level and major level
• Clarify roles and
contributions
• Re-think the business

12. Areas Ripe for Co-production
• Long term conditions
• Behavioural pathways for prevention
• Carer Support
• Post operative care
• Cardiovascular event rehabilitation
• Primary care mental health

13. Building the Commissioning
Landscape
• Bring partnerships together
– Formation of DASB as overarching
partnership
– Elected member led
• Public Health led commissioning cycle
and approach from County
• Working with every other agency (Sports
Partnerships)

14. Monitor/
Evaluate
Plan
Review Need for
Service and
Effectiveness of
existing services
Public Health Input into the Commissioning
Cycle. Can be throughout or can be on
specific areas playing to the PH strengths
Community
Engagement
Support in establishing
meaningful indicators of
delivery and outcome
Model whether need will
Be met by proposed
volume
Check whether plans equate
To evidence and need and
Test for equity / inequity
Support and advise on
Evaluation and conduct
Bits of it if enough resource
Needs Assessments
Equity Auditing
Evidence of Effectiveness
Health Impact Assessment
Triangle of critical
influence – where public
health should be most
visible
Contract/Deliver
Triangle
of critical
influence
Triangle of
critical
influence

15. Working out who does what
Lead Enforcement and
Control
Prevention Support,
Treatment and
Care
Community
Safety
County Community
Safety Unit
County Community
Safety Unit?
Probation, NHS,
Public Health
Domestic
Violence
County Community
Safety Unit
Domestic Violence
partnership
?Childrens Services
Drugs and
Alcohol
County Community
Safety Unit
Both working
together
Public Health
Alcohol related
violence
County Community
Safety Unit
Multi agency NHS Acute Trusts
People with
learning
disabilities
who are
victims
County Community
Safety Unit
Multi agency LD Partnership

16. Where next?
Over to you
Thanks
Jim.mcmanus@hertfordshire.gov.uk