The document summarizes a workshop on co-production and commissioning held in Flintshire, Wales. It discusses the challenges of co-production and commissioning services with those who use them. Participants shared ideas on how to improve commissioning through a more person-centered approach, focusing on outcomes rather than processes. They emphasized the importance of understanding community assets and involving service users in designing and reviewing services.
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1. Co-Production and Commissioning
Workshop Report
w www.WorkingWithNotTo.com
e studioscarletdesign@gmail.com
@WorkingWithNot2
Event Location Flintshire
Date 02.04.2014
Session presentation by Craig McCleod, Senior Commissioning Officer, Flintshire County Council
Report produced by Pam Luckock & Fran O’Hara. Directors ‘Working WIth Not To’ Co-Production
Project, working with people at Meetup 5 and our community
Visual Minutes: Scarlet Design Team
2. 3CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
The many and varied challenges of co-production
commissioning had emerged as a theme during our
conversations with our community in North Wales over
the last few months. Craig McCleod and Mark Cooper
from Flintshire County Council agreed to sponsor Meetup
5 and to speak on the topic. They also encourage people
to come, so the conversations we had were as rich and
valuable as possible.
Good commissioning is critical to delivering high quality
outcomes for people, whatever the service they require.
Looked at through an equality and human rights lens, the
person in receipt of the service must be placed at the
centre of the process, from commissioning to delivery.
This sharing of power and budget transforms the process,
and requires new conversations and learning on both sides.
Having worked with two county councils in North Wales we
could see that the importance of people working together
to create their own personalized model that worked for
their service. This requires people to move out of their
comfort zone, and really listen each other, and use the
learning’s to inform their approach.
At the meet-up our first aim was to create a warm
hospitable space where we could contribute in the way
they wished. We learnt a lot from the workshop, both in the
outcomes and how to facilitate better conversations. The
outcomes from the day speak for themselves, we hope you
find this report valuable and do please share your insights
with us. Also your suggestions for workshops at future
meet-ups.
We also want to take this opportunity to thank Craig and
Mark for their unwavering support and enthusiasm for
encouraging us to start WWNT and throughout our first 12
months. Without these two key ‘gate-openers’, and many,
many others, we would not have had courage to grow the
project.
Pam Luckock & Fran O’Hara
Directors, ‘Working With Not To’ Co-Production Project
CO-PRODUCTION AND COMMISSIONING
8. 9CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
Integrate Social Services with Health:
•• No power struggle
•• No arguing over cost
•• Put the person first
•• Not so much red tape
•• Makes sure staff (workforce) know how to co-design,
embrace ‘Freda’
•• Skills: active support; inclusive communication
•• Person centred approval
•• Like, admire, important to
•• Unified assessment
•• Needs deficits, risks
•• Lessons to learn from learning disability approach > but
how upscale to volume within other populations?
TRUST • DECISIONS • RISK
•• “Good commissioning”
•• Clarity of roles and responsibilities:
•• Local authority |
•• Provider | > Relationships
•• Citizen |
Local authority:
•• Broadest – not just about social services
•• Broader – preventative and wellbeing role
•• Statutory agencies: managing fear of risk and not over-
egging duty of care
•• Flexible
•• Innovation
•• Person centred
– what can you do
•• Shaping communities
•• Local community grants rather than commission
•• Using person centred approaches
•• Encouraging peer support
•• Outcomes focused
•• Look at assets – the individual and the local community
•• Listening to what people want and how to help/support/
enable them to achieve that
•• Positive risk taking – as a shared experience
•• Balancing what is important to someone with what is
important for someone
•• Encouraging autonomy – greater control
•• Helping to shape services in the way that people want
– working with individuals, families and providers – a
shared approach
Who has a say:
•• People receiving the service
•• Getting their views, thoughts and experiences
•• People delivering the services
•• Good insight
•• Working together effectively – partnership working
•• Which?: Partner? Competitor? Enemy?
GROUP DISCUSSION TABLESHEETS
9. 10 CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
GROUP DISCUSSION TABLESHEETS
•• Good
•• Promotes innovation
•• Takes balanced approach to risk
•• Not unduly restrictive / prescriptive
•• Address prevention – low-level interventions
•• Lighter touch to reporting
•• Let’s go – loosening its grip
•• Co-designs service models
Start with the person
•• What do they want?
•• Listen and act
•• Ideal – individual budget – design my service (but with
support)
•• And/or – are people wanting things that aren’t available
•• Co-design and produce
•• Look at ‘resources’ in the community
•• Access to good practice from other places
Keep it simple
•• Use personal networks
•• Stop creating competitiveness (prevents co-production)
•• Local area coordination
•• Work together in communities and across services
Know what’s available, legal and possible
•• Commission someone/organisations/groups asking what
people want for their life, and asset mapping
•• Then only commission services that are needed so
people achieve what they want. i.e. commission more
community strengthening things. Expect to commission
fewer “core services”
•• Its not just about commissioning, its about de-
commissioning
•• Stop trying to protect company interest’s and put
peoples interests first
•• Direct payments are a great way to commission exactly
what you want
•• First barrier is needing a service but only ‘moderate’ so
get nothing, so nothing commissioned
Models:
•• Dutch social brokers
•• Bob Broad L.A.C.
•• Asset maps
•• Local services – local knowledge
•• One stop shop
•• Outcome focus
10. 11CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
Local assets:
•• What is there?
•• What do we need?
•• What to stop?
•• Specific outcomes:
•• Continuity of support
•• Staffing/skills/knowledge
•• Find small, local before commissioning
•• Don’t formal commission first
•• There’s a gap between ‘what I need’ and ‘what I can
have’
•• DPs – DIY commissioning and support
•• People don’t fit in boxes
•• Battling all the time as a service user
•• Want to be free from the tick box
•• Stereotypes
Creative solutions > outcomes
•• Turn negative assessments into positive
•• Needs to be outcome based i.e. outcome of individuals
•• Commissioning should be done together start with a
‘blank sheet of paper’
Positives:
•• Has improved life slowly
•• Improved wellbeing, socialise
•• Social life outside the world of disabilities
•• Feel inclusive
•• Built confidence
•• Better mental health, fight!
•• Change attitudes
Negatives:
•• Wasting money – could be spent better
•• Always after tick boxes
•• People don’t listen to what we want
•• No prevention work currently – fighting with demand
•• Broken communities
•• Listening in other ways
•• Positive thinking
•• Control – money
•• Give people more responsibility they know what they
want
•• Communication
•• Communities in control
•• LA monitoring/standards
Consult on:
•• What services exist?
•• What would you like to have?
•• Number of people benefitting from service. Who are
they?
•• Think ahead about the issues
•• Understand what everyone is doing
GROUP DISCUSSION TABLESHEETS
11. 12 CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
•• Review/check
•• Listen people
•• Make things better
•• Take action!
•• Self help!
•• Myself and everyone else
•• Buying the right services for the right areas
•• Reviews/checks/listen to what they need
•• Action plans
Keep on at them:
•• Go above them
•• Keep phoning
•• Email
•• Meetings
•• Send letters
How do you know/find out about the assets in your
community?
•• Space and time for statutory services (social workers) to
have conversations?
•• Better links/knowledge exchange between third sector
and public sector
•• Secondaments?
•• Back to floor for service managers
•• Service providers that include/employ service users?
(Barod example)
•• Turn around the question… not what do you need? More
What can you give, assets focus?
•• Making the time to do things properly – not ticking boxes
or filling in bits of paper
Lived experience:
•• How do you find out this?
•• Mystery shopper
•• “Trip advisor” for respite care
•• Buddy system
•• Loneliness and isolation – a big factor in shaping services
correctly
Important:
•• Person centred planning – should be at the heart of all
the commissioning
•• Use volunteers – make sure people can be heard in
places such as care/residential homes
Better ways and new ways to find out if commissioned
services are actually meeting need:
•• ‘Moles’
•• ‘Spies’
•• Buddies
•• Secret shoppers
•• Reviews on the net
•• Technology
•• Volunteers
•• Ways to find out what assets are out there
•• Making time for ‘proper’, meaningful co-production
•• “Care” is only provided by unpaid ‘carers’ paid support
GROUP DISCUSSION TABLESHEETS
12. 13CO-PRODUCTION AND COMMISSIONING WORKSHOP REPORT 02.04.2014
workers are not ‘carers’
•• Everything to do with disabled
people must be based on a
social model paradigm
•• Outcomes – not
outposts
•• We can afford high
quality social support
neither Wales or the
UK are poor
•• Value not cost
•• Focus on what matters – not paperwork filling
Co-production:
•• Get out to see pressures – what is out there and
understand
•• Secondments 3rd public services need to understand
•• See services first hand quality of services
•• Need to ensure robust processes to check quality – vital
that people are asked
•• Care/respite providers need to be monitored from the
inside out, not outside in! (Care checker?)
GROUP DISCUSSION TABLESHEETS