Exploring, Measuring And Enhancing The Co-production Of Health And Wellbeing At The National, Regional And Local Levels Through Comparative Case Studies In Sweden And England: The 'Samskapa' Research Programme (Study Protocol)
1King's College London, United Kingdom; 2Jönköping University, Sweden; 3Djursdala, Sweden; 4we coproduce, London
Introduction: co-creation, co-production and co-design are advocated as effective ways of involving citizens in the design, management, provision and evaluation of health and social care services. Although numerous case studies describe the nature and level of co-production in individual projects, there remain significant gaps in the evidence base. Our overall aim is to explore, enhance and measure the value of co-production for improving the health and wellbeing of citizens. We will focus on three fundamental issues: (a) measures of co-production processes and their outcomes, (b) mechanisms that enable inclusivity and reciprocity, and (c) management systems and styles.
Methods and analysis: nine confirmed co-production projects will form the core of an interactive research programme (‘Samskapa’) during a six-year period (2019-24). Six of these will take place in Sweden and three will be undertaken in England to enable knowledge exchange and cross-cultural comparison. The programme has a longitudinal case study design using both qualitative and quantitative methods. Cross-case analysis and a sensemaking process will generate relevant lessons both for those participating in the projects and researchers. Based on the findings we will develop explanatory models and other outputs to increase the sustained value (and values) of future co-production initiatives in these sectors.
Dissemination: Given the interactive nature of the research programme, knowledge dissemination to stakeholders will be ongoing throughout the six years. An additional dissemination mechanism to practitioners and other interest groups will be through external workshops in collaboration with participating case studies and citizens both during and at the end of the programme.
Photovoice As A Promising Approach To The Co-Creation Of Knowledge: Capturing And Communicating Ethnic Minority People’s Lived Experiences Of Severe Mental Illness And Its Treatment
1Queen Mary University of London, Centre for Psychiatry, UK; 2University of Manchester, Sociology, UK; 3Words of Colour Productions, UK
Mental health related stigma inhibits many from seeking help. Conventional therapeutic methods relying on the spoken word only may not elucidate the full range and nuances of patient/lived experiences. We present a photovoice project as a promising approach to the co-creation/co-production of knowledge, in which ethnic minority service users and those involved in their care captured photos of their own lived experiences of severe mental illness and/or its treatment.
Evidence suggests that many projects claiming to co-create/co-produce knowledge merely employ service users to verify their findings. In contrast, our photovoice participants steered the process from its inception by representing their lived experiences, selecting issues of importance to them, reflecting on these through photography, and pursuing wider impacts by dissemination at public exhibitions.
Altogether seven photovoice workshops were facilitated over six months in London and Manchester (England), while three local exhibitions were hosted at participating community centres and two subsequent exhibitions showcased the participants’ work to the public. Twenty-one people, from a diversity of ethnic minority backgrounds and receiving a variety of diagnoses, were involved in the project.
Participants reflected on how the use of photography had provided an empowering platform from which to communicate sensitive issues. The public exhibitions enabled their narratives to reach a public audience, contributing towards challenging mental health stigmatisation. 92% of delegate feedback at the public exhibitions either ‘very strongly’ or ‘strongly’ agreed that ‘photos and captions were well displayed to communicate the narratives of lived experience of mental health and its treatment’.
When is Co-production not Co-production? Investigating co-production within the context of Patient and Public Involvement (PPI) in healthcare research in England
King's College London, United Kingdom
UK health policy dictates that members of the public, patients and carers are to play a key role in healthcare decision-making on the basis that ‘lay advisors’ or ‘experts by experience’ can help to improve health policies and services. It is for this reason that the National Health Service (NHS) strongly encourages patient and public involvement (PPI) and that PPI is a mandated component of all National Institute for Health Research (NIHR) funded research. Co-production has only recently come to prominence within PPI for NIHR funded healthcare research but has quickly been promoted as a gold standard. However, there is now such variety in conceptualisation and practice of co-production that critical inquiry is required to investigate: (i) to what extent ‘co-production’ occurring within the context of PPI in healthcare research represents and resembles forms and practices of co-production which have gone before (ii) how this compares with co-production practices in the healthcare sector outside of funded research and (iii) how and in what ways the state-sponsored process of PPI in healthcare research alters the fidelity of co-production as understood and practiced elsewhere? These lines of inquiry are being pursued in a three year qualitative study investigating a national network of applied health research organisations. Of particular consideration is the historical development of the concept of co-production and the needs and constraints of those applying it in different contemporary contexts. The ultimate aims of this research are to address instances of perceived misappropriation and to promote good practice and positive outcomes.
Revealing The Labour. The 'Hidden' Co-Production of Planning for (Tele)Care in the Home.
1Northumbria University, United Kingdom; 2Northumbria University, United Kingdom
Telecare refers to the use of digital or information and communication technologies (ICTs) to facilitate health and social care delivery to individuals in their homes. This paper explores the idea of telecare by foregrounding its interconnections with care and caring activities, paid and unpaid. It draws on research as a part of a wider study of business models of assistive living technologies from of a set of interviews about telecare with older people and their carers in the North of England, UK. Previous sociological work on telecare conceives it as a function and components of technical systems with the focus being the effects such systems have on the user. This has led to observations that such tools and technologies create work for the user in their domestic environment. The question is what is the form of this work, who is involved and how does the work get done? In order to address these questions we adopt a conceptual positioning of telecare as part of a wider carer network using Glucksmann's framework of the ‘total social organisation of labour’ (TSOL), we provide an analysis that contributes to understanding how a socio‐technical approach to telecare reveals ways to improve our understanding of how formal and informal care interact.