My slides for a recent workshop I delivered at the Kings Fund for Clinical leaders from Barts Hospital..

1. Co Production
Working with patients
as partners

2. Co Production
What do you
understand by the
term?

3. A Continuum of Co Production
Partnership
Patient
Voice/influence
Passive Patient

4. Mindsets not
models

5. We are at a turning point in health policy: the
nature of 21st century health, changes in
society and technology call for a radical
change of mindset and a reorganisation of
how we govern health in the 21st century.
This changes the role of the health sector, of
health professionals, of patients and of
citizens – and of other sectors and societal
actors including the private sector.
WHO 2020 Framework

6. Current healthcare system boundaries
are limited by a professional-knows-best
mindset which can be blind to the
powerful actions and forces that shape
health outside of the boundaries of the
healthcare system
Batalden 2015

7. FIVE YEAR FORWARD VIEW
A new relationship with patients
and communities
We have not fully harnessed the
renewable energy represented by
patients and communities
But collectively and cumulatively
(these initiatives) and others like
them will help shift power to
patients and citizens
,

8. Patients are impatient of being
treated like chipped flowerpots
in for repair
Gerda Cohen

9. Self government by
the patients must
involve pretence
because as soon as
they encroach on
real power they are
brought up short
Gerda Cohen

11. Who Am I?

13. STAGE ONE – PASSIVE PATIENT

14. FREQUENT FLYER MILES
15 stays in psychiatric units
One year trapped on MH ward “delayed
discharge due to housing”
2 residential rehabs
1 therapeutic community
1 Social Services hostel
Over 100 acute hospital admissions
18 months in supported housing
2 substance misuse day programmes
2 dual diagnosis day programmes

17. Frozen Assets

18. Stage Two - Patient Voice

20. CONSULTATION FATIGUE

21. Beyond
Involvement to
Co-production
STAGE THREE
PARTNERSHIP

22. I didn’t like feeling
useless. My idea of who I
was - the ‘me’ that I
valued – was someone
who could be special for
others, who could do
something they needed
and here I was, a
passive recipient of
everyone’s help
Edgar Cahn

23. Co-production means
delivering public services in an
equal and reciprocal
relationship between
professionals, people using
services, their families and
their neighbours. Where
activities are co-produced in
this way, both services and
neighbourhoods become far
more effective agents of
change NEF/NESTA 2009

24. CORE PRINCIPLES
Assets: Transforming the perception of people from
passive recipients to equal partners.
Capabilities: Building on what people can do and
supporting them to put this to work.
Mutuality: Reciprocal relationships with mutual
responsibilities and expectations.
Networks: Engaging a range of networks, inside and
outside ‘services’ including peer support, to transfer
knowledge.
Blur roles: Removing tightly defined boundaries
between professionals and recipients to enable
shared responsibility and control.
Catalysts: Shifting from ‘delivering’ services to
supporting things to happen and catalysing other
action.

25. IT’S ABOUT
TIME…
and value…

26. • Co-design, including planning
of services and commissioning
• Co-decision making in the
allocation of resources
• Co-delivery of services,
including the role of service
users in providing the service
• Co-evaluation of the service

27. What’s
stopping
us?

28. CAN I COME OUT YET?

31. The moats we dig between
patients and clinicians can
drain spirit from both.
Don Berwick

32. In moments of crisis the wise build bridges
The foolish build dams
Nigerian Proverb

33. Alison Cameron
Patient Leader
Kings Fund Associate
@allyc375