Purpose The purpose of this paper is to outline the current thinking on co-production in health and social care, examine the challenges in implementing genuine co-production and argue for a pragmatic version of co-production that may assist programme managers in deciding which type of co-production is most suitable for which programme. Design/methodology/approach A discussion paper based on the professional and academic knowledge and insights of the authors. A focus group interview schedule was used to guide discussions between authors. Findings The authors argue for a pragmatic approach to co-production within integrated care programmes. The authors set out the basic parameters of such an approach containing procedural rather than substantive standards for co-production activities leaving sufficient room for specific manifestations of the practice in particular contexts. Practical implications The authors put forward a pragmatic model of co-production that defines the essential elements of a process for ensuring services are designed to meet with the needs of patients yet allowing the process itself to be adapted to different circumstances. Originality/value The paper summarises the discussion on co-production in relation to integration programmes. It formulates a pragmatic model of co-production that may assist programme managers in establishing good practice co-production frameworks when designing or implementing integrated health and social care services.

The application of realist approaches to health services research and evaluation has continued to grow over the past two decades. However, difficulties in defining and operationalising key realist concepts of contexts, mechanisms and outcomes in healthcare settings continue to be recognised within the realist evaluation literature. Reflecting on an ongoing realist evaluation of a healthcare quality improvement programme across an inter-organisational context, this article explores some of the methodological challenges encountered by the author in the early stages of programme theory development. An individualised operationalisation and application of realist concepts are presented to demonstrate how initial programme theories can be developed despite the methodological difficulties presented.

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PurposeThis paper aims to provide a response to the previously published paper on “Gerontocracy”.Design/methodology/approachThis paper views care services through the lens of safeguarding, risks and responsibility in contradistinction from the largely economic and cost relevant argument put forward in the original paper.FindingsThis paper articulates the contribution of informal carers to integrated care solutions solely from an economic perspective overlooks the wider human and social dimensions of care provision in society.Originality/valueEngaging in the wider debate about the status, contribution of informal carers to care solutions highlights the complexity of the carers' role in society which should evoke a more holistic debate of this important topic.

Research is critical for effective and innovative social work practice, yet social workers do not always have time to engage with research and there are limited accounts of how practitioners can undertake research in practical and meaningful terms (Mitchell, Lunt, and Shaw 2010). Using a reflective, storytelling methodology (Beresford 2016), which centres experiential knowledge, we describe how one regional social work teaching partnership nurtured practitioner research over a three-year period. We introduce a regionally administrated 'hub', that connected social workers and academics and supported the development of seventeen research teams. The studies that resulted, focused on a range of important issues including child protection, young people in transition to adult services, adults in community and residential settings, lived experience-led provision, and social work education. In terms of limitations, our reflections are descriptive and illuminative, rather than critical, our findings are also not representative but rather reflect a snapshot of practice. Despite limitations, this commentary reveals the feasibility and value of proactively nurturing practitioner research and offers a blueprint for cultivating similar initiatives in other regions.