Co-production in integrated health and social care programmes: a pragmatic model

Abstract

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.

Citizens as Active Participants in Integrated Care: Challenging the Field’s Dominant Paradigms

“…Inspired by our own research and based on a critical review of key publications in the field, we have sought to further the debate on citizen participation within care integration. If we approach care not only as a product but also as something that is constituted within the interactions between care users, lay caregivers and professionals [2271], then co-production inevitably lies at the heart of all care delivery [80]. Illustrated by the field’s predominantly professional and organizational characterization of integration [219], we believe that this notion has yet to be fully reflected within established approaches to integrated care.…”

Co-producing health care - pragmatic principles and an illustration

“…We have articulated previously some key principles that should guide managers when planning co-production activities (Kaehne et al 2018;Kaehne & Taylor, 2016). These principles reflect basic assumptions articulated in the management literature about health care services in times of change (Braithwaite & Mannion, 2011;Chambers, 2011;Fitzgerald, 2017) which can help us understand the impetus and direction of travel of co-production.…”

“…With some notable exceptions, patients may frequently express individual needs, whereas organisations have obligations towards all potential users of their services. This aspect is often couched in terms of representativeness of patient involvement, yet the literature also clearly articulates the epistemic boundaries of individual patient experiences (Kaehne et al, 2018;Kaehne & Catherall, 2013). Whilst it is important that individual voices are heard, extrapolating from these voices to wider population needs may be perceived as problematic when patient needs are framed by the concept of person centred care.…”

Co-producing health care - pragmatic principles and an illustration

“…With some notable exceptions, patients may frequently express individual needs, whereas organisations have obligations towards all potential users of their services. This aspect is often couched in terms of representativeness of patient involvement, yet the literature also clearly articulates the epistemic boundaries of individual patient experiences (Kaehne et al, 2018;Kaehne & Catherall, 2013). Whilst it is important that individual voices are heard, extrapolating from these voices to wider population needs may be perceived as problematic when patient needs are framed by the concept of person centred care.…”

“…We have articulated previously some key principles that should guide managers when planning co-production activities (Kaehne et al, 2018;Kaehne & Taylor, 2016). These principles reflect basic assumptions articulated in the management literature about health care services which can help us understand the impetus and direction of travel of co-production.…”