The Potential Pitfalls of Co-production: An Overview on the Co-design of Public Services with and for Family Caregivers Living in Rural and Remote Area

Abstract

Background: Co-production has been widely recognized as a plausible solution to reduce users’ dissatisfactions, service providers’ inefficacy and to diminish conflicts in relations between users and providers. However, this enhancement of co-production has started to be query: co-production is not always a panacea and its effects may not be always fruitful. To understand and prevent unsuccessful users and providers’ collaboration, the recent literature has stated to focus on the causes of co-destruction. This paper investigates the possible factors that may facilitate the shifting of a co-production process applied to family caregivers of older patients living in rural and remote area, into a co-destruction process by looking at the whole service network. Methods: To investigate this open topic, we performed a single case study by looking at a longitudinal project (Place4Carers) that aimed at co-producing a new public service with and for family caregivers of older patients living in rural and remote area. We organised collaborative workshops and semi-structured interviews to collect the perspectives of family caregivers and service providers on the co-production process. As part of the research team that participated at the co-production process, the authors joined the reflections with a reflexive approach. Results: Results confirmed the occurrence of some causes of co-destruction suggested by Jarvi’s model during the co-production process: insufficient level of trust, mistakes, inability to change from caregivers and inability to serve from providers. Moreover, they identified the difficulty of creating a cohesive partnership between research members as a possible pitfall of co-production. However, all these causes did not imply an inevitable process of co-destruction. Conclusions: Our article suggests that pitfalls identified by Jarvi and the cultural differences within research members can actually influence co-production but do not inevitably lead to co-destruction. Moreover, we argued that co-creation and co-destruction processes might coexist. The role of researchers and service providers is to prevent and recover from co-destruction effects. To this ends, conviviality could be a powerful tool to avoid lack of trust and create a successful co-production.Plain English SummaryCo-production, defined as ‘the provision of services through regular, long-term relationships between professionalized service providers and service users or other members of the community, where all parties make substantial resource contributions’[1], has been widely recognized as a plausible solution to reduce users’ dissatisfaction, providers’ service inefficacy and to diminish conflicts in relations between users and providers. However, the effectiveness of co-production has started to be queried. This paper investigated the possible factors that may facilitate the shifting of a co-production process into a co-destruction process by looking at all the actors of the service network. To this end, we performed a single case study by investigating the co-production of new public service with family caregivers of elderly people living in rural and remote area, a local home care agency and researchers. Participants were interviewed about pro and cons of the co-production process. The results highlighted that the effectiveness of co-production was limited by some pitfalls: insufficient level of trust, mistakes, inability to change and inability to serve. Moreover, a difficulty of creating a cohesive partnership between research members has been highlighted as a challenging factor in the co-production process. However, all these factors did not imply an inevitable process of co-destruction. Indeed, the process of co-production resulted to have both pitfalls and benefits. Therefore, researchers and service providers should facilitate the shifting from negative toward positive effects of co-production. To this ends, conviviality could be a powerful tool to avoid lack of trust and create a successful co-production.