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Implementing Co-Production in Adult Social Care: An Example of Meta-Governance Failure?

Published online by Cambridge University Press:  07 October 2014

Peter Scourfield*
Affiliation:
Faculty of Health, Social Care and Education, Anglia Ruskin University E-mail: Peter.Scourfield@anglia.ac.uk
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Abstract

The idea of ‘co-production’ has been promoted by both New Labour and Coalition governments as a means to help ‘transform’ adult social care. With its emphasis on active citizenship, community support networks, voluntary effort and power sharing, the idea might have been expected to have been received more enthusiastically by those expected to put it into practice and benefit from it. However, unlike other ‘big ideas’ intended to ‘transform’ adult social care, such as ‘personal budgets’, co-production has gained comparatively little traction with either local authorities or service users. Despite the publication of much promotional literature in recent years, co-production has not yet become a significant part of either official or lay discourse on adult social care. It is concluded that apart from definitional problems and conceptual ambiguity, the inability of successive governments to effectively deploy common techniques of meta-governance might also be contributory factors to its sluggish take up.

Type
Articles
Copyright
Copyright © Cambridge University Press 2014 

Introduction

This article is prompted by the belief that despite the publication of a plethora of reports, pamphlets, guides and papers in recent years designed to promote the need to work towards the ‘co-production’ of social care in England, the concept has not gained as much traction at the level of local policy implementation as its proponents would have expected or, at least, hoped for.

After explaining how that belief came to be formed, the discussion draws on selected literature to explain that in the context of social care, co-production is recognised as being a ‘slippery concept’ with several definitions and with multiple policy purposes.

To better understand the challenges faced in bringing about the ‘co-production’ of social care across England, the article applies ideas from governance theory (specifically meta-governance), such as ‘hands-off’ framing and story-telling. It is suggested that the protean nature of the concept means that ‘steering’ various actors into being ‘co-productive’ has proved challenging, not least because policy makers have so far failed to produce a coherent or credible enough story-line to enable a diverse range of potential stakeholders to fully buy into the idea.

Context and rationale

There is no single, agreed definition of what it means for public services to be ‘co-produced’. However, the idea of ‘co-production’ in public services is said to date back to the 1970s (Alford, Reference Alford1998; Bovaird, Reference Bovaird2007; Needham and Carr, Reference Needham and Carr2009). Some of the complexity surrounding its meaning will be highlighted in the discussion that follows; however, broadly speaking, it is an idea that requires:

the involvement of citizens, volunteers and clients in producing public services as well as consuming them. (Alford, Reference Alford1998: 128)

In October 2013, the Social Care Institute for Excellence (SCIE) issued the Guide, Co-production in Social Care: What It Is and How To Do It (SCIE, 2013). This was the latest of many guides published in England on the topic in recent years. In discussion with managers responsible for adult social care in one local authority later that year, it transpired that not only had they not heard of that particular guide, but neither had they actually ever heard of the idea of ‘co-production’ in relation to adult social care. When the idea was outlined to them, they were able to relate it to the transformation agenda (HM Government, 2007) about which they were knowledgeable and with which they were fully engaged in putting into practice. It was, nevertheless, noteworthy that otherwise knowledgeable professionals had such a ‘blind spot’ about what is supposed to be such an important idea in their area of policy.

The specific knowledge possessed by a small number of managers might not have been representative of how far that particular local authority had embraced co-production. Out of curiosity, it was decided to examine the local authority's relevant web pages for what had been published on the topic. This was on the assumption that, particularly following the implementation of Modernising Government (HM Government, 1999), ‘official’ websites such as those operated by local authorities are valid sources of documentary data that can provide important insights into the purpose, culture and function of the organisation to which they belong (Flick, Reference Flick2009; Denscombe, Reference Denscombe2010).

The search of the local authority's web site revealed that unlike terms such as ‘personalisation’, ‘personal/individual budgets’ and ‘self-directed support’, which are all related to the agenda of transforming adult social care (HM Government, 2007), the term ‘co-production’ did not feature anywhere in the local authority's communications about adult social care. In fact, the specific search terms ‘co-production’ and ‘co-produce’ revealed just one link: to a news item that a time bank scheme involving homeless people had opened in 2011.

Research design

This local authority could have been an exceptional case. Therefore, in December 2013 it was decided to purposefully sample a further fifteen local authority web sites clustered around the local authority in question. All the web pages visited were operated by county councils or unitary authorities situated in the east midlands, south east and eastern England (not including London boroughs). The websites were searched using the in-built search facility provided. As with the original search, it was assumed that all the local authority web pages met key criteria set for validity (Denscombe, Reference Denscombe2010): authenticity, representativeness and credibility.

Specific searches for the terms ‘co-production’ and ‘co-produce’ yielded nothing at all from nine of the local authorities’ web pages. The findings from the remaining five sites can be summarised as follows:

  • Local authority A

  • Three links were found to ‘co-production’ in documents such as the council's Joint Strategic Needs Assessment

  • Local authority B

  • One link was found to that council's 2010–13 Adult Social Care Strategy which contained a brief reference to ‘co-production’ in it.

  • Local authority C

  • One link was found to that council's Health and Wellbeing Board's minutes, where co-production was the eighth item on the agenda.

  • Local authority D

  • This local authority had recently added a page with seven lines of text explaining about ‘co-production’.

  • Local authority E

  • The single link to ‘co-production’ found on this website was to a ‘co-produced’ TV series which had been recently broadcast featuring locations in that council's area.

To double check that references to either ‘co-production’ or ‘co-produce’ were not to be found on web pages related to the cognate topics of ‘personalisation’, ‘personal budgets’ or ‘self-directed support’, separate searches were made under these terms. However, no further references to ‘co-productive’ activity of any type were found using this technique.

Given the very low hit rate from the searches mentioned, further ‘analysis’ of data was not deemed to be necessary. Fourteen local authority web sites had been searched for published evidence of co-production, nine had yielded nothing and the other five had provided either very brief details or references that were of only marginal relevance.

Limitations

The relatively small sample size means that any generalisations from the data can only be moderate (Payne and Williams, Reference Payne and Williams2005). It is also acknowledged that there is also an inherent instability about website data (Flick, Reference Flick2009). It might also be argued that local authority web pages alone might not reveal how much co-produced social care is actually being undertaken in the local authority areas involved. However, that said, a council's web pages are public documents expressly designed to provide information about the local authority's activities, and therefore these findings do convey something noteworthy about the current level of co-productive activity in adult social care in England. The fact is that fifteen English local authorities had little or nothing to say on the subject, either to potential service users or to the public at large. At worst, it can be inferred from this that very little is actually being done in social care under the heading of co-production. However, looking at it more positively, even if the local authorities were engaged with co-producing adult social care, it would appear that unlike with personal budgets and self-directed support, they had very little, if anything, to say about it publicly. Co-production was neither explained nor defined, and neither were specific stakeholders such as service users, carers or local voluntary groups informed about what they could or should be doing about working co-productively.

As will be discussed in the following section, ideas about co-production in social care have been in circulation since the introduction of community care and have been more intensively promoted in the last ten years (Needham and Carr, Reference Needham and Carr2009; SCIE, 2013). However, the findings from the research exercise suggest that compared to other ideas underpinning the transformation agenda, co-production has so far failed to fully take root in mainstream adult social care discourse. There are several possible reasons for this. A useful starting point might well be to consider the very protean nature of the concept itself and the broad and diverse range of political purposes that co-production, in its many guises, is expected to fulfil.

Co-production

Co-production is an idea whose time has come. (Boyle et al., Reference Boyle, Coote, Sherwood and Slay2010: 6)

A key limitation of co-production is its ‘excessive elasticity’, evident in the various ways in which it has been defined and interpreted. (Needham and Carr, Reference Needham and Carr2009: 4)

Co-production is a slippery concept and if it is not clearly defined there is a danger that its meaning is diluted and its potential to transform services is reduced. (SCIE, 2013: 7)

Advocates of co-production can be quite ebullient about its importance to the transformation of public services. However, as the latter two quotations above indicate, others are aware that clear, accessible definitions of what exactly co-production is have proved difficult to pin down. However, at its heart lies the belief that service outcomes are improved with the ‘active input’ of those who use them (Needham and Carr, Reference Needham and Carr2009: 1).

The idea of co-production in public services is said to have originated in the 1970s in the USA, mainly in the context of municipal services such as waste management, road maintenance and community policing (Alford, Reference Alford1998; Needham and Carr, Reference Needham and Carr2009). However, few applied the idea to adult social care until Wilson (Reference Wilson1994), following the official introduction of ‘community care’ in the UK. Wilson's paper argued that there was a need to empower service users and carers by including them as full partners in social care arrangements. However, community care was mainly predicated on ideas about offering ‘choice’ through consumerism and the creation of quasi markets, which hardly created a fertile environment for more ‘radical’ ideas about power sharing to take hold (Means et al., Reference Means, Richards and Smith2008). Consequently, community care discourses in the UK seldom referenced ‘co-production’, if at all. Ten years after Wilson, during New Labour's second period in office, think tanks such as Demos (see, for example, Chapman, Reference Chapman2002) and the New Economics Foundation (for example, Burns and Smith, Reference Burns and Smith2004) actively advocated for co-production in public services. Leadbeater is generally most closely associated with the reintroduction of the concept in the context of the personalisation of adult social care (Leadbeater, Reference Leadbeater2004; Spicker, Reference Spicker2013). Co-production was most noticeably revived in official discourse on social care during the New Labour government's third term of office. Key policy statements were the White Paper, Our Health, Our Care, Our Say (HM Government, 2006), which provided a broad vision for the transformation of adult social care, and the 2007 Comprehensive Spending Review (House of Commons Treasury Committee, 2007), where the focus was on the reform of the social care funding system. However, the official case was made most explicitly in Putting People First (HM Government, 2007), which stated that:

It seeks to be the first public service reform programme which is co-produced, co-developed, co-evaluated and recognises that real change will only be achieved through the participation of users and carers at every stage. (2007: 1)

The argument for co-production is driven by more than dissatisfaction with traditional models of service delivery in social care. There is a wider political and economic context and, according to Needham and Carr (Reference Needham and Carr2009), the drivers behind co-production include:

  • a crisis of faith in target-based and process-driven models of service delivery;

  • a call for ‘double devolution’ of power, down to town halls and out to frontline staff and citizens along with the promotion of the idea of ‘place shaping’ in local government;

  • pressures to increase service efficiency and reduce public spending;

  • the growing awareness of new types of knowledge, particularly that which is user-generated;

  • a desire to reinvigorate local democracy;

  • a determination to make social care services more personal though the effective participation of the people who use them. (2009: 2)

This represents quite a challenging and ambitious list of agendas on which co-production is said to be able to make a positive impact. However, as the authors also observe:

Co-production has something to offer the implementation of these reforms, which highlights both its popularity and the ambiguities surrounding its definition. (ibid.: 3)

Needham and Carr make a valid point in highlighting the link between co-production's popularity (at least in some quarters) and the ambiguity about what it actually means. New Labour governments were creative in their use of ambiguity in policy making. Ambiguity served many purposes, including helping to defuse tensions, manage potential conflicts and, in effect, depoliticise certain difficult issues (Seldon, Reference Seldon2007; Diamond, Reference Diamond2013). Malleable and slippery policy concepts can therefore be quite helpful in garnering support when faced with ‘wicked problems’ (Rittel and Webber, Reference Rittel and Webber1973). Therefore, probably for similar reasons, the Coalition government has embraced co-production with the same enthusiasm as its predecessors (see, for example, Building the Big Society (Cabinet Office, 2010)).

In A vision for adult social care, published in 2010, it is stated:

this vision, proposes a new agenda for adult social care. It will be co-produced with the social care sector, voluntary and community organisations and people who use services over the coming months and years. (Department of Health, 2010: 31)

The Think Local Act Personal partnership (2011), which was launched to succeed Putting People First, maintained this approach. Therefore, since 2004, there have been many initiatives, guidelines and publications put forward from both government and other organisations (for example, the New Economics Foundation and NESTA) that have promoted various forms of co-production. Alongside this, it is true that there have been various examples of co-productive activities involving user-led and other voluntary organisations taking place in different localities (Needham and Carr, Reference Needham and Carr2009). However, perhaps concerned that the message was still not getting across as fully as it could be, despite the many guidelines published, in October 2013 the Social Care Institute for Excellence (SCIE) issued the guide, Co-production in Social Care: What It Is and How To Do It.

Governance and meta-governance

Ideas about governance and meta-governance have become the focus for study in social policy in recent decades (Bevir, Reference Bevir2009, Reference Bevir2011). The precise meanings of these concepts are contested and a fuller discussion of this is beyond the scope of this article. However, for the purposes of this discussion, according to Enroth (Reference Enroth and Bevir2011: 19):

Governance, involves a plurality of actors interacting in networks that cut across the organizational and conceptual divides by means of which the modern state has conventionally and all too conveniently been understood: notably, the distinction between state and civil society, and the distinction between public and private sectors.

Therefore, when applied to policy on social care, governance is a very useful concept in the context of this discussion. For example, the state is only one of many players in the production of social care in England. Networks of diverse private and voluntary organisations, as well as millions of informal carers, also play a huge role.

To make social care policy happen in these circumstances, the state and its institutions are required to engage in direct and indirect work with a plurality of actors across the various sectors in order to ensure that there is general agreement about policy goals and preferred styles of working. The increasing use of indirect work is an important element in understanding the shift from traditional hierarchical forms of ‘government’ to more diffuse forms of ‘governance’ through networks (Bevir, Reference Bevir2009, Reference Bevir2011; McGuire, Reference McGuire and Bevir2011). Equally important to understand is that the state needs to ensure that the multiple actors involved take ownership of the process and ‘run with it’ themselves. This is where the concept of ‘meta-governance’ is useful. This has notably been described by Jessop (Reference Jessop2002, Reference Jessop and Bevir2011) as ‘the organization of self-organization’. Meta-governance therefore involves managing complexity and plurality from a distance. Therefore, as Bevir explains, when ‘power and authority are more decentralized and fragmented among a plurality of networks’ (2009: 131), the role of the state has needed to shift:

from the direct governance of society to the ‘metagovernance’ of the actors that now are involved in governing society. Similarly, in this context, the mode of state action – and so the main policy instruments it uses – are said to have shifted from command and control within a bureaucracy to the indirect steering of the actions and interactions of relatively autonomous stakeholders. (ibid.: 131)

Hands-off framing of self-governance

This is what Bevir (Reference Bevir2011: 206) has described as ‘setting the rules of the game’. Sørensen explains that framing involves the use of ‘various forms of incentives that seek to influence self-governing actors through the strategic construction of institutional designs or game structures that enhance desired choices among autonomous actors’ (2006: 101).

For example, funding arrangements or the awarding of contracts might be linked to those organisations that can demonstrate the greatest level of the desired behaviour. If that preferred behaviour happens to be ‘partnership working’, then those actors who can demonstrate that they are good partnership workers will attract funding, whilst those that do not will not.

Hands-off story-telling

The use of story-telling in policy making and policy analysis is not a new technique (see, for example, Rein, Reference Rein1973). Stories that draw on either specific people's real or imagined experiences have been commonly used as case studies or vignettes to illustrate ‘how the future might unfold if certain actions were taken’ (Rein, Reference Rein1973: 75). As a technique of meta-governance Sørensen (Reference Sørensen2006: 101) argues that:

storytelling represents a forceful means to influence self-governing actors and thus to promote unitary strategies to problem solving. Through storytelling, it is possible to shape images of rational behaviour through the construction of interests, images of friend–enemy relations, and visions of the past and possible futures for individuals and groups and for society at large.

Therefore, if chosen well to resonate with the specific audience, stories can help shape the mind-sets of actors, provide a vision, or at least examples, of what is expected, and make the abstract concrete through the use of other people's lived experiences. Stories with positive outcomes can be chosen to suggest the sorts of activities in which actors should be engaging. Alternatively, stories which have negative outcomes can be selected to illustrate past policy failure, to help provide a rationale for change and to provide examples of activities from which actors should abstain. Story-telling can be a particularly useful method when different viewpoints might exist amongst diverse actors and a sense of common purpose and cohesion of activity needs to be achieved (Bevir, Reference Bevir2011).

Hands-on support and facilitation

Preferred behaviour can be encouraged by more direct methods. Sørensen explains that ‘hands-on support and facilitation’, is where:

the supportive and facilitating metagovernor interacts directly with the self-governing actors. (2006: 102)

This might mean, for example, the central and/or local state acting as an information hub, distributing resources, making connections between actors and providing guidance that helps promote the activities wanted from self-governing networks.

Hands-on participation

A more assertive method of ‘hands-on’ meta-governance is when the meta-governor participates directly as an actor in order to help bring about desired outcomes. Sørensen explains that:

the metagovernor becomes one of a number of actors who negotiate collective solutions to shared problems. The hands-on participation in self-governance might serve as a valuable supplement to various forms of hands-off metagovernance, not least to storytelling, because it provides a metagovernor with an inside platform within a self-governing body from which a specific story can be told. (2006: 102)

This method has the appeal of being able to exert influence from the inside. However, it is not without its complications, because, as an insider, the state too has to play by the set rules or risk the accusation that it is exercising command and control.

Whilst it is possible to find ‘steering’ methods of meta-governance typologised or phrased slightly differently (Bevir, Reference Bevir2011), for the purposes of this discussion it is proposed that Sørensen (Reference Sørensen2006) provides a clear and credible framework with which to discuss the current failure of co-production to gain traction in England.

Discussion

The research discussed earlier indicated that there was very little co-productive activity being talked about on local authority websites. Therefore, in order to examine the current ‘state of play’ as far as the co-production of social care in England is concerned, this discussion focuses on two key documents published by the Social Institute for Excellence (Needham and Carr, Reference Needham and Carr2009; SCIE, 2013). This is because the SCIE plays an important role in helping to translate ideas about social care into practice for managers, practitioners and other relevant stakeholders. SCIE assert that they ‘are committed to co-production’. Taken together, the two SCIE publications provide the rationale, ‘emerging evidence base’ and guide on ‘how to do’ co-production. They are informed by a combined total of 161 references (with considerable overlaps between the two it must be said). As such, they provide a more than adequate insight into the many issues, debates and challenges faced by those attempting to push the agenda forward, as well as providing an account of what is actually happening on the ground.

It is important to note that both documents acknowledge that there is a lack of clarity over definition. They also both state that co-production can operate at three different levels: ‘descriptive’, ‘intermediate’ and ‘transformative’. At the ‘descriptive’ level, it is said that co-production can be seen as ‘compliance with legal or social norms’, and examples provided include ‘children doing their homework or people taking medication’ (Needham and Carr, Reference Needham and Carr2009: 5). At this level, co-production seems to be about complying with the directives of others. The so-called ‘co-producer’ does what they are told to do.

At ‘the intermediate’ level Needham and Carr (2009: 6) explain that:

co-production can be a tool of recognition for the people who use services and their carers, acknowledging their (usually uncosted) input, valuing and harnessing the power of existing informal support networks and creating better channels for people to shape services. This improvement-focused form of co-production envisages ‘more involved, responsible users’, who are invited – although perhaps also required – to make a greater contribution to the service.

At this level, co-production seems to be about people being recognised for either supplementing, or plugging the gaps, in public services. They also might be consulted on how the public services that they are helping to supplement might be improved.

The ‘transformative’ co-production is talked about in more aspirational and abstract terms in that it is said to require:

a relocation of power and control, through the development of new user-led mechanisms of planning, delivery, management and governance. It involves new structures of delivery to entrench co-production, rather than simply ad hoc opportunities for collaboration. (ibid.: 6)

Only at this level does one get the sense of co-production where the service user actively shapes the services they receive, and, therefore, has some genuine control over the production process.

If the use of ‘co’ in ‘co-production’ is supposed to suggest some form of power sharing between producers, then, from the explanations and examples provided of the three levels, it appears that the basic idea has been stretched to the point where one wonders whether it has any meaningful application, so little do they have in common. At the first two levels, there is no real ‘co’ in the co-production’, whilst for the third level, there is, but it requires structures of delivery to exist that currently are rarely found.

As a consequence, there is a fundamental difficulty in being able to say with any confidence what co-production actually looks like and therefore how it is made a reality. This inevitably creates a significant challenge for the ‘meta-governor’ to know how and where to ‘steer’ the various actors. This will be demonstrated by applying the techniques outlined by Sørensen.

Hands-off framing of self-governance

At the less ‘assertive’ end of the scale, there have been no specific regulatory conditions, standards or performance criteria introduced that require organisations to work ‘co-productively’. In fact, since the Coalition government came into office, national performance measures for local government have generally been relaxed (APSE, 2011), and the only specific outcome measures relevant to adult social care do not mention co-production. Therefore, it is difficult to see how institutional designs and structures have helped frame or facilitate co-production. If anything, such changes that have taken place in this respect suggest that co-production is less likely to take place.

In terms of ‘game structures’ that would activate co-production, SCIE states that:

Organisations, programmes and projects that use co-production have a complex and dynamic nature, which makes it difficult to assess their costs and benefits.

Evaluations of co-production have tended to focus on how people have participated and on their experiences, rather than on costs and benefits. (SCIE, 2013: 17)

Therefore, no clear case has been made for co-production that is measurable in terms of financial benefits if it is adopted or penalties if it is not. However, as SCIE indicate, there are potential non-financial benefits that working co-productively can bring. SCIE talk, for example, about how (at the intermediate and transformative levels) co-production brings about ‘more recognition and mutual respect’ (SCIE, 2013: 8). However, these types of benefits are subjective, being experienced differently by different people in different contexts. Therefore, being hard to quantify, their potential for use in designing systems or structures that will bring about tangible co-productive behaviour at the individual or collective level is weak. SCIE also assert that other ‘intrinsic benefits’ that might come from co-production are:

an increased sense of social responsibility and citizenship and benefits to the wider community (sometimes defined as social capital), particularly to improved health and wellbeing. (ibid.: 19)

The first point to make about this kind of claim is that although it might appear to be true on an intuitive level, very little hard evidence is adduced to support it. However, even accepting that it is a valid claim, perhaps a bigger problem for developing co-productive activity is that far from creating the conditions for building social capital and strengthening civic society, such as resourcing and facilitating voluntary effort and community cohesion, recent government cutbacks in community services have significantly eroded them (UNISON, 2013). When the Coalition Government came to power in 2010, it launched a programme of deep cuts in public spending (Ball and Rogers, Reference Ball and Rogers2011). Partly as a consequence, different statutory departments either downsized or merged (NAO, 2013). In this context, it appears that recent Coalition policy on communities would indicate that conditions for co-productive activity are actually framed less favourably than they were a decade previously.

Hands-off story-telling

Story-telling has been a favoured method used by both New Labour and Coalition governments as part of the transformation of adult social care (Needham, Reference Needham2011a and Reference Needhamb). As Needham explains:

Key to understanding the effectiveness of personalization is the recognition that it is a story that is told about public services, their history and the roles and experiences of the people who use them and work in them. (Reference Needham2011a: 55)

To unpack this, Needham explains how the ‘personalisation’ story-line gained traction through the artful construction of a narrative that deployed variously:

the testimonies of social care service users alongside formal evidence of service improvement and claims that the benefits of personalised approaches are self-evident. (Reference Needham2011b: 7)

It would be fair to suggest that exactly the same form of approach has been adopted with co-production. However, as suggested earlier, this appears not to have gained anything like the same degree of traction. Arguably, this is to do with both the quality and quantity of the three elements available to the story-teller (i.e. personal testimonies, formal evidence of improvement and claims that benefits are self-evident). Needham and Carr's ‘emerging evidence base’ deploys four mains ‘stories’ to illustrate co-production. They are: time-banking (of which several examples are provided); the KeyRing community support system; the French Villa Family programme for older disabled people; and the Local Area Co-ordination scheme from Western Australia, which uses locally based area coordinators to provide support for people with disabilities. Whilst the benefits of such schemes are highlighted, they are not presented uncritically. So, for example, various issues are highlighted, including difficulties over accountability, resource shortfalls and the potential for certain marginalised groups to be excluded from such schemes.

The ‘emerging evidence base’ gathered by Needham and Carr, and published by SCIE in 2009, struggled to provide a credible story-line because not only were there too few narrative components, but also those that were presented were not able to be woven into a coherent enough narrative. However, the more recent guidance published by SCIE (2013) builds on the earlier document and includes an additional nine projects as practice examples. Yet, whether they are always examples of ‘practice’ is open to question. For example, below is the first list of ‘practice examples’ provided (SCIE, 2013: 9):

  • Action for Carers Surrey

  • For this organisation, co-production meant that it was treated and valued as an equal partner in the coalition it brought together to develop a new service to provide breaks for carers.

  • Birmingham City Council's Adults and Communities Directorate

  • The Adults and Communities Directorate defines co-production as ‘a way of working in partnership to understand and agree the things that need to improve and work together to change things for the better’.

  • All Together Now

  • This project defined co-production as ‘a value based approach that is about building relationships, is a force for good, and can be used in a variety of settings’.

Whilst aspirational, these descriptions are vague in detail and fairly thin in terms of any real practical application. As a consequence, they have little, if any, narrative power. There are more concrete details provided for some other projects, but the authors are unable to present a sufficiently coherent, ‘fleshed out’ body of evidence to construct a credible vision of a ‘transformed’ social care system. Elsewhere, Needham (Reference Needham2011a: 56) explains that:

A dominant story-line provides a compelling account of policies which ‘sounds right’, based on its plausibility, trust of the author, and acceptability for the listener's own discursive identity . . . The thread of a story-line provides a rallying point, under which a diverse range of projects can be accommodated.

Judged by these standards the current story told about co-production has not been successful. There are too many holes in the narrative and the use of the terminology is too loose for there to be an effective ‘rallying point’.

A big challenge for the future is to generate robust evidence (and therefore plausible stories) that co-production actually works for people who require high levels of social care because they have complex health conditions, significant degrees of physical or mental impairment and who also might be socially isolated or marginalised. An equally important challenge with producing a credible story might well be connected to the fact that in the context of a sustained, large-scale programme of spending cuts, many believe that the government's priorities are less to do with fostering genuine co-production and more to do with cutting public services (see, for example, Duffy, Reference Duffy2014). From other governmental utterances (Rigby and Cumbo, Reference Rigby and Cumbo2014) that would appear to be the far more plausible story-line.

Hands-on support, facilitation and participation

The SCIE documents provide examples of co-production taking place at different levels. However, to be effective the real challenge is to find evidence of genuine ‘transformative level’ co-production (as opposed to more general notions of community support) taking place in social care with people with complex and high support needs, who also might lack the mental capacity to make decisions in important areas of their lives. As some commentators have observed (see, for example, Beresford, Reference Beresford2009), the way that the personalisation of social care for this group has been implemented via the use of personal budgets to buy care ‘off the peg’ has not really represented a true empowerment model. The development of ‘self-directed support’ along consumerist lines is an important reason in understanding why the progress towards co-production might be sluggish. Sørensen (Reference Sørensen2006) indicates that direct participation techniques often go hand in hand with story-telling techniques. Therefore, because to date personalisation has been implemented in ways that are more about buying rather than co-producing services, the stock of genuine social care stories available to the meta-governor is very sketchy.

There are other problematic issues in bringing about co-production through the state taking more of a ‘hands-on’ role. Co-production has been strongly predicated on the principles of power sharing, equality and ‘user-led mechanisms’. However, activating, managing and steering (in other words ‘leading’ without being seen to be too conspicuously leading) networks of autonomous actors towards a common purpose presents complex challenges (McGuire, Reference McGuire and Bevir2011). If ‘facilitative’ leadership becomes too dirigiste, then, effectively, any outcomes can hardly be described as ‘co-productive’. There are also problems for user groups, voluntary organisations and other non-state actors in being able to steer a path between being collaborative and being co-opted (Barnes and Cotterell, Reference Barnes and Cotterell2012). Therefore, quite what the ‘co’ entails in co-production is critical. The reluctance of autonomous user-led organisations to enter into ‘co’ relationships with branches of the state is understandable if they believe, as Farr indicates, that it ‘may compromise their ability to tackle wider issues beyond service delivery’ (Reference Farr, Barnes and Cotterell2012: 88). Uncovering evidence of ‘hands-on’ meta-governance that has brought about genuine co-productive activity has proved problematic for a variety of reasons.

Conclusion

It would require further research to establish fully the extent to which ‘transformative’ co-productive activity in social care in England is taking place. However, findings from the web site research and from the examination of the SCIE documents suggest that currently the project to embed co-production in adult social is a long way from being accomplished.

The article has used the concept of meta-governance to try to explain why this might be so, and in so doing has highlighted that there is no one single reason why co-production has failed to take root. Jessop (Reference Jessop2002: 7) has pointed out that:

we can safely assume that, if every mode of governance fails, then so will metagovernance! This is especially likely where the objects of governance and metagovernance are complicated and interconnected.

In this case, the object of meta-governance – co-production – is complicated by the ‘excessive elasticity’ of the concept itself. Therefore, a starting point in making the co-production more likely to take place would be to more clearly explain what it is, with the benefits of working co-productively made much more tangible and accessible to those who are expected to participate.

However, additional problems appear to lie in the state needing to manoeuvre too many diverse elements into place without having the necessary techniques at its disposal and in conditions that are less than conducive. Co-production can only begin to take place as hoped for by its proponents when the concept is clarified; when members of the public, either as individuals or collectively, are sufficiently empowered to participate as proper partners; when incentives for all stakeholders to participate are made more attractive; and, not least, when a more compelling and credible story-line is constructed.

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