Co-production in local public services- a new partnership with citizens

Kim RyleyChief Executive

What drives demand?Human factors – the values, attitudes and

behaviours of the public, which form their expectations of the “social contract”

Our behaviours and relationships with the public

Our commissioning prioritiesOur model of delivery

Types of demandExcess demand: people asking for what they don’t

needAvoidable demand: arising from behaviours which

create problems that need to be solvedPreventable demand: the result of not noticing or not

acting earlier to prevent problems occurringFailure demand: unnecessary demand caused by the

failure of servicesCo-dependent demand: a state of need or

dependence which is unintentionally reinforced by the state

Engaging with our citizens – an evolutionary journey?

Consultation Engagement Active Participation

Empowerment and

EnablementCo-design and Co-production

Co-production

Co-production is a partnership between citizens and public services to achieve a valued outcome. Such partnerships empower citizens to contribute their own resources (time, will power, expertise and effort) and have greater control over decisions and resources.

What does co-production mean?

How could co-production in public service be accelerated?Choice and control- give citizens greater control over resources and decisions

Peer Support- empower citizens to support one another

Partnerships- strengthen partnerships between professionals and service users

Professional Culture- ensure professionals value citizen empowerment and partnership working

Co-production is a partnership between citizens and public services to achieve a valued outcome. The most effective partnerships are based on four clear values

Everyone has something to contributeEveryone has something to contribute, even though some have more resources than others to give

Reciprocity is importantTwo-way mutual relationships where responsibility risk and power is shared and decisions are negotiated

Social relationships matterSocial networks, especially families and communities, are vital for achieving some types of change

Social contributions are encouragedRecognise the unpriced and often unvalued work of families and communities, not just people’s financial contributions

However, evidence suggests that co-production is higher in the UK than other countries and that people believe their contribution can make a difference

An EU survey shows that people in Britain are more likely to believe that they can make a difference to public outcomes through doing more themselves. The same survey shows that levels of involvement in public services is highest in the UK

How much do people believe they can make a difference in improving community safety, the

local environment and health?

Index of the belief in making a difference

Germany

Czech Republic

France

United Kingdom

Denmark

0 100

64

70

71

77

79

None Maximum

Level of citizen participation in public services in EU countries

Index of co-production

Germany

Czech Republic

France

United Kingdom

Denmark

0 100

48

51

52

53

56

None Maximum

Equivalent to 56% saying they ‘often

get involved’

Evidence indicates that a high proportion of patients and parents want to be treated as partners and what to do more for themselves

An EU survey shows that people in Britain are more likely to believe that they can make a difference to public outcomes through doing more themselves. The same survey shows that levels of involvement in public services is highest in the UK

People often find themselves less involved in services than they would like

Proportion of patients feeling uninvolved in decisions(%)

Primary Care 2006

Inpatient 2006

Mental Health 2006

Stroke 2004 Emergency 2004

Outpatients 2004

CHD-5

5

15

25

35

45

55

%

90%+ patients interested in being more active self carers

50% patients said ‘not often’ encouraged by professionals to do self care

33% patients said they had never been encouraged by professionals to do self care

43% said the NHS could do more to support self care

65% of parents would like to be more involved in their child’s school life

A significant number of people are willing to spend more time each week and month improving their health, neighbourhood and environment

An EU survey shows that large numbers of citizens are willing to spend more time trying to improve their health, neighbourhood and environment. Taking these three areas together:

How much more time are citizens willing to spend in different sectors?

About how much time are you willing to spend to…

improve your local environment

make your neighbourhood safer

improve your health/health care

0 10 20 30 40 50 60 70 80 90 100

• 28% willing to spend a few hours more per week

• 43% are prepared to spend a few more hours per month

• Only 29% indicate that they are not willing to spend any time at all

Few hours a week Few hours a month Few hours a year No time at all

Evidence suggests that citizens in the UK are more likely to participate in groups that improve their health, environment and neighbourhood

An EU survey shows that citizen participation in groups and organisations that encourage a partnership between citizens and public services is highest in the UK.

Particularly encouraging are the higher than average participation in health focused civic groups such as exercise groups, weight watchers, alcoholics anonymous and community safety groups such as residents associations, tenants groups and neighbourhood watch.

Levels of regular participation in community safety, local environmental and health organisations/groups across countriesHow often do you participate in a group or organisation that

works to improve…

Total France Germany UK Czech Denmark0

2

4

6

8

10

12

14

16

SafetyEnvironmentHealth

Perc

ent “

ofte

n”

Excellenceand fairness

Government enabling change through incentives and support

without micro-managing

Citizen empowerment

New professionalism

Strategic leadership

Pers

onal

ised

ser

vice

s th

roug

h

empo

were

d ci

tizen

s an

d

prof

essi

onal

s wo

rkin

g to

geth

er

Greater accountability and

transparency enabling citizens to

hold services to account