Do you think there's a need for people to seek to work more closely with those responsible for health, the providers of social care and the deliverers of other services? And by 'those responsible for health' I mean, of course, the general public and by 'the providers of social care' I mean the unsung and unrewarded army of unpaid carers. Should the public service professionals ask for a bigger role in the actual, day to day business of health and social care? Essentially, public services and the general public both 'provide' a wide range of 'services' and it really makes sense for them to work more closely together in doing that.
That would have been no surprise to participants at the launch of the LGIU / Governance International publication – Making Health and Social Care Personal and Local: moving from mass production to co-production on Monday. They, and the book, were full of examples of how service users were playing a valuable role on an equal basis in everything from drug and alcohol recovery networks to managing parks. It includes people doing things for themselves, people supporting each other and people taking a bigger role in decision making, such as young people influencing commissioning decisions.
This is not about volunteering or handing over services to the community. It's about doing things better together. It requires investment of time, effort and skill. And it requires a change in relationships. As one person said at the launch event, many of our professional services have a built in dependency relationship. Co-production requires a different way of thinking and behaving.
There are lots of examples of how it has improved outcomes for those involved, and often saved money – but if you go into it for that purpose, you'll probably miss the point. But there are obstacles, and like anything, things can go wrong. Most of the current arrangements in public services are designed for 'service delivery': from training, to performance management systems and legal regulations. However, many inspiring examples show that with the will, those things can be overcome and changed.
One of the key changes is to think in terms of people with assets rather than just needs. The 'patient' with a litany of long term limiting conditions, may also be the grandparent who delights the family with stories or who provides a lifetime of advice to neighbours. It's a genuine challenge to find ways to tap into this 'free resource'. But it's also a challenge to move away from thinking about 'patients', and 'clients' and just to think about 'people', and how to work with them on an equal basis to improve their lives. As one participant said on Monday, discussions with people that start with what they want for their lives open up many more opportunities than closed consultation on specific services.
So, we might not yet be at the stage of 'Doctor, the patient will see you now' but a more equal relationship between professionals and the public could certainly pay dividends for both.
