The barriers to co-production - a Q&A with Dr Phil Moore
Following the successful ‘Meet your CCG’ campaign last year, Rethink Mental Illness has published the ‘Progress through Partnership’ report. This report highlights low levels of co-production within the design of mental health services, and identifies ways in which CCGs can be supported to involve experts by experience more.
We spoke to Dr Phil Moore, Chair of the NHS Clinical Commissioners Mental Health
Commissioners Network and Deputy Chair of NHS Kingston CCG, who talks about the barriers which may be preventing co-production becoming the norm, and discuss next steps.
What is your background, and how does your CCG involve people with lived experience?
I have been a GP for many years and I work extensively in the commissioning of mental health and wellbeing services. In my own CCG, we asked our local community to lead on writing our mental health strategy and over 200 people have been involved, working alongside our mental health professionals and commissioners. We are now setting out to ensure the implementation is co-produced.
The Five Year Forward View for Mental Health recommended that co-production with experts-by-experience should be a standard approach to commissioning and service design. Why do you think services need to be co-produced?
In my foreword to this paper, I write, ‘Why would we even think of designing and implementing a service without the input of the people who need it?’ The truth is that the knowledge and understanding lies with the very people who have often found it difficult to be heard – those who use the services and those who care for them. Unless we draw on their knowledge, understanding, good and bad experiences and their aspirations, we will be unable to deliver the very best services. They are the ones who really know what it is like to live with mental health issues.
What does it take to truly co-produce a service?
It takes effort, time and resources! Commissioners need to set a culture that enables local people with lived experience to engage and contribute. It means treating them as equal partners, valuing one another’s opinions, views and expertise. The aim is that once a service is up and running, we can recognise that its shape reflects our input.
It is such a shame that local people have often felt frustrated that they cannot shape services as they would like to. So they can end up living with the consequences of a service that could have been designed better if only they had been listened to.
We all need to work together to find compromises that use limited resources to the best effect. Our experts by experience can help to prioritise what we do and help us make maximum use of limited money, staff, accommodation and time. We will only achieve this if we build mutual respect and understand and honour our shared aspirations and frustrations. Our local people can support commissioners to make the bold, and at times radical, changes they want to see, to ensure that local communities have the high-quality mental healthcare they need and deserve.
What do you think the barriers are which prevent this from being the norm?
Commissioners have huge pressures: competing demands on CCG resources at the same time as prioritising innovative ways of working. We need to encourage one another to make the time for co-production. It is the only way to overcome the issues and deliver improved mental health care and services.
What would you like to see happening?
This report is a great first step. It has been written to support and enable commissioners to involve people with lived experience of mental illness in commissioning, and not to be an additional burden to those already hard pressed. I will welcome the opportunity to support this work and encourage my fellow commissioners to embrace its messages.
To read our ‘Progress through Partnership’ report, please click here. You’ll also find a toolkit to support you to meet with your CCG. You can also download a copy of our Progress through Partnership Grid which can be used to map and embed co-production in CCGs by clicking here. If you have any questions, or if you like to give us some feedback on a meeting you’ve had with a CCG, please contact firstname.lastname@example.org