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Beyond Participation to CoproductionNerida Hyett MHSc BOT

PhD Candidate, LecturerLa Trobe Rural Health SchoolJuly 2013

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Improving the Health of Communities through Participation

INTERNATIONAL CASE STUDIES ON COMMUNITY PARTICIPATION AND HEALTH

INCLUSION AND EXCLUSION IN COMMUNITIES

COMMUNITY HEALTH LITERACY

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Community Participation and Health

Schmidt & Rifkin (1996) defined community participation in health as:

A social process whereby specific groups with shared needs living in a defined geographic area actively pursue identification of their needs, take decisions and establish mechanisms to meet their needs

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Iap2 Spectrum of Public Participation

Increasing level of public participation

INFORM CONSULT INVOLVE COLLABORATE EMPOWER

Adapted from the IAP2 Spectrum http://www.iap2.org.au/documents/item/83

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Arnstein’s Ladder

Arnstein, S. (1969)

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Inclusion and representation

• Seeking a diversity of views rather than a representative view

• Public is not homogenous

• Dynamic and self-defining entity

• Active public whose positions are formed through a process of engagement, and dialogue, with others

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Mobilisation and Sustainability

• Readiness

• Community assets, skills and resources

• Funding

• Community organising

• Local solutions

• Longevity

• Intensity

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Coproduction

• Involving consumers in the production of the services they consume

• Lived experience has equal weight with clinician experience

• Overcome challenges posed by health service silos

• Social process

• New health care delivery models resulting in long term changes

• More effective use of natural and existing resources

• Volunteers

• New pathways into education and training

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Examples of coproduction

National Health Service UK: Consumers co-design care pathways, primarily for chronic disease

Peterborough Citizen Power: Recovery Champions working with AOD services to co-design more effective interventions for service users, and institutional mapping to integrate care between services

Service Users Network South London: Co-design and co- facilitation of a group program for people with personality disorders

More examples available here: http://allinthistogetherwales.wordpress.com/coproduction/co-pro-case-studies

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Lessons learned

• Dialogue is critical

• Social and financial imperative

• There is no panacea and this is not easy

• Requires a cultural change

• Assumes that people want to be involved, some may not want to be, and this might change for different issues

• Does not necessarily need expensive or time-consuming methods

• Building coproduction into existing processes is more cost effective and meaningful

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References

Arnstein, S. A. (1969). A ladder of citizen participation. Journal of the American Institute of Planners, 35, 216-224.

Bovaird, T. (2007). Beyond engagement and participation: User and community coproduction of public services. Public Administration Review, 67(5), 846-860.

Coproduction Network. Resources. Retrieved from http://coproductionnetwork.com/page/transitioning-to-coproduction

Draper, A. K., Hewitt, G., & Rifkin, S. (2010). Chasing the dragon: developing indicators for the assessment of community participation in health programmes. Social Science & Medicine, 71(6), 1102-1109. doi:10.1016/j.socscimed.2010.05.016

Nesta. (2011). The Business Case for People Powered Health . Retrieved from http://www.nesta.org.uk/areas_of_work/public_services_lab/health_and_ageing/people_powered_health/assets/features/the_business_case_for_people_powered_healt

Needham, C. (2007). Realising the potential of co-production: negotiating improvements in public services. Social Policy and Society, 7(2), 221-231.

Rifkin, S. B., Muller, F., & Bichmann, W. (1988,). Primary health care: On measuring participation. Social Science & Medicine, 26(9), 931-940. doi:http://dx.doi.org/10.1016/0277-9536(88)90413-3h

Thank you

latrobe.edu.au CRICOS Provider 00115M

Contact:

Nerida Hyett

N.Hyett@Latrobe.edu.au

Dr Amanda Kenny

A.Kenny@Latrobe.edu.au