Welcome to another blog by Matthew Mckenzie unpaid carer for someone close. Most of my website focuses on unpaid carers caring for someone with mental health needs and healthcare in general. I do not just often blog and post, I try to be active out in the community. I have been runinng carer strategy forums close to 4 years to seek co-production and engagement from those who provide health and social care.

Engagement from my local mental health trust has been fairly good, although getting people’s time is not easy, but engagement from commissioners is even more difficult, perhaps not enough staff perhaps. Co-production with the CCG’s and council has been very slow and sometimes I am wondering if it is valued, although I hear of some good works, I still feel its lacking.

Did you know that from the 5th of July it is National Co-Production week? This is the week were those who use services and their unpaid carers can use their voices to express what they know or want to understand about co-production. It is also a chance for health professionals to showcase their co-production examples and also learn how to increase co-production.

What is co-production?

Unfortunately co-production can be a loose term and is used all too frequently. To strip it down to its basic premise. It could be defined as “users of a system joining together to influence the way that services are designed, commissioned and delivered”. Still, such a term cannot be agreed by everyone and the meaning of co-production might chance over time.

Even more importantly, co-production aims to shift the culture of power towards the end users, because the problem is what health commissioners and designers feel on who is experienced to create policies and commission services. It sometimes is not always health professionals and commissioners fault, as co-production becomes difficult if only a few users want to be involved.

This is one of the reasons why National co-production week helps to try educate others on the importance of co-production. It should be a time where patients and carers focus on what we can do, rather than what is always being done to us.

A culture problem

Health services, social care and psychiatry often suffer from a problem of a top down organisational structure. Only the experts know best and there is pressure for them to produce results. If its not about saving costs and producing quality results, its also the culture of the health professionals being highly educated to know what is best. History unfortunately has shown the mistakes where the culture of who knows best can do untold amount of damage to the community. The culture barrier can stop/limit the end user or community from using their voices to get involved and tackle inequalities of health and social care.

Too often health professionals and commissioners have the idea that because the end user was not educated about health and social care, that some health experts feel end users do not have anything to contribute. The policies, practices and principles are guarded for dear life and the impact on the community is limited.

Too often health commissioners feel that funding community idea is the answer to co-production, when the focus should be on engaging with those who want to engage and help spread the message. It is not always about a cost cutting exercise and people want to be given the power to be heard and contribute to health systems and services.

Unpaid carers co-producing.

It can be difficult for unpaid carers like myself to aid in co-production. There is too few of us, we do not have the time and the sacrifice can be high. As for myself, I feel I tend to get on commissioners nerves as they give me the angry look when I ask for engagement or a chance to try co-produce. My experience as been fairly ok, but I do get the situation where commissioners tend to start hiding answers, do not respond, do not want to be in room, feel bored and evasive. I do not want to have to keep asking MPs to ask health commissioners and hospital leads to be dragged into community strategy forums. This takes up too much energy and leads to making powerful enemies.

Sometimes to be fair, there is too few driving powerful systems that do not have the time. It can be a resource issue in demanding time from those that are too few and want their reputation to be guarded. If this is the attitude of some health commissioners then one needs to wonder if they belong, if there is a sense of identity or if co-production has become rather token.

A need for belonging

It is not about power, we in the community need to feel we belong. The end user be it the service user or carer would like to feel examples of involvement. Since engaging with psychiatry and psychology, some things has rubbed off on me. I feel a stronger sense of how important people act, I can often sense the tone of voice, body language and if the person is being sincere. I am grateful for at least having some idea of those two fields, but it is almost depressing to think education rather than just experience of the impact of psychiatry and psychology is more valued.

I offer praise to those who respond quickly to engagement, especially a lot of staff at South London and Maudsley even though some are critical of the NHS Trust. The healthwatches from Lewisham, Southwark, Lambeth and Croydon and beyond have impressed me due to backing my carer forums immensely.  Plus the Carer Centres who host my Carer forums.

I thank the British Psychological Society for paying so much attention and engaging so much, I am still amazed they have time for my ramblings. I am proud to have support of Carers Trust and support of Jen Kenward from NHS England as they seek to raise awareness of the often quiet carer voice.

I also thank some of the MPs who have to make noise to ask those to attend carer forums, you know who you are. I thank the MPs for attending and keeping a close eye on how the forums are being engaged.

Lastly I want to thank many NHS trusts who have involved me as their ‘adopted carer’ especially Sussex NHS Trust, WLMHT, Kent and Medway NHS Trust, Oxleas, Coventry and Warwickshire Partnership NHS Trust,  CNWL, SWLSTG NHS Trust and many more NHS trusts focusing on the triangle of Care scheme and especially Ruth Hannan and the work WeCoproduce does. Sorry if I missed praise on others since there is so many to mention.

There is still a long road to co-production and I suspect it might never end, but if the healing results and impact of psychology, psychiatry and health and wellbeing are to improve, we must continue to focus on co-production.

More on Co-Production

Did you know that the Social Care of Institute for Excellence is very busy raising awareness of National co-production week?

If you want to know a bit more about co-production, check out my educational video below.

Check out their site for more information on co-production.

https://www.scie.org.uk/co-production/week

There are also other website and links worth reading during National Co-production week 2019

http://coproductionweek2017.blogspot.com/

CEO of We-coproduce view on Co-Production

https://www.kingsfund.org.uk/blog/2016/10/co-production-inconvenient-truth

Thanks for reading the very small voice of an unpaid carer.