Co-designing and Co-producing Health
Similar to PCC, the co-production agenda is gathering momentum within the healthcare arena. Unlike PCC, this does not seem to be a nurse-led phenomenon and is being embraced by all healthcare professionals. Critics might say, traditionally, healthcare services have always recognised the need for some kind of partnership with patients. It is the attention this has been given more recently in policy and organisational documentation that has promoted this as something central to improving healthcare. For example, in the US the Center for Medicare Services identifies patient and family engagement as a pillar in its efforts to improve healthcare (McCannon and Berwick 2011). Similarly, in social care participatory delivery of services is actively sought by policy makers (Cayton 2004; Needham and Carr 2009). Co-production is seen as a model of service delivery which should result in a positive impact on service users (patients) and on wider social systems (Realpe and Wallace 2010).
Some scholars propose that there is a continuum of perspectives on co-production which includes user involvement being “added into” the operational process of service delivery, as well as higher levels of co-production where the consumption and production of the service are taking place at the same point (Osborne et al. 2015). There is still confusion over the similarities and differences between co-production and co-design and how the latter impacts on this continuum.
If we consider co-production within the context of improvement, understanding value from the perspective of the user/consumer should be central to any (re)design activity and very often the starting point. Co-production is described as the concept which has profound implications for improving healthcare quality, safety and value (Batalden et al. 2015, p. 1). Drawing on multiple disciplines Batalden et al. (2015) helpfully discuss the theoretical underpinnings of co-production and how these have expanded our understanding of the notion. They argue that the domain of public services administration and management is particularly helpful and relevant.