Today we are releasing a summary of our research findings into what drives poorer outcomes for patients and service users.
With a background of working in service transformation for children and young people, I have seen the words “co-production” or “engagement” frequently used. However, I question whether this has just been a tick box exercise in many cases. The importance of undertaking true co-production, participation or engagement activity has become more apparent since I joined IMPOWER last year.
Challenges of co-production with children and young people
Youth services often use Hart’s Ladder of participation as guidance for carrying out effective participation activity with young people. Experience to date tells me that rungs two (young people are decoration) and three (young people are tokenised) of the ladder are often used. I have experienced in previous roles the tokenistic nature of engaging with young people to develop services, and have seen the negative impact this can have. Young people become disengaged and if anything become resentful of the time they have spent being involved.
I have also seen a variety of pieces of work to redesign universal and preventative services for children and young people without undertaking engagement activity. This leads to them feeling confused about the changes taking place and in turn they stop using these crucial preventative services.
Moving beyond tokenistic engagement and co-production
Co-production in service development may not be appropriate at all times. However, engaging where possible with children and young people, and then truly using this to inform decision making, will only make the changes more likely to be a success. The changes that the public sector is currently going through will only deliver what is required if those accessing the services are genuinely brought in to this, and that the service supports them in whatever way is required.
I feel we should be aiming for at least rung six of Hart’s participation ladder, with young people making decisions in a shared and informed way to support effective changes. If we want children and young people to connect with the changes being made either at a service level, or on a personal level, it is crucial that we actively involve them in service development.
Once the engagement activity has taken place the critical part is how this evidence is fed in and used to inform changes. After all, there is no point in doing the exercise if this isn’t going to be used effectively.
Here at IMPOWER it is part of our DNA to co-produce all of our work with our clients, and encourage that they effectively engage with service users and staff to support successful delivery of work. By co-producing we are not only able to understand the organisation better, but we enable knowledge transfer with our clients. This principle can be applied when working with children and young people to develop services. Not only can we gain great insights from them, but we can also reach a point where they take real ownership of the services and ultimately support the delivery of better outcomes.