As a part of my work placement with the Volunteers in Communities project I will be writing a series of blogs on the concept and practice of co-production.
Co-production lies at the heart of Living Well. The effort and dedication of healthcare practitioners, GPs, co-ordinators, older people, volunteers, and community groups combine to deliver a bespoke care service to older people. The existing literature on co-production contributes to our understanding of the processes that work to make the Living Well Project a success and vice versa. It also reveals several key themes, the first of which will be the focus of this post: the history of the term co-production; the complexity of its definition; and its recent revival in public service and health and social care literature.
The concept originates from the USA in the 1970s, amidst civil rights and social action work. It arose from a concern with challenging professional power, as recognition was sought for the involvement of citizens or clients in community services. Research at the time became concerned with the rarity of one single producer of a service; there were usually several actors involved and, importantly, the client acted as an active participant. As such, the term ‘co-production’ was coined.
However, defining co-production in the context of public services, and health and social care in particular, appears to be very complex. The nature of co-production varies significantly between examples. The concept may be broken down into co-production, co-management, and co-governance. Co-governance refers to participation in the planning and delivery of public services, therefore focuses on the creation of actual policies. In contrast, co-management and co-production focus more on the operation of services. Co-production in its strictest sense is used to describe citizens playing a part in the production of their own services, and co-management refers to a combination of the third sector, public agencies, and for-profit actors in public service delivery.
Fast-forward thirty years from the point the co-production concept was introduced, and the term once again became the topic of discussion. With the turn of the century, there was a renewed interest in co-production amongst academics. Several reasons have been suggested for this, the first of which is trust. Declining public trust in the government in the 1980s and 1990s resulted in concerns about the quality of public services. Public sector reforms attempted to bridge the gap between government and citizens, using market-based approaches in the New Public Management paradigm. However, with mechanisms of control and compliance that go hand-in-hand with treating citizens as consumers, it appears to have been largely unsuccessful in increasing trust levels. This, therefore, paved the way for a new approach; greater citizen involvement, whereby citizens become active co-producers of services.
Another suggestion for the revival of interest in co-production is the economic crisis of 2008 and the increase in austerity measures. Traditional modes of public service delivery became difficult to maintain and, consequently, greater emphasis was placed on engaging citizens in the production of public services. A key component of this was volunteering, which was seen as a sustainable means to strengthen communities and increase social capital. In addition to this, financial pressure also requires services to operate more efficiently, and past research on co-production has revealed that is one of the key benefits of the approach.
Finally, citizens are increasingly empowered to play a more prominent role in the production and delivery of services as a result of increased knowledge. This knowledge is largely due to the growth of mass media and the accessibility of the internet. The notion of the client as a passive consumer therefore becomes increasingly unrealistic as they are equipped to play an active role in various aspects and at various stages of public service delivery.
To begin delving into the co-production concept, this blog post has covered the following topics:
- The background and history of co-production
- The complexity of its definition:
- Co-production is often used as an umbrella term to refer to both co-governance and co-management, too
- The recent revival and interest in the concept due to:
- Declining trust in government
- Economic crisis in 2008
- Greater knowledge and empowerment of citizens