Coproduction lies at the heart of the Living Well programme. In Living Well the aim is to firmly position volunteers as integral to the coproduction of care for older people. In practice this is about volunteers having the power to: 1) shape how volunteers are trained and deployed; and, 2) be part of healthcare delivery through their involvement in the decision-making for their elderly clients.
To achieve these twin aims the Volunteers in Communities (VIC) team have produced this qualitative review of the coproduction of care model in the Living Well programme. This paper examines coproduction from two perspectives. Firstly the paper reviews the current spaces for coproduction in Living Well. Secondly it reviews the challenges and opportunities for delivering alternative models of coproduction. The paper concludes by making recommendations about how coproduction can be better delivered through Living Well.
1. Living Well recruitment and training should emphasise the maxim ‘medically aware, not medically trained’; emphasising the importance of risk identification, not necessarily action, and the process of how to escalate an issue.
2. Integration of volunteers into MDT should be trialled and reviewed and the lessons learnt embedded in the current Living Well areas before scaling up to a Cornwall-wide policy. The trials should happen at MDT where the GP chair is ‘on board’ with the coproduction model and, crucially, the meeting structure arranged to be accommodating for non-medical experts. If the trial is deemed successful an MDT protocol should be developed to guide MDT chairs in how to integrate volunteers without breaching confidentially.
3. Delivering the co-production model necessitates a change in approaches to volunteer management and deployment. The integration of volunteers into MDT will not suffice alone to deliver the co-production model. Lessons learned so far indicate the importance of: i) regular peer support opportunities for volunteers; ii) a system for non-medical referrals; iii) communication of ‘success stories’ back to volunteers.
4. Trial the attendance of medical staff to Living Well volunteer meetings; both formal and informal types. Review benefits of approach.