Debs writes...
The Children and Families Bill, currently working its way through parliament is very big on practitioners in education, health and social care working in partnership with parents - or "co-production".
Now, this is clearly a fine goal, but it is going to require a shift in attitudes on all sides and an extensive programme of re-training in some quarters as well. For some, it will be easier than for others and there are already examples of great practice that need to be identified and held up as examples for others to learn from.
If you search the web, you will find several parent views on co-production but we thought it would be useful to get the views from a practitioner (we used to call them professionals, but then, what does that make us?) about the challenges, issues and positives of co-production.
Phil Brayshaw is a registered nurse for people with learning disabilities and has post-graduate qualifications in child mental health and family therapy. He has worked in health and social care for over twenty years and until recently, was the lead commissioner for disabled children and young people for NHS Calderdale. Phil also led Calderdale's SEND Pathfinder work before moving to NHS England in April 2013.
We thought he was an ideal person to ask about co-production from the 'other side'.
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I was really chuffed to be invited to write about working alongside parents from a practitioner's perspective. As an NHS employee however, I've been asked to say that my 'top tips' reflect my own views and not necessarily those of either NHS England or NHS Calderdale.
Writing a guest post is new to me, as co-production is to so many of us, and I had a few false starts but I persevered - and that is the key to trying anything new. So, here are my 'top five' points to remember.
If you have any questions, leave a comment and I will do my best to answer.
1. Don’t be afraid to try new things and if they are tough…KEEP GOING!
Co-production is about more than not doing the same things that we have always done, but doing new things together. It’s about talking to each other and working together to find brand new ways of doing things. Doing things differently can be tough, but don’t give up – after all it is better to write a dozen opening lines than none at all.
2. Be clear about what you want or what you want to achieve
Having meaningful conversations is so much easier if we are all talking about the same thing. People often talk about shared goals and ASPIRATIONS, but these are not always easy to agree on or describe. My advice is to always start with the end in sight. You could try asking, “What would success look like?” In Calderdale, we found the best answers to this question come from children and young people themselves.
3) Get a sense of what other people need to ACHIEVE and help them achieve it.
Shared aspirations and goals are essential to co-production. There is little point in working together if we are not all heading in the same direction. That said there are often a number of different priorities for families, communities and the various organisations. It can be useful to understand what other people need to achieve, within their families or professional roles. Helping someone to achieve their objectives often frees up some of their time to help you meet yours.
4) Learn to TRUST - be open and honest.
If we are going to work together we need to learn to trust each other. In my experience people generally want what is best for children and young people. Believe it or not professionals don’t come to work just to make your lives more difficult [honestly] and parents aren’t unreasonable and difficult on purpose! There is no question that the current system is adversarial and there is little wonder that we are all a little suspicious of each other. Trust will take some time and effort.
5) Ask for help (and act on advice)
It is okay not to know all of the answers and it is equally okay to ask for help. We are all very LUCKY to have such a wealth of experience around us - in families, communities and services - we need to get much better at using it; And whether you are in a family, community or a service, it is important to remember - it isn’t always the professionals that have all the answers or solutions.
So, SNJ friends, would you like to hear more from Phil? What would you like him to write about? We would love to hear your thoughts on this post. As Phil said, he is happy to respond to any comments and questions below.
You can also contact him directly via Linkedin or @PhilipBrayshaw on Twitter.
- Accountability: the number one change you would like - March 7, 2016
- Life Skills – are children with VI missing out? - March 2, 2016
- Tests:Do you and your child find them testing? - February 3, 2016
Being a practitioner myself as well as a parent, I know that practioners are in their jobs because they care, but my experience as a parent is that practitioners often change frquently and the system is more important than working together because nowhere in their job description does it yet mention co-production. They are respnsible to their employer and accountable to their line manager – not patients, clients or families. What are your thoughts on this? Also do come to the Towards a Positive Future Conference on 20th June in London if you can. We would love to see you there.
This looks very good. I don’t think this is practical for everyone, but the key to my partnership with parents is that one sits in on every lesson. They can then follow up what I do, and sometimes spot things I don’t.
Hi Debs! Thank you for sharing these useful tips. I really appreciate your brilliant words. I know you’ll be able to help a lot of people with this. Very good read and excellent blog post!
As a parent I find the concept is a good one but undermined by the lack of resources. If there aren’t enough schools, local services or respite for example then can coproduction really achieve anything. Sorry if I sound cynical but working together has to be backed up by being able to access the things that can really make a difference to families. You know, I’ve worked well with many practitioners but in the end of the day our relationship has been strained by not having access to services and resources.
Firstly, thank you for your feedback, I will try and answer some of your points and comments as best I can. Janet, I absolutely agree that there is currently a difference in what people are trying to achieve. I think the key to changing this is to be clear about the outcomes we are trying to achieve and then aligning the system to them. For example if we are saying that it is important for children to try new things, have a group of friends or be invited to birthday parties then why shouldn’t that be reflected in how we commission services, write job descriptions or think about staff appraisals? Hi John, adopting a model of co-production isn’t always practical, but moving towards one is. It is great to hear that you are involving parents in lessons – it is my experience that when we introduce new ways of working together good things happen. Janet, I am with you on this Debs is wonderful.
WorriedMum, I wasn’t ignoring you in my post above – I just wanted to spend some more time thinking about what you had said. I wouldn’t say you sound cynical, you maybe sound a little hesitant – and to be honest if I were a parent I would too. I am hugely encouraged that despite your reservations you like the concept of co-production. My view is that co-production is as much to do with culture and attitude as it is to do with resources. The way I think about it is this – the current system ‘tricks’ us into taking certain positions and our conversations become about resources or services rather than about children and young people. Co-production is about us stepping away from that and having new conversations “We all want little Jimmy to live his best life – how can we work together (and use everything available to us in our family, community and services) to make this happen?” I know this isn’t always easy for parents battered and bruised by the system or for professionals working to statutory requirements, deadlines and budgets. However, in a time when resources are stretched, co-production becomes even more important. We need to work together to meet the challenges that our children, communities and services face.
Thankyou for replying. I’m giving some more thought to your views at the moment but yes I can see that it is about cultural change which is important. One of the situations I am in is that my SEN child is not in education. The current SEN system, lack of understanding of ASD, underresourced CAMHS (they refuse to see my child) and lack of special schools/units has caused a terrible strain between us.
So for me, coproduction (I prefer the term working together) has to be matched with better training about ASD (not awareness), improved mental health care provision and more schools/local services. It doesnt matter how good a practitioner is, the strain of getting good local support is a blight to my family’s life.
However, i can see even within this nightmare situation that the way individuals are behaving towards one another could be improved.
Just an illustration of this is when a home tutor looked at my child’s statement of SEN and laughed outloud and said that I would never ever get my childs needs met! I tried hard to talk to this person as an equal; I desperately wanted to share my knowledge of my daughter but this teacher just didn’t want to listen. It was very hardgoing and in the end I lost confidence. In fact it got so bad I had to ask for another tutor which caused even more upheaval for my daughter.
If working together could eradicate that sort of situation then yes it is absolutely a good idea; at least its one less thing for me to feel stressed about which in the end is better for my daughter.
I’m not yet a cynical, battle weary Special Needs mum… and I truly hope not to become one! I would however have to agree with what WorriedMum has put – the resources just don’t seem to be there. What we really need to be doing is building up the information which shows what resources are going to be needed in the future, and thinking of how we achieve that. In our area for example that may equate to a Free School – but that will help/suit some but not others. So someone needs to be documenting first the real needs and secondly the wishes of children with special needs and their families – but if no-one is responsible for that, or if everyone is working on co-production per individual family and not looking at the bigger picture, what happens then? It may be true that the professionals don’t have all the answers, and as a parent I would say I’ve received far more advice, information and support from other parents than from any professional up to this point – but I haven’t given up hope! And I do like the idea of co-production in principle…
Hello every week I read your blogs tania abd debs as well you know and tonight I tune in to see a familiar face of a guy who I met and worked with the very own phil brayshaw. I can honestly say as a parent he is fantastic , he gets it he listens and he works hard to achieve outcomes not only fir disabled people but for the families and the carers. I took part in the pilot of individual budgets fof children and phil was a panel member, I first met him when i worked in a steering group around napoies/pads many moons ago. I also went on to do some work with the pathfinder in my local area and spoke as a parent atthe launch that phil was one of the leads on. He will be and us sadley missed already to who ever gets to work with him as a parent he really is a genuine guy. Hello phil hope your well from patsy
and yes can you feature Phil again please. Its good to be able to discuss things with a practitioner/professional. I’m totally isolated and get little opportunity to discuss things with anyone. I’m particularly interested in mental health provision for children/young people and am concerned about reports that suggest a reduced funding for CAMHS. My question is what can parent of children with MH problems do if they can’t access CAMHS? What can we do to help our children if there are long waiting lists? Are there any other services? Many thanks.
Thanks for your comments. We did a post recently about CAMHS – https://specialneedsjungle.com/2012/08/28/whats-your-experience-of-camhs/ – happy to raise more awareness of these issues as we are hearing similar in Kent too.
I totally agree with stephstwogirls, why is everything always reactive? We should be working (together) towards proactive solutions to the problems faced by our children. My AS son is currently under CAHMS for the third time, and I feel as if they don’t know what to do about him. At the last appt they actually said to me “what do you want us to do?”. It feels as if they are bound by the constraints of budgets, and daren’t suggest things that would help in case it costs too much money.
One of the things I learned working together for change with Phil and lots of others in Calderdale is that there isn’t a whole load of difference between parents and practitioners. Becoming the parent of a disabled child is rarely planned, yet time and time again we rise to the challenge. Not the challenge of the child, but of the system. The most important part of working together is a shared set of values, a belief that we need to remove barriers, teach everyone to dream, and never, ever, use the excuse of money to stop people living their lives.
Working together is not about a battle of dividing scarce resources, it is about re-thinking the nature of resource. It’s about people, people matter.
Total agree with you there liz another parent I have had the opportunity to no and gain experience from. Things are going to be rough for everyone but if we stick to our beliefs and values about having hopes dreams and aspirations for our loved ones and also ourselves then together we make the biggest changes and no money or resources can change that, there is only us the carer and the person themselves that can want to change, rome wasnt built in a day and change takes time slowly but surely some areas are getting it and understanding what co-production is and are working hard to get it right but without parents and professionals working in partnership change won’t happen and the authority will be setting families up to fail.
I am not sure I can add very much to what Patsy and Liz have said. I would just like to say one of the best things about co-production is that it shifts the relationships between those involved. At a recent event a parent left feedback that said “I have made friends with other parents and professionals” and I know exactly how she felt.
i feel i have made friends too along my travels, sometimes its hard and other times things just happen without a fight or challenge but as long as everyone is singing from the same hyme sheet achievements will happen
I don’t think we even need the same songs, different voices make a harmony. As long as we don’t give up we will get there.