Patient safety and co-production, a blog by Anthony O'Connor

Summary

Anthony O’Connor is a co-production and lived experience consultant. In Anthony's first blog for Patient Safety Learning, he looked lived experience, its definition, its usage, and its impact.  

In this blog, he talks about the benefits of co-production and why it is essential to patient safety. Anthony gives examples of how co-production can be used more in healthcare and encourages everyone to develop their knowledge of co-production and start embedding it into their work. 

Content

I try to co-produce as often as circumstances will allow. Sometimes this is easy; the right people with the right mindset working on a project that lends itself easily to co-production principles. Often, it’s more difficult than that, and this is particularly true in the NHS. Politicians can legislate, and Senior Managers can mandate, but unless there is a basic understanding of what co-production entails, it will always struggle to be adopted. This is a shame as co-production is not difficult to do, is often the best solution to a problem, and is generally used again by people who have previously used it successfully.

The benefits of co-production

When it comes to patient safety, co-production is an obvious resource for learning, sharing and embedding good, safe practices in all kinds of settings. When we teach Quality Improvement, co-production is an essential ingredient in getting all voices heard; patients, carers, providers, funders – everyone who plays a key role in patient safety.

Co-production is about levelling hierarchies and getting people to engage with one another in a mutual and reciprocal arrangement. It’s about sharing risk and responsibility and looking out for each other. Good co-production will always contain elements of lived experience, a fundamental resource in finding problems, fixing issues, and growing best practice. More than this, co-production enables the individual voices of lived experience to come together, identify common cause, and develop identifiable themes for progress. This elevates lived experience to a higher level where it’s impact as a resource takes on greater significance.

There will always be hierarchical hindrances in systems, but it is possible to deliver co-produced outcomes in targeted and specific programmes. Setting parameters is not necessarily a bad thing, particularly if these are to do with resources; co-production has a long history of being a useful management tool when resources are scarce and have to be shared across multiple stakeholders. The important thing is to make sure all of the stakeholders are present and make an equal and equitable contribution to the conversation.

Using co-production in multidisciplinary teams (MDTs)

A good example of where co-production could be more widely utilised to enhance patient safety within the NHS is the multi-disciplinary team (MDT). Research on these teams has shown that they work best when there is no hierarchy, each member has an equal voice, everyone knows what their own role is, and what their colleagues’ roles are. These teams operate most effectively when there is mutual respect and trust – two core principles of co-production. This approach has the added advantage of increasing staff safety; team members tend to watch out for one another. If you add into this mix the ongoing engagement and inclusion of the patients voice you will start to see real progress around patient safety issues.

Patient Safety Partners

The ongoing roll-out of the Patient Safety Partner role is a further opportunity to embrace some basic co-production ideas. This role with its wide brief of engagement with both service users and service providers could become a pivot for those all-important mutual and reciprocal conversations that really must take place if we are to make meaningful progress with patient and staff safety.

I believe there is an opportunity here to develop a safe space, co-designed, co-facilitated, and co-produced with patients, carers and staff where we can begin to build a better, more open culture of safe practice. The beauty of this approach is that there are no top-down demands, no stream of complaints in the other direction, just a recognition that this is everyone’s business and it need everyone’s attention. With co-production, everyone owns a piece of the work and that makes a profound difference to the mindset of the people involved.

A culture shift has begun – be part of it

Recent legislation has called for more use of co-production and of lived experience at every level of decision-making but this will only begin to happen when these concepts are more widely understood and appreciated. Like every change in culture, this starts in small ways, but will eventually reach everywhere.

I would encourage anyone reading this to learn more, and to try things out. In my own experience, whenever I have worked on projects that use co-production the results are good and everyone involved wants to do more of it.

Related reading:  Patient safety and lived experience, a blog by Anthony O'Connor

Share your insights

Have you been involved in co-production work as a patient, carer, healthcare professional or social care professional? Do you have insights to share around co-production and patient safety? Comment below (sign up first for free) or get in touch with the editorial team at content@pslhub.org. 

About the Author

Anthony currently works as a Participation Lead at a Mental Health Trust, and teaches Lived Experience and Co-Production at a NHS Affiliate Organisation. He also works as an Expert by Experience Consultant across Health and Social Care and in Academia.