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Launch of the co-production guide

This afternoon the Department of Health has launched their new Co-production guide. In our blog this week Chief Nursing Officer, Charlotte McArdle tells us the importance of this document and what it means for our Health and Social Care services.

To meet the challenges of a 21st century population, we need to be ambitious in how we plan to transform our Health and Social Care services to meet the needs of our population, in a safe and sustainable way, so they can enjoy long, healthy, active lives and to enable those with long term and life limiting conditions to live as well as possible.

In order to make this happen, HSC services across Northern Ireland need to start working hand-in-hand with patients, clients, carers, communities and staff so that we all have an opportunity to shape current and future services.  There’s a term for this type of collaborative working, it’s called ‘co-production’.  Co-production is not just a word, it is not just a concept, it is a genuine partnership approach which brings people together to find shared solutions.  It places people at the centre of decision making and aims to connect people together in representative networks so that they can meaningfully influence, shape and participate as real partners in the commissioning, planning, delivery and evaluation of services.

To support this important work the Department of Health formally launched our ‘Co-production guide’ this afternoon.  The guide sets out how our health and social care services can meaningfully work together with the people that use them, and the staff that provide them, to effect real and positive change.  It requires all HSC organisations to review the extent of partnership working across their services and develop an integrated plan in order to strengthen co-production between people who use services, staff, their representatives, local communities and multi-agency partners.

Of course, colleagues from across Health and Social Care have already been ‘co-producing’ for some time now, with positive outcomes.  It is hoped that with the clear guidance set out in our Co-production guide that, going forward, transformational change can be achieved to continue to bring our HSC services in line with modern requirements.

You can read a copy of the co-production guide here.

Have you been involved in co-production before?  What do you think of the co-production guide?  Do you think you’ll have better opportunities to get involved in decision making going forward?  Share your thoughts in the comments section below!


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Doreen Patton 07-Sep-2018 at 18:39 hrs

Agree with Irving Nixon about the use of plain English. I find most of the material produced is impossible to follow due the continually use of jargon and acronyms. The number of levels of management in the NHS, large numbers of committees looking at similar interlinked topics and the pace things move at any change will take a long time. People giving of their time to co-production may not be prepared to go to meeting after meeting and see no timely results of their involvement.


Irving Nixon 01-Sep-2018 at 17:08 hrs

While I applaud the ambition to involve multiple stakeholders in improving Health and Social Care provisionin Northern ireland, I regret that I found reading the Co-production Guide virtually unintelligible. It needed a good dose of Plain English to appreciate what may be a helpful approach.

Unfortunately, a talking shop of committees reporting to committees, which this proposal seems to be, is a proven route to failure. I congratulate SCIE on creating a template designed to perpetuate consultancy support ad infinitum. Sadly, I fear it will achieve nothing to improve the abyssmal quality of health and social care in NI.

The current fragmentary structure needs radical reform. In Belfast alone, there are 4 H&SC boards and 3 levels of health care, primary, secondary and tertiary, all communicating with each other by typed letter (unchecked) sent through the Royal Mail in the digital age. The best way to improve health and social care outcomes is by studying and, most importantly, understanding why best practice in other countries delivers better, faster results.

My experience is that of an elderly patient with several health restricting problems, first in France and then in Northern Ireland. In France, health care was truly national and operated on a Just-in-Time basis. If a patient needed treatment the system provided it straight away. For example. blood results were available to the patient online the following day. Each town has its own laboratory. Sent by their GP, patients walked into the facility, were processed and their blood samples simply passed through a hatch for immediate analysis. Patients could then access a comprehensive 3 page print out of all their blood tests, together with comparisons from the previous time. In NI it takes weeks before the GP gets the report, leaving the patient in the dark.

Similarly, each town centre has a centre for scans. As each scan requires a radiographer to interpret it, one is on hand at the same time. As a patient, you wait after the scan for 20 minutes and a qualified radiographer explains your result and gives you a copy of his report and a printout of the scan. At the same time, all these results are instantly available to the GP through the central database. In NI the GP has to refer you and it takes weeks again to get any results.

In France, when I had heart problems, I saw my GP on Thursday. He immediately phoned a consultant at the local hospital (secondary level healthcare) who arranged for a more detailed ECG the following day. I had to return on the Saturday morning for a stress test and was immediately admitted for further tests. I was transferred by ambulance to the regional centre, one and a half hours away, for an angiogram and suspected fitting of a stent on the Wednesday. As it turned out I needed a quadruple bypass which was completed 2 weels later. Had I required a stent, this would have been fitted immediately after the angioplasty as the consultant was present and I was already prepared. On moving to Northern Ireland I had a recurrence of angina and was admitted to hospital overnight while staying in Scotland. They recommended an urgent stress test. This took 9 months to arrange. I required another angiogram which took another 9 months and a stent was finally fitted 3 months after that. An exercise in France that would have taken 5 days took 21 months in Northern Ireland.

The moral of this story is that before any tinkering withthe current system takes place, primary, secondary and tertiary healthcare needs to be integrated into one common system, as in France. Everyone there has a Carte Vitale or chip card which ensures their medical details are recorded for instant retrieval by the GP, the consultant, the hospital the chemist, the laboratory etc. anywhere in France. Patients are kept informed and also empowered because in most cases they arrange appointments directly to suit their diaries, thereby freeing up GPs to heal the sick rather than dictate letters into a machine.

Co-production may have place in the future but only when the basics have been done. These are:

1. Amalgamate the 5 H&SC Boards into 1 Regional H&SC Board. 2. Install a single integrated reporting system to replace the obsolete record keeping in existing GP surgeries.

Just-in-Time systems will ensure Northern Ireland's ageing population are fit and healthy and able to carry out the care work for their families, which at present only immigrants are prepared to do. Today, we geriatrics are housebound waiting interminably for our turn in the queue to come up. We suffer immobiliiy, sight deprivation (in my case to avoid this I paid to have my cataracts replaced) and require social care. Freeing us from these shackles would go a long way to solve the social care crisis because we, as a group, would then be available to help, rather than hinder, society. Pouring money into the existing system, with or without Co-production, will be a continuing waste of valuable resources.


Brendan Clarke 31-Aug-2018 at 16:50 hrs

While Health Professionals continue to dictate that the agenda should be a magic wand to achieve an immediate massive impact but see no ego or career enhancement in implementing the small improvements needed to remove much of the hassle of being an NHS patient things will continue to plunge into ever greater chaos. I stopped participating in groups because the Health Professionals supposedly leading the groups changed so frequently with each new leader bringing their own new agenda so nothing was ever sorted. One does occasionally meet some very able, competent and committed Health Professionals but meetings about improving the health service are generally devoid of NHS power-brokers or the GPs who are having more of the burden of health care imposed on them by the modern slavers leading the NHS from hidden bunkers..