Re-defining Clients As Assets
By David Boyle, Sherry Clark and Sarah Burns
‘Co-production’ has emerged as a general description of the process whereby clients work alongside professionals as partners in the delivery of services. This research, from the New Economics Foundation, examines ‘co-production’, its definition, effects and prospects. It looks at how public service institutions and government might better recognise the contribution to their neighbourhoods played by people outside paid work and the relationship between such activities and welfare and public services.
A growing volume of literature supports the importance of ‘social capital’ in maintaining public health, tackling crime and other social imperatives. This need for active engagement by people to make society operate is particularly relevant for the work of public service professionals. ‘Co-production’ has emerged as a general description of the process whereby clients work alongside professionals in order to be more effective.
Without engaging the co-operation and confidence of clients or patients, there is a danger both that welfare systems and philanthropic programmes affect day-to-day symptoms rather than underlying causes and that professionals will create dependency, convincing clients they have nothing worthwhile to offer and undermining what systems of local support do still exist. Co-production redefines clients as ‘assets’, with experience, the ability to care and many useful skills.
This research looked at organisations in the public and voluntary sector which are using co-production in various ways, supporting and enabling their clients and beneficiaries to play an active role in their recovery and that of their neighbours.
The research concentrated on various co-production projects, most but not all ‘time banks’, in south east London, Gorbals in Glasgow and the Welsh Valleys. (Time banks are mutual support systems, based in the community, that measure and reward the effort that participants make to support the neighbourhood.) The range of activities included mentoring, advising, befriending, doing repairs for, shopping for and tutoring each other. These projects are intended to be valuable in their own right, but are also a means to an end: more social cohesion, better recovery and a changed relationship between public service institutions and the communities they serve.
What is ‘co-production’?
The term ‘co-production’ began as a way of describing the critical role that service ‘consumers’ have in enabling professionals to make a success of their jobs. It was originally coined in the 1970s by Elinor Ostrom and others to explain why neighbourhood crime rates went up in Chicago when police stopped walking the beat and lost connection with local community members. It was used also in the UK in the 1980s by Anna Coote and others at the Institute for Public Policy Research (IPPR) and the King’s Fund to describe the reciprocal relationship between professionals and individuals necessary to effect change.
The concept has also been expanded by US civil rights lawyer, Edgar Cahn, who emphasises the involvement of the wider network of families and neighbours. Cahn defines co-production as depending on the following values:
- Assets: Every human being can be a builder and contributor.
- Redefining work: To include whatever it takes to raise healthy children, preserve families, make neighbourhoods safe and vibrant, care for frail and vulnerable people, redress injustice, and make democracy work.
- Reciprocity: The impulse to give back is universal. Wherever possible, we must replace one-way acts of largesse with two-way transactions both between individuals and between people and institutions.
- Social networks: Humans require a social infrastructure; this is as essential as roads or bridges. Social networks require ongoing investments of social capital generated by trust, reciprocity, and civic engagement.
The researchers came to two major conclusions about the spread of co-production.
First, there is an emerging co-production sector, though it may not be aware of itself as such. Two overlapping categories of co-production exist:
- ‘generic’ co-production – the effort to involve local people in mutual support and the delivery of services; and
- ‘institutional’ co-production of the kind advocated by Cahn. Currently this seems difficult to achieve, mainly because of institutional systems in the organisations that might benefit and because of the way public services are managed
Second, generic co-production is both widespread and probably a natural part of human life. Thousands of projects already embody many of the principles of co-production, even if they do not all work in quite the same way. Successful co-production projects tend to have some or all of these characteristics:
- Provide opportunities for personal growth and development to people who have previously been treated as collective burdens on an overstretched system, rather than as potential assets.
- Invest in strategies which develop the emotional intelligence of people and the capacity of local communities.
- Use peer support networks instead of professionals as the best means of transferring knowledge and capabilities.
- Reduce or blur the distinction between clients and recipients, and between producers and consumers of services, by reconfiguring the way services are developed and delivered: services seem to be most effective here when people get to act in both roles – as providers as well as recipients.
- Allow public service agencies to become catalysts and facilitators rather than being central providers themselves.
- Devolve real responsibility, leadership and authority to ‘users’, and encourage self-organisation rather than direction from above.
- Offer participants a range of incentives – mostly sourced from spare capacity elsewhere in the system – which help to embed the key elements of reciprocity and mutuality.
The voluntary sector has been using co-production in an innovative way to improve health, housing and education, and to reduce crime. However, this has generally taken place outside the nationally funded services that are supposed to achieve this, and usually despite – rather than because of – welfare and administrative systems inside public services.
The public service institutions studied had been experimenting with co-production; this was usually due to the enthusiasm of specific individuals inside the organisation. This suggests that funding might eventually be forthcoming from public services, simply because co-production approaches are effective. But there is a danger that the whole concept could be subsumed into a more utilitarian public service agenda, aimed at reducing expenditure and the efficient pursuit of targets. This would undermine the human-scale nature of co-production, and the ability to define almost any human capability as ‘assets’.
There is a need therefore to recognise that working in neighbourhoods is not just valuable in its own right, but a vital aspect underpinning the local economy. In interviews, practitioners stressed repeatedly that co-production must remain an end in itself as well as a means to other ends.
The research findings also suggest something of a paradox. On the one hand, co-production projects can help break down institutional barriers; on the other, they require some barriers to be blurred already to have any chance of success. However, existing administrative systems can make breaking down institutional barriers difficult.
Where it does work, the success of co-production seems to be largely due to the efforts and inspiration of a few public sector managers and largely despite the best efforts of the system as a whole. Co-production might better be defined as ‘parallel production’ – useful to the public service, but in practice organised separately in the voluntary sector, with little contact or involvement from institutions.
The effect on individuals
This research confirmed the importance of social networks as a pre-requisite for support for people outside paid work. It also confirms recent thinking that it is not just links with powerful institutions that matter, but “rather the nature and extent of the relationships between them” (Social Capital in Practice, Hampshire, A and Healey, K (2000)).
Interviewees confirmed that the projects had helped them extend their social networks and the range of opportunities open to them. They reported improved self-esteem and confidence and often improved health. The projects enabled people to work together to achieve common goals, and to draw on resources contained within the group of participants.
People as assets
The researchers found that the work the participants were doing was worthwhile and important – including youth work, befriending or mutual support for recovering mental patients, for example – even though it was outside paid work. The research suggests that co-production networks are helping to build capacity in communities in a more meaningful way than more passive resident involvement: increasing awareness and understanding of community issues, bridging social divides, and encouraging a willingness to challenge authority.
It also implies that there are enormous assets among people outside paid work, and that these are human skills rather than trained ones – the ability to care, to give time, to empathise, for example. Recognising these skills in a reciprocal way – often through ‘time banks’ – seems to broaden the social reach of the projects.
The impact on communities
All the projects had fostered strong links both with other community groups and with some professional agencies working in the area. Many participants reported that they were becoming active in more than one community group, while several gave examples of a new-found confidence to challenge those in authority.
All the projects also emphasised empowering the participants and valuing their contribution. Those that were most successful seem to have been those where reciprocity and mutuality were most prominent. One project, on the other hand, began with an emphasis on community leadership but, when it came to be led mainly by paid staff, seemed to lose much of its energy.
Most of the projects were organised as time banks, which have reciprocity built into the basic design. Although there were different ways of making reciprocity explicit, this does seem to have allowed them to attract hard-to-reach groups more successfully. It seems likely that some form of reciprocity can have stronger, wider and more lasting effects than conventional participation. The exact balance of rewards that is effective in different situations needs further investigation, but it seems likely that the reciprocal aspects of these projects form the active ingredient in building social capital.
Implications for policy and practice
The researchers draw out the following implications:
Increasing professionalisation of service delivery risks disempowering clients, who become passive, losing their status as co-producers of health or education. If co-production is to become more mainstream, the role of professional staff needs to shift from being fixers who focus on problems to becoming catalysts who focus on abilities.
Front-line staff are central to delivery and empowerment. Staff need more interpersonal, facilitative skills rather than just having a rigid, delivery focus. Developing staff morale and capacity is as important as client morale and capacity: in practice, the participation that staff are asked to extend to clients is often not extended to them.
The capacity of communities to take on responsibility also seems to be related to the capacity of institutions to ‘let go’. There is a dilemma about how to catalyse social energy without over-formalising it, as well as the need for a new approach to risk that does not stifle much of what ordinary people do for themselves. This requires more space for staff to experiment, providing them with a sense of possibility, rather than reinforcing the sense that they are working in a vast, impersonal structure in which they have little power to change anything.
Measurement and evaluation
The current system of narrow target-setting and commissioning does not encourage innovation or recognise the assets represented by clients. Time banks are an effective method of valuing people’s informal efforts, but often they – and projects like them – run into difficulties under the current system because they are not recognised by existing targets.
There is evidence that public services, and especially key enthusiasts inside public services, would like to find new ways of engaging clients as partners in the delivery of services in every area. However, while services are based on target-driven delivery, the scope for embracing co-production as a mainstream idea is limited.
Government departments also have difficulty planning and co-ordinating services that cross departmental boundaries, though clearly progress has been made. Interventions seem to work best when they do not challenge existing public service administrative systems and assumptions directly. A more sophisticated approach may be to recognise this and find other ways of bringing the parallel approaches closer without actually trying to force them together.
If co-production is to become more mainstream, policy-makers need to develop an acceptable way of allowing people on benefits to be recompensed for their effort in the community, without them losing money. This would require:
- a new official focus on volunteering and participation, not necessarily as a step towards paid work, but as a way of carrying out the vital work that is necessary for a healthy society and economy.
- encouragement of informal, self-help activity for people outside paid work.
- reform of Incapacity Benefit regulations which may discriminate against effective methods of rehabilitation.
Yet simply extending benefits to cover these areas of non-paid work may also undermine the very energy of the sector by seeking to define it, regulate it and strip it of the informality which is core to its success. It is important that this new category of ‘work’ is rewarded in such a way that participants can earn the basic necessities of life, and that this is done through local intermediary agencies – which may often be properly resourced time banks – which can manage it whilst retaining its informal approach.
About the project
This project was co-ordinated by the New Economics Foundation and involved the Gorbals Initiative, the Wales Institute for Complementary Currencies and the South London & Maudsley NHS Trust.
In keeping with the concept of co-production, the researchers recruited and trained field researchers from the study population – people outside paid work. These teams used a range of approaches including face-to-face interviews, paper-based questionnaires and focus groups to assess the impact of a co-production approach. Staff at the New Economics Foundation interviewed a range of high-level policy-makers and academics about their views on the merits of a co-production approach, and barriers to its implementation.
For further information
The full report, Hidden work: co-production by people outside paid employment by David Boyle, Sherry Clark and Sarah Burns, is published by the Joseph Rowntree Foundation.