Working Well Together

This resource (NCCMH, 2019) was commissioned by NHS England to support delivery of the Five Year Forward View for Mental Health and the NHS Long Term Plan. 

A service that has been commissioned based on the principles of co-production is more likely to be cost-effective, responsive and have high satisfaction and health outcome rates from people using it.

Here are the evidence and tools to enable co-production in mental health commissioning.

Introduction

Background

Recommendation 8 of The Five Year Forward View for Mental Health called for the development of evidence-based approaches to co-production in commissioning:

“NHS England should work with NHS Improvement to run pilots to develop evidence-based approaches to co-production in commissioning.”

The NHS Long Term Plan also encourages collaboration between people, primary care and community services and commissioners, clinical commissioning groups (CCGs), and between services and trusts. The NHS Long Term Plan's pledge to 'do more to develop and embed cultures of compassion, inclusion and collaboration across the NHS' means that co-production in mental health care commissioning is vital and achievable.

Purpose and scope of the resource

By setting out the evidence, including examples of positive practice, this document aims to improve local strategic decisions about, and the provision of, current and future mental health services for children, young people, adults and older adults.

This document also talks about co-production with people who are at risk of developing mental health problems, including those who have an increased risk of being detained under the Mental Health Act 1983 (amended 2007 and by the Policing and Crime Act 2017) and people who may face discrimination because of their protected characteristics (see Section 1.5 of the document for more information on protected characteristics and inequalities).

The recommendations from this document are aimed at commissioners of mental health services, as well as people who need mental health services, their families, friends and carers, and those who work in mental health care and support.

Co-production defined

Co-production is an ongoing partnership between people who design, deliver and commission services, people who use the services and people who need them.

How to use this resource

  • View an online plan for co-produced commissioning - this is a summary taken from the resource
  • Download the full resource. It contains
    • Key principles of co-production
    • Solutions to the challenges of co-production
    • Approaching and planning co-produced commissioning
    • Practising co-produced commissioning
    • Positive practice examples
    • Helpful resources and tools for co-production in mental health commissioning

The six key principles of co-produced commissioning

The six principles were developed by the Co-production Working Group, including people with lived experience of mental health needs, carers, commissioners and providers. These principles were selected as fundamental to supporting co-production in mental health commissioning, based on people’s views and experiences.

All types of involvement are important and fundamental to the process and should be celebrated at each stage and be received with an open and fair approach. Co-production is a continuous process rather than an aim or event and there should be ownership, understanding and support of the process from everyone involved throughout.

Adapting the approach to co-produced commissioning to ensure the community of interests voice is heard at every level, ensuring that inequalities are identified and addressed throughout.

Organisational and dedicated resources, and integration into processes, should be built in at every level. Co-production should be built into work programmes and business plans and resourced as a fundamental integrated part of the whole commissioning process. There should be a dedicated member of staff to champion co-production in practice.

A collective understanding that acknowledges the power of individuals and organisations, the influence it can have and the perceptions it can lead to. A culture of honesty, value and respect should be fostered, with each person committed to sharing power and taking responsibility for the decision-making they take part in.

Accessibility is fundamental to co-production, so people’s needs should be considered and any barriers minimised. This includes consideration of the location of meetings and events, travel to and from venues, and preferred methods of communication. Terminology should be discussed and agreed at the start, and communication should always be clear and available in agreed formats. The environment and space must also be accessible, inviting and supportive of the overall values of co-production. The environment needs to foster creativity, courage and curiosity, so that everyone present has an equal opportunity to be involved.

Quality assurance needs to take place to maintain, improve and grow the co-produced commissioning process as well as the quality of services. This should be evidenced through outcome measures.

Benefits of co-production

There is strong evidence to support that taking part in co-production, as well as being part of a community of peers, is a positive experience both for people with experience of mental health problems and those involved in mental health commissioning and provision. Co-production contributes to a sense of shared identity and purpose among all involved.

Benefits for people involved in co-production:

  • confidence to develop new peer relationships
  • development and enhancement of skills and employability
  • empowered professionals in front-line practice who are confident in positive risk-taking and have more empathy
  • improved confidence and self-esteem
  • improvement in own individual health and wellbeing
  • improved recognition of working group members’ expertise, leading to an exchange of skills
  • improved relationships, understanding and power balance between people who use the service and service providers
  • increased social connectedness and new peer relationships

Download the resource

working well together

Download the full resource
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