In Mind: Importance of co-production

In the first of a series of guest blogs over the next few weeks, Julian Raffay, Mersey Care’s Specialist Chaplain, discusses the importance of co-production to this Trust and the future of the NHS.

Imagine you’re about to go on holiday, but on planet Ourchoice. Ourchoice is like earth, with one difference; on Ourchoice, holiday companies decide what people need. People grumble but the companies quote evidence showing they know best. Ourchoice’s expert travel agents are kind, thoughtful, and often overworked.

You suggest people might benefit from choosing holidays themselves. Some agents argue they provide choice: rapid check-ins, seat selection, extra leg-room. Others say they know the travel literature and value colleagues’ opinions. A few like your idea but cannot find time. You struggle to understand why the holiday sector should be unique. Do people become incapable on holiday? Surely what works elsewhere in people’s lives works on holiday?

Kind, thoughtful, and often overworked, describes most mental health staff. However, I am convinced our services are effective to the extent we do things ‘with’ rather than ‘to’ people. (Of course, there are times when people lack capacity but, as the Mental Capacity Act 2005 (and Code of Practice) recognises, they rarely lack capacity entirely). Wherever possible, we should focus on people’s assets instead of their deficits.

An approach that does this is co-production. It recognises everyone’s ‘vital’ contribution towards researching, designing, commissioning, and delivering services people want to use. I’m not suggesting we should take people from acute wards into board meetings but, once recovered, their lived experience is invaluable.

I’m delighted we talk so much about co-production in Mersey Care. Often, however, we’re like Ourchoice’s agents, patting ourselves on the back for meaningless pseudo-choices like rapid check-ins and seat selection. Co-production, working alongside service users/patients, carers, and other staff, offers massively more than tokenism.

My work as Research Chaplain and Lived Experience Advisory Panel member, takes me beyond shallow formal relationships with service users and carers. Co‑production takes us into deeper waters where genuine trust and mutual respect flourish. We no longer have three groups – service users/patients, carers, and staff – but human beings committed to developing a shared vision that works for all.

Indeed, service users/patients often credit their recovery to a staff member sharing their humanity rather than to technical skill. No one should ever regard their role as insignificant, no matter what their job title is within the organisation. Everyone has a part in helping recovery.

Our spiritual and pastoral care team is exploring how we can more fully co‑produce services service users/patients and carers consider effective. Last month, we brought academics, chaplains, service users/patients and carers together for a national symposium. I will shortly be finishing a chapter for Essentials of Mental Health Nursing to be published by Sage. I am also involved in evaluating Mersey Care’s Life Rooms project. Plans are underway for an innovative research project in Ashworth involving co-production throughout the research cycle. This means patients choosing what aspects of care they want to research.

Of course, with great power comes great responsibility but also great opportunity. In the film Titanic, Jack offered adventure, life, and hope to the depressed Rose. Captain Smith, not to mention the shipbuilders, squandered their expertise through too narrow a focus on performance and targets. Co-production values everybody’s vital contribution. I suggest it offers the possibility of a better NHS. The choice is ours!

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Annual General Meeting

For those of you unable to attend this week’s Annual General Meeting at Aintree Racecourse, you will have missed the video message sent by Chief Executive Joe Rafferty in his absence.

In it he reflected on the year since we became a Foundation Trust: our good CQC rating, with an outstanding result in Specialist LD, a major change for the Trust as we take on community physical health, our status as a Global Digital Exemplar and co-production with service users. 

In particular, Joe speaks of “the tremendous opportunity of physical and mental health as two sides of the same coin – they shouldn’t be treated as being different.” You can watch Joe’s message here while this year’s annual report can be accessed here.

Rev Julian Raffay