Category Archives: Catherine Wilton, C4CC Director

C4CC supports extending personal health budgets

C4CC co-chairs have welcomed the announcement yesterday that the Government is to back NHS England plans to make Personal Health Budgets (PHBs) more widely available as part of its Integrated Personal Commissioning (IPC) programme.

A formal consultation to extend legal rights to PHBs, which are currently restricted to people receiving NHS Continuing Health Care and children receiving continuing care, will be launched later this month, managed by the Department of Health.

Key C4CC partners have long pressed for people to be treated as equal partners and to have more control over their own health, care and support and believes PHBs are a key element in delivering better outcomes for people with long-terms conditions.

“PHBs can play a vital role in providing person-centred care to fit the needs of the individual and enable them to access resources that are available to them in their own community, ” said C4CC director Catherine Wilton.

“This proposed extension of PHBs aligns with our current work programme, which is focused on our ‘Three Cs’ of better conversations between patients and their care providers, co-production of health through better partnerships and the involvement of community resources in supporting people with long-term conditions.

“We will be liaising with our partners to provide our collective input into the consultation with the hope that our recommendations are fully taken into account when the plans are finalised.”

The consultation announced today will consider extending the legal right to PHBs to people who access wheelchair services; people with a learning disability or autism; armed forces personnel discharged from the service under medical grounds and people eligible for Section 117 aftercare services with ongoing mental health needs.

C4CC co-chair Anna Severwright said: “As somebody with multiple long-term conditions I warmly welcome the announcement yesterday to increase the number of personal health budgets.

“PHBs give people more choice and control over their care, allowing them to select the support that works best for them and to be able to live the life they want.”

Paula Fairweather, a member of the C4CC co-production team, said a PHB helped change her life and wants others to benefit.

“My PHB meant I was able to access different support in a way that worked for me, buying equipment for physio specific to my needs and improving my health and helping me be more independent.”

“I have also seen PHBs make a huge difference in many other people’s lives, improving their health and quality of life. For example enabling someone previously housebound to volunteer and help others in the community.”

C4CC helped develop the IPC programme, which aims to integrate health and social care to better meet the needs of the individual and empower people to play a more active role in their own health and wellbeing.

Our co-chair Nigel Mathers commented: “I am pleased with this announcement endorsing the roll out of IPC and PHBs and the forthcoming consultation on extending the legal right to have a PHB.”

“C4CC has been a supporter of PHBs since their inception and the rolling out of IPC will strengthen the voice of people with long-term conditions in the NHS. “

C4CC Launches New Care and Support Planning Tool

One of the core aims of the Coalition for Collaborative Care (C4CC) is to ensure care and support planning is a mainstream activity and I hope that the launch of our new planning tool will make a real contribution to making that happen on the ground.

Progress front coverIt is vital that people with long-term conditions have the opportunity to have a conversation about what matters to them and to be seen as an equal partner in their care by those supporting them, in health and social care.  Many of our partners and co-production team have evidence and stories about the positive difference the right conversations can have on people’s wellbeing, in achieving the outcomes that are important to them and on their confidence in taking control of their own health.

C4CC wants care and support planning to be available to everyone with a long-term condition and not just the “lucky few.” This tool has the potential to ingrain this best practice across the entire health and social care sector, providing organisations with a baseline starting point and the ability to continually assess their progress.

The toolkit has come about as a result of extensive work with C4CC partners such as the Alzheimer’s Society and Royal College of GPs, because they recognise the value of those conversations in achieving a better deal for people with long-term conditions.  This partnership approach will also be vital as we look to make its use widespread and bring about the system change we are all so passionate about.

In the coming year we will be continuing to deliver training, development and awareness raising sessions around better conversations, using the strength and breadth of our networks to build this movement for change.  Please get in touch by emailing if you want to collaborate with us to help us keep up the momentum.

C4CC’s Perspective on the Five Year Forward View Delivery Plan

Catherine Wilton, Director and Fiona Carey, Co-Chair of the Coalition for Collaborative Care, offer the partnership’s perspective on the new Five Year Forward View Delivery Plan:

Since the Five Year Forward View (FYFV) was published two and a half years ago, the Coalition has been working together with our 50 national partners to effect change at pace and scale across the whole health and care system, to provide a better deal for people with long-term conditions and their carers.

At the heart of our approach has been the ‘Three Cs’ of better conversations, building community capacity and co-production.  For people with long-term conditions this means a new relationship with the NHS – in which people have the opportunity to have a conversation about what matters to them and what good looks like, to explore the assets and supports they have available to them – among their family, friends and local communities – and to plan and coordinate with healthcare professionals the services and treatments they might need to ensure they get the best possible outcomes.  It also means NHS organisations behaving differently – actively supporting and working with local people and communities to build community resilience and to co-design the supports that people want.

The original ‘Chapter Two’ of the FYFW championed the importance of empowering people and communities, and while it doesn’t have a separate chapter in the new Delivery Plan, many of our partners know that to make the plan become a reality, the NHS needs to fully embrace the power of people and communities.  ‘Health’ is not just created by health services – it happens when people are able to take control of their own lives and have a voice in what needs to happen locally to support them, on a one-to-one, and on a collective, level.  It is great therefore that the delivery plan has recognised the need for Sustainability and Transformation Partnerships to develop the concept of and collective action for ‘Health Creation’, as advocated by NHS Alliance. 

Having access to health and care services is vitally important but it is the quality of conversations between people and professionals that will ensure the best outcomes for people with long-term conditions.  The RCGP have stated that it is a ‘necessity’ for care and support planning to become core business for general practice, as it is an effective way to support people with multiple long-term conditions.  And they believe it is so important that they have made it part of the RCGP curriculum, meaning that to qualify as a GP, new recruits will have to know the principles and have the skills to do care and support planning.  Over the coming year we will be working very closely with the RCGP and other C4CC partners to roll out care and support planning – not only is it the right thing to do for people themselves, we believe that it can reduce the pressure on acute services for two reasons – because people are able to look after themselves better, and better coordinated care is more efficient.

There are huge challenges facing health and care over the coming years but we also share the optimism of the delivery plan that a better and more effective NHS can be delivered. We strongly believe that a people- and community-centred vision of collaborative care, delivering the ‘Three Cs’ is the best way to build an NHS fit for the 21st Century and one that will continue to sustain us all in the future.

C4CC’s Co-production Team View 

Sue Denmark from C4CC’s Co-production Team reflects on what this means for people.

“As someone with multiple long-term conditions, I was glad to see GPs getting the recognition they deserve as I all too aware of how important they are. The increase in their numbers is good to see, but I did feel there was something missing around the quality of the conversation between the professional and the person – more access is great, but we need to ensure care and support coming from the time together is person-centred.

“I was also pleased to see such a focus on mental health and the increase in talking therapies, but I did feel this could have gone a step further, looking at how community-based services could provide support, in a different way to medical treatment.

“I know from my own personal experience how community-based groups and activities can contribute to a person’s health and wellbeing. A few years ago, myself and others needing regular leg treatments worked together with our GP practice to create our own group and receive our care there instead of making appointments. The group, simply by its existence, began to tackle other wider issues such as isolation and loneliness – friendships made there led to walking groups and learning new skills. This has helped to improve people’s physical and mental health and reduced pressure on the GP practice.

“Reading this plan, I was unsure how I as a person fitted in to it, but having considered it, I think we can help by taking the lead on looking at our own communities and helping to fill in any gaps with local, tailored solutions. This, together with the work of NHS England, will start to deliver real change where it is needed.”

Timebanking, Good Gym and Social Prescribing

From social isolation to valued sports coach in one move…

I have recently signed up to Reading’s ‘Ready Friends’ befriending network on behalf of the timebank that I set up and continue to chair. NHS England allows staff to spend a week, fully paid, volunteering in their community or on other charitable projects, so I took advantage this by spending half a day at a workshop with about 10 different community organisations, all committed to combatting loneliness and social isolation in our town.

The groups at the meeting spanned from traditional-type befriending services, like those run by Age UK, to community transport schemes and one small group of neighbours who provide a home cooked meal for someone else in their street by just cooking a little more than they would normally.

Our timebank is providing social opportunities and links between people who share interests or who need help, and we have lots of success stories – someone who got a longed for job as a result of the skills and experience that running the timebank gave them, a person whose path to alcohol recovery has been helped by meeting people outside their usual circle, and one older person who used to go away every Christmas because it was too painful to be alone stayed in Reading last year, to meet up with friends made through the timebank.

There are examples like this from timebanks across the UK – where fantastic outcomes that improve people’s lives are the result of people and communities helping each other and not about the services they receive.

Another organisation at the meeting sparked some interest – Good Gym is doing fantastic work, particularly in the London area, but now expanding its reach. It encourages people to take up running and help their community at the same time.

Participants have three choices – join a group that runs somewhere to do a community-based activity like a gardening project; run to do a job to help someone, usually an older person, like putting a shelf up, then run back again; or be paired with an older person, with the aim of running to their house at a given time in the week. The twist is the older person is designated as the runner’s ‘coach’, providing a real reason to turn out on a dark and cold night.

I have pledged to sign up when Good Gym comes to Reading, as goodness knows I need the extra motivation to drag myself out to exercise on a wet Wednesday.

And lastly, we heard how the social prescribing project being run by Reading Voluntary Action has really demonstrated the power of person-centred conversations. Coupled with signposting to other support and helping people get connected to people and groups in their local community it has delivered improvements in all aspects of wellbeing for those involved.

The key to all this continuing to happen is of course the statutory sector recognising the huge contribution that community groups make to health, even though some of the schemes in the network do not look like traditional ‘services’ and have grown from the bottom up rather than as the result of a commissioning process. We are hoping that by working together we can build a network of supports across the town so that people are less likely to fall through the net. And my vision is also that those ‘befriended’ start to be seen for what they can do for their community, not what their community can do for them.

Future Hospital Programme – Better Conversations

The past few weeks have been busy for me, meeting lots of C4CC partners and community groups and learning how the principle of ‘better conversations’ is being played out and reaping rewards for people with care and support needs across the country.

A few weeks ago, I was invited as an outside expert to attend a seminar on the Future Hospitals Programme run by the Royal College of Physicians.

It highlighted the fantastic work which is being done at a number of sites around the country to create a much better deal for people using their services, in particular older people with frailty and multiple long-term conditions.

All the ground-breaking projects were to be commended, but two in particular caught my interest.

Betsi Cadwaladr University Health Board serves a largely rural community in North Wales, which brings its own obvious challenges. Their C@rtref project (meaning ‘home’ in Welsh) is pioneering the use of teleconferencing video technology in local community clinics to enable people to have a follow-up consultation with a doctor in the main hospital, without the need to travel.

It has proved a much more effective use of time for staff, with clear efficiency savings, while for the older people themselves it has meant having a single, holistic conversation with a geriatrician rather than several different conversations with different doctors, as well as much less wasted time in travelling. Seventy-two per cent of those seen were aged over 75, yet more than 80 per cent were satisfied with this new way of doing business.

I was also struck by the project in East Lancashire Hospitals NHS Trust, which aims to provide personalised care for people at, or as close to home as is safe and appropriate. One study showed that their multi-disciplinary and co-designed approach prevented 59 per cent of admissions. I was impressed they had trained a team of volunteers to carry out detailed interviews with people in their own homes about their experience of care. In their words, in-ward surveys, ‘only tell you about a part of the journey.’

The examples showed that better conversations can be about the way we conduct doctor-patient consultations or how we take the time to really listen to what matters to people, whether in hospital or the community. And what struck me was that the staff involved were genuinely committed to making a difference to people, sometimes under very difficult circumstances. We are very much looking forward to working with the Royal College of Physicians and others over the coming months, to see if we can grow these person-centred approaches far and wide.

Engaging and Empowering Communities

I was delighted to speak at the November 2016 launch of Engaging and Empowering Communities: A Shared Commitment and Call to Action – an initiative headed up by Think Local Act Personal (TLAP) but co-authored by the Coalition for Collaborative Care, the Association of Directors of Adult Social Services, the Local Government Association, Public Health England, the Association of Directors of Public Health, the Department of Health and NHS England.

The document is a sector-wide commitment to developing and nurturing strong communities, something very close to our hearts in C4CC.  We know that things need to change- councils, clinical commissioning groups and doctors can’t ‘prescribe’ wellbeing- it comes from having friends, family, social contact and support, being able to get out and about, having the opportunity to do something for others and feeling valued for our contributions through paid and unpaid work or being part of a group.

With our partners, the Coalition for Collaborative Care wants to see a shift away from ‘What’s the matter with you?’ to ‘What matters to you?’ by local people and organisations coming together to nurture and build on the assets in local communities, reducing loneliness and social isolation, increasing community resilience and enabling people to take control of managing their  health.

This is something very personal to me as chair of my local Timebank in Reading, covering a diverse and thriving community in the Oxford Road area of the town. I have seen powerful examples of how the Timebanking model keeps previously isolated people, often people with multiple medical conditions, connected to others in their community in a positive way.  From what we know about the work carried out by C4CC partners Timebanking UK and Spice we know that people are likely to be less reliant on health services and more expensive interventions as a result of their involvement in community activity.  See the London School of Economics report that I was involved in, and Spice’s recent impact assessment here.

Whether through Timebanking or other innovative approaches, we need to drive forward on this agenda, particularly at a time when resources are stretched in the public sector.  It’s therefore fantastic that national sector leaders have been prepared to sign up for a paradigm shift in how we support citizens, families, people, to live happy and healthy lives.

Another key landmark, was this week’s publication of the conclusions of the Realising the Value (RTV) programme, undertaken by Nesta and the Health Foundation and funded by NHS England.

This builds the evidence base for person and community-centred approaches to health and wellbeing and how they can be developed across the country.

To quote from its key findings:  “The most successful examples of person – and community-centred approaches in practice are those that are developed by people and communities, working with and alongside commissioners and policymakers to build on existing assets and co-produce solutions that work.”

I hope that health professionals, providers, commissioners and those in charge of implementing local Sustainability and Transformation Plans will read the report and take on board its 10 key actions, and work with local authorities, the voluntary sector and local people to make the fine aims in our shared commitment happen in reality.

Engaging and Empowering Communities: a shared commitment and call to action

C4CC partner, Think Local, Act Personal launched  a commitment and call to action on Engaging and Empowering Communities at National Children & Adults Services Conference in Manchester on Wednesday 2 November 2016.

Engaging and Empowering Communities: A Shared Commitment and Call to Action provides a persuasive case for working collaboratively to create strong and empowered communities, which is a key aspect of the Coalition’s ‘three Cs’.

The Coalition for Collaborative Care co-authored the commitment, together with other system leaders including ADASS, Association of Directors of Public Health, Department of Health, Health and Care Voluntary Sector Strategic Partnership, Local Government Association, the new NHS Alliance, NHS Confederation, NHS England, Public Health England, Skills for Care and Think Local Act Personal.

You can download the full commitment here:

Further details, including the press release and where to go for more information can be found below.

For the first time, care leaders are offering a clear way of making sure that community centred approaches are embedded in health and social care services. The clear set of principles and actions are launched today by the Think Local Act Personal Partnership on the first day of the annual National Children & Adults Services Conference in Manchester.

Engaging and Empowering Communities: A Shared Commitment and Call to Action offers a compelling case for working collaboratively to create strong and empowered communities, and for this to be central to the transformation of the health and care sector.  It’s co-authored by all national health and care system leaders including The Association of Directors of Adult Social Services, Coalition for Collaborative Care, Local Government Association, Public Health England, Association of Directors of Public Health, the Department of Health and NHS England.

The report was produced following a National Leaders’ Seminar on community and citizen empowerment, attended by NHS England Chief Executive Simon Stevens, which called for national agencies to work together in realising the policy ambitions of the Care Act and Five Year Forward View.

The report argues for the need to build strong and inclusive communities that can address persistent health and wellbeing inequalities. Key principles and broad actions are set out with a commitment from key partners to develop a detailed plan to support practical actions on the ground.

Kate Sibthorp and Clenton Farquharson, members of TLAP’s National Co-production Advisory Group, said: “A better life for me is just common sense. What we need is for this collaboration to result in all the parts of the system working together to help better lives be a common experience for everyone who use health, care and support services. People who work in this area need to be reminded that knowing you should do something about it is not the same as actually doing something about it. Organisations need to create the conditions for this shared commitment to work, and central to this is having good relationships so we can all work together to support practical action on the ground.
We welcome this report whole-heartedly and hope it will inspire genuine commitment to working with people and communities. We look forward to hearing and sharing lots more stories of how people are achieving their best health and well-being, both physical and emotional, through this approach.”

Alex Fox, CEO of Shared Lives Plus and Think Local, Act Personal’s board lead for building community capacity, said:
“There have always been aspects of our lives, such as the health of our lifestyles or how connected we feel to others,  that have a huge impact on our health and wellbeing and long term use of services. At a time when budgets are more and more stretched, the organisations and resources outlined in the shared commitment will show the help that is out there for hard-pressed commissioners in working with people who use services to develop the health and care system we  need, rather than manage the one we have.”

Lynda Tarpey, Director of Think Local Act Personal, said:
“There is clear consensus amongst sector leaders that people and communities must be central to the redesign of care and other public sector services, using approaches that go beyond traditional statutory interventions.  Increasing evidence from research and practice demonstrates that building community and helping people to develop social networks has the potential to address wellbeing, improve outcomes as well as more effectively apportion limited public finances”.

Anu Singh, NHS England’s Director of Patient and Public Voice and Insight said:
NHS England is delighted to sign up to the Shared Commitment to Engaging and Empowering Communities. The NHS Five Year Forward View sets out our vision to develop a new relationship with people and communities. Aligning the work of national agencies is critical to creating the conditions for success and delivering the ambition to reposition the nation’s health on a social, rather than biomedical model that supports people and communities to manage their health, wellbeing and care. We are looking forward to working together to help make this a reality.”

Martin Farran, Director of Adult Services for York City Council, said:
“I welcome the Shared Commitment across local government and the NHS. It’s a crucial next step to personalising people’s care and support and the “commitment” supports a community asset based approach critical to the transformation of the health and social care system.”

Dr Brian Fisher, GP and Vice-Chair of New NHS Alliance, said:
“The New NHS Alliance is committed to the key ideas and actions recommended in this document – we welcome it. In particular, we see that the NHS and local authorities need to work together with communities to help create health and build confidence and resilience. We see these approaches as essential to shift towards a greater focus of the social determinants of health, health inequalities and improving the control people have over their lives. Working on these issues with other agencies such as housing will be the next paradigm health improvement.”

Catherine Wilton, Director of the Collation for Collaborative Care, said:
“We know that things need to change- councils, clinical commissioning groups and doctors can’t ‘prescribe’ wellbeing- it comes from having friends, family, social contact and support, being able to get out and about, having the opportunity to do something for others and feeling valued for our contributions through paid and unpaid work or being part of a group.
It’s fantastic that national sector leaders are demonstrating a shared commitment to create the conditions for strong and healthy communities. With our partners, the Coalition for Collaborative Care aims to achieve change on the ground. We want to see a shift away from ‘What’s the matter with you?’ to ‘What matters to you?’ by local people and organisations coming together to nurture and build on the assets in local communities, reducing loneliness and social isolation, increasing community resilience and enabling people to take control of managing their own health.”


Download the Engaging and Empowering Communities – A Shared Commitment and Call to Action at


Notes to editors

  • The report will be launched at the Think Local Act Personal Stand B24 at Manchester Central Exhibition Hall at 5:00pm, Wednesday 2 November. All delegates attending the National Children’s & Adults Services Conference are welcome to the launch.
  • TLAP convened a National Leaders Seminar in June 2015 which brought together key public sector system leaders including NHS England CE Simon Stevens. The aim of the seminar was to develop a shared narrative about the importance of engaging and empowering communities in achieving sustainable health and wellbeing. This was followed by regional events in which several hundred sector colleagues contributed to the narrative.
  • This shared commitment has been co-authored by all national system leaders: ADASS, Association of Directors of Public Health, Coalition for Collaborative Care, Department of Health, Health and Care Voluntary Sector Strategic Partnership, Local Government Association, the new NHS Alliance, NHS Confederation, NHS England, Public Health England, Skills for Care and Think Local Act Personal.
  • Local areas will define how they propose to effect community capacity building at local level with detailed action plans to include approaches such as co-production, asset-based commissioning and evidence-based practice.
  • National Children and Adult Services Conference takes place in Manchester Central from 2 – 4 November 2016. It is organised by the Association of Directors of Social Services (ADASS), the Local Government Association (LGA) and the Association of Directors of Children’s Services (ADCS) and is regularly attended by more than 1,000 delegates. It is vital to all with responsibilities for or interests in social care, children’s services, education, health and related fields.
  • Think Local Act Personal (TLAP) is an alliance of over 50 national social care, health and housing partners committed to improving the delivery of personalised, community-based care and support. It brings together people who use services and family carers, central and local government, major provider bodies, the third and voluntary sector and other key groups to work together to ensure people live better lives.

For more information, contact / 07850 774453

A Co-production Model: five values and seven steps to make this happen in reality

Catherine WiltonCo-production: a single-page guide, Catherine Wilton, Director Coalition for Collaborative Care 

Over the last few months, our co-production group have been working with others to produce a simple guide to help organisations embed co-production into their day-to-day working.  The ‘Co-production Model’ describes the values and steps needed to ensure the voices of people with lived experience are included in decision-making, from commissioning to co-design and co-delivery.

As one of our three Cs, co-production is an essential part of achieving a better deal for people with long-term conditions.  Co-production involves sharing power and recognising that people with `lived experience’ have a hugely important contribution to make in decisions about every aspect of healthcare and in creating the conditions for better health and wellbeing in communities.

The model is available now for everyone to access and we look forward to hearing your stories about how it is helping you to embed co-production into the work you do. Further materials and resources will soon be available, so watch this space. Click here to download and print the model.


Fiona CareyWhy We Need It, Fiona Carey, C4CC Co-chair 

Get your Co-production Model here!

Co-production – the best, if most elusive, version of ‘people involvement’ – is gaining ground as an idea. So it’s great news that C4CC has produced this Co-production Model. Even better, is that it’s on a single A4 page and that it is a model, too, of simplicity, sense and plain English. In a meagre 300-or-so words* it:

  • explains what co-production is,
  • describes five ‘values and behaviours’ that need to be present in an organisation to make co-production possible,
  • offers seven steps to implementation.

It has already been received with huge enthusiasm in several places where it’s been presented, which seems to reflect the reality of where we are with co-production. That is, that the argument ‘for’ has largely been won, but that people aren’t sure how to do it, or where to start.

The rightness of doing co-production

In fact, there is a growing acknowledgement that co-production is simply the right thing to do, both for people who use services and for their families. But it also makes operational sense. This is true for lots of reasons, but here are the three biggies (and some slogans!).

First, it’s better for patients to be actively involved in their care. People with long-term conditions are probably best-placed to know what services they want and need, and can contribute massively to their proper design and planning.

Slogan alert #1: Plan with us, not for us.

Second, you get better outcomes. Individually, patients will understand more, ‘comply’ more, and be healthier. Where systems and processes are designed with users, you’ll get to the right solution quicker, and with fewer iterations. Then once in place, the systems and services will work better, faster, and with fewer revisions.

Slogan alert #2: We know things you don’t know; we see things you don’t see.

Slogan alert #3: As ‘expert advisory groups’ go, if people who use services didn’t exist, you’d have to invent us.

Third, it’s better for health care professionals. Usually a bit scared and sceptical at first, the experience of the C4CC Co-production group, and hundreds of other ‘users’ working with professionals around the country, is that once professionals have co-produced properly, they are bitten by the bug, and become serious advocates of the methodology. Pathways work better, systems work, and job satisfaction goes up.

Slogan alert #4: Co-production helps us to prioritise and that’s better for us all.

How to do it and where to start

The interest shown in discussions about co-production, and early reactions to the Co-production Model, suggest that there is a huge number of professionals out there who really want to work using co-production, but aren’t sure how to go about it. (Although the oft-cited difficulty in ‘finding patients’, frankly seems a bit weird to me…)

Co-production is the easiest thing in the world to do badly, and really hard to get right. But the basic principles aren’t difficult, and the Co-production Model suggests a methodology that is simple and straightforward.

It’s a great place to start. And it’ll be followed soon with some case studies that will help further to address some of the practicalities.

The chances are you won’t get it right the first time, but don’t let that stop you!

Slogan alert #4: Don’t wait until the plan is perfect. Make a start, and fix it as you go along.

* Beaten into a cocked hat by the Gettysburg address, one of the finest examples of concise writing ever produced, at just 272 words. We did try.

Shahana RamsdenHow we created it, Shahana Ramsden, Senior Co-production Lead, C4CC

Before the first co-production model meeting I was influenced by two concepts extracted from different authors. The first was Susan Cain’s book, “Quiet; The power of introverts in a world that can´t stop talking” and the second was Time to Think: Listening to Ignite the Human Mind by Nancy Kline. Both authors remind us of the importance of creating an open and safe space in meetings so that every perspective is heard and valued.

We acknowledged that people have different learning and thinking styles so during our first meeting we gave everyone space to think about what co-production means to them and how to make it happen in reality. Each person had uninterrupted time to share their ideas so instead of a heated debate where people might forget to listen to other perspectives, we highlighted what everyone in the room agreed on. So by the end of the session we had a checklist of the common themes that the whole room believed in.

These discussions created the foundation of the Co-production Model.

We have been completely committed to modelling collaboration and co-production in the way that we have worked. Within the context of our precision-planned project spreadsheets where we set tight deadlines for delivery, we allowed the engagement to be slightly messy, releasing the energy of all our steering group members to carry the draft co-production model with them wherever they went – discussing the content of the model at meetings and events and gathering feedback about what changes were needed. Using this approach, we triggered multiple conversations about co-production in corridors, trains, coffee shops, patient groups, board meetings, team meetings, national conferences and regional events.

Within a three-month period we collectively had conversations about co-production with hundreds of people, including at notable events such as Fiona Carey’s presentation to the Q event and our popular workshops at the C4CC regional events for New Care Models sites.

During the later stages of development of the model, we were pleased to be led by our Young Health Ambassador, Alexandra Burroughes, supported by Justine Thompson, Macmillan Patient and Public Involvement Lead who facilitated a two-way session to ensure that we used plain English and kept communication clear.

As Christine will explain, now that the model is completed, we have started the process of developing practical tools and materials to show how co-production can work in practice in a range of different organisations.

Christine MorganWhat we plan to do next and how you can be involved, Christine Morgan, Co-production Group, C4CC

One of the great joys of being able to share the Co-production Model as we worked on it was that we had lots of feedback, as Shahana has described, which we used to amend and adjust the model.

People were getting stuck in and having a go even if it wasn’t perfect from day one and, indeed, why would it be? At the Vanguard events in Leeds and London we heard about different projects where people were working together to improve outcomes in health and care in many different organizations. People were very honest and shared their successes and the ‘not so good’ moments too, which often – and perhaps inevitably – provided the most learning.

Just remember FAIL – First Attempt In Learning (attributed to Dr. A P J Abdul Kalam).

Gathering case studies

To enable more people to hear about these projects, we are gathering case studies to give people some direct information about how this approach works, and to encourage more sharing so that many more people will be encouraged to work in a truly co-productive way.

We want to hear from you so that the case study collection can reflect what co-production can look like in commissioning, primary and community care, hospital trusts, Local Authorities, the Voluntary Sector and any other groups you are working with. Please contact Shahana at to share your experiences.

Capturing hearts and minds

One thread of feedback that was repeated many times was that senior leaders usually backed co-production, as a theory, but largely saw it as something their excellent communications people did. It is certainly true that a lot of expertise for the ‘how do we do this?’ question can come from communications experts but our model is about more than that.

Co-production and wanting – actually needing – to work with patients, carers and the public is a value and ‘must have’ that should underpin everyone’s way of working in any organisation that commits to it. That means the behaviour of the board, governing body or executive team should model co-production within the organisation and outside it. If that can be achieved then every team, department or  group within any organisation, or across systems, will know which parts of their work must be done co-productively, and while they might need some advice on the ‘how’ they will own their specific way of working.

So, calling all leaders – how co-productive are you and your organisation? Is co-production embedded in all that you do? Do you feel confident that the patient and carer voice is heard and informs all that you do in service improvement?

Diagnostic tool

Finally we want to be able to help you. Often a good place to start is to hold a mirror up to see where you are currently: ‘How co-productive or collaborative are you in your work?’ To help you to get the best for your organisation and the people it serves, we are planning on developing a diagnostic tool to help you to carry out a self-assessment. This will help you to see what you do well and where you want to make changes to work more co-productively.

As this work progresses, information will be published on the C4CC website – and of course if you already have a self-assessment or diagnostic tool that works well and are willing to share this,  please do get in touch.

Why we must shift the power

I’m delighted to be sharing some thoughts with you in this, my first blog as Deputy Director of the Coalition for Collaborative Care. It is an exciting time – the launch of a new partnership, a commitment in the NHS Five Year Forward View to put people with lived experience at the centre of the NHS and the chance to work with a talented and inspiring team. It is also a challenging time, and we have a big task ahead of us to change both culture and practice across the NHS to get a better deal for people with long-term conditions.

My guiding principle in helping to shape and lead this work is this: the single most important thing I have learnt during my years working in health, social care and communities is that a service model of identifying need, professionals formulating solutions and then delivering to a set standard via targets and monitoring is a model that is doomed to failure for two main reasons. Firstly, there will never, ever, be enough public resource available to solve every problem and deal with every need you find. Secondly, it ignores the very essence of what it is to be human: our need to be valued, for self-esteem, to be part of families, friend networks and communities, and to be independent and in control of our lives.

Public services that ignore our human nature as social animals can never get the best outcomes. I think this is something we all instinctively know, what you might call common sense, though we have yet to make connecting people together or an asset-based approach an intrinsic part of any mainstream public service.

Some time ago I spent a number of years as a local councillor. Like most local politicians I stood for election because I wanted to make a positive difference to my community and to improve lives. It was hard work but hugely rewarding and, looking back, I’m happy that I did my bit to make a difference. However, as much as I wanted to make things happen myself it was the effort I made and saw others make to nurture and unleash the assets of communities and local people that made the biggest difference. The projects that involved tricky partnership-working that were led jointly with local people that supported groups and empowered communities – they were the ones that achieved most and lasted longest.

Community development does cost money, but shifting power to people means that public resources can achieve far, far more than they can alone. This is what motivates me in my new role. I believe that we will make a huge difference together and will be thankful that we got the opportunity to be part of this movement for change.

Catherine Wilton is Deputy Director of the Coalition for Collaborative Care