Co-production is the key to success

Although the pace at which councils are deploying TEC to drive and embed the transformation of new care models has been inconsistent, the report highlights 97% of leaders in adult social care said they are planning to increase their use of TEC in the next 12 months. One in three indicated they plan to do more in every area, including support for hospital discharge and replacing traditional care.

Given these ambitions, how can councils accelerate the adoption of TEC and critically do it in a way which ensures there is take up whilst avoiding digital exclusion? Kent CC is responding to that challenge by putting ‘co-production’ at the heart of its Making a difference every day vision and strategy that has then inspired its Technology Enhanced Lives (TELS) service to do the same.

The Care Act’s statutory guidance (2014) defines co-production as, ‘when an individual influences the support and services received, or when groups of people get together to influence the way that services are designed, commissioned and delivered’. For Kent CC’s Adult Social Care and Health directorate, co-production is not just about commissioning or developing services, it is about sharing power more equally at many levels.

Their starting point is to engage people through established networks to form co-production groups, as well as a clear recognition that co-production is neither a separate nor a "one and done" process, but ongoing from TELS specification to implementation.

One way the council does this is through the Your Voice network, which provides a way for people with lived experience to stay updated about activities that interest them. This is underpinned by a Valuing Your Voice policy which sets out how the Adult Social Care and Health Directorate will work with those people, including providing the support required to ensure participation. The directorate has a dedicated Involvement and Information Team that undertake this work to create the right conditions for more co-production.

Part of this support comes from volunteer digital ambassadors who help to build residents’ digital confidence and from technology facilitators who work in adult social care to support the increased adoption of care technology. They work closely with care staff to increase awareness and confidence and deliver training, demonstrations and work closely with teams to develop the use of TELS.

In addition, adult social care staff in Kent share power and influence through a number of groups with senior representation from the council, its partners (e.g. health and the third sector) and individuals with specific care needs (e.g. learning or physical disabilities, mental health needs).

The approach’s success is ensured by recognising that disagreement can be a good thing and providing opportunities for debate. Clear sponsorship from senior leaders and robust governance arrangements has also meant that co-production is an integral part of key business activities. This includes attending and presenting to leadership teams, helping with cultural growth in shaping and delivering training, engagement and communication with the social care workforce.

Kent CC’s adult social care teams have adopted an Agile approach to service development, using ‘innovation sprints’ and a ‘fail fast’ mentality. For example, before commissioning the current PA Consulting (PA) led county-wide TELS service, Kent CC undertook a ‘build and test’ programme in one area of Kent, in order to explore different care technologies.

Kent CC then used the results to inform the specification and service requirements for TELS. The co-production group were involved in the decision to adopt an equipment agnostic approach for the county-wide service. The service specification was then co-produced with staff, technology providers and importantly people with lived experience. These individuals volunteered via the Your Voice network.

They then contributed to the tender specification and proposed evaluation questions to the Adult Social Care and Health leadership team. After tenders were received, they joined bidder presentations and informed the evaluation process. They have continued to play a role by designing the branding and training material, approving Key Performance Indicators (KPIs) and participating in the recruitment of Kent CC team members.

In collaboration with PA, who continue to support the work, this involvement is ongoing with a group of 10 individuals continuing to work with the council to shape TELS and its operations. The group meets monthly and has had input into the design of the branding and training materials and has delivered training, as well as reviewing the provider’s KPIs. They are also involved in shaping solutions to particular challenges working with the joint Kent CC/PA TELS team.

For example, input from the co-production group led the service to pilot the use of ‘James’, a smart watch. Kent CC have used this device for one individual in their 30s with learning disabilities and a severe hearing impairment. Historically, this person has faced challenges living independently such as being unable to return home after a bus was delayed or plans were changed. The James watch can raise an alert, send SMS messages between the individual and TELS, to decide when to call responders.

Additionally, the user has an ‘Amazon Alexa Show 15’ for supporting domestic tasks such as cooking and cleaning. The device also allows the person to stand back and use BSL to communicate with friends and family more effectively. This has reduced isolation, as previously they were trying to hold a mobile phone and sign.

The impact of the group has been significant. As the co-chair of Kent CC’s Adult Social Care Digital Group and who has lived experience has said: ‘Co-production needs to be the beating heart in every service to enable people to live their beautiful independent lives. Co-producing the Technology Enhanced Lives Service worked well because there was respect for each other and understanding that everyone is individual.’

Georgina Walton, Digital and Innovation Lead, Adult Social Care & Health, Kent County Council and David Rees, Head of Local Government Services, PA Consulting

This article was first published in The MJ