But what am I doing right now?
Currently I'm planning for a 6 month project with a group of Primary Care Trusts (PCTs) in the East Midlands, which I will be leading. Their ambition is to embed 'coproduction' in all of their service development work, to go beyond stakeholder engagement and try to create more equal relationships in the delivery of health.
The aim is to train a small group in the techniques of experience based design and coproduction, to provide them with practical means to empower all stakeholders. Our team also includes organisational development experts who will complement the development of these skills by creating a sustainable environment for the team.
Here and here are some good papers on the concept of coproduction; better understood in theory than in practice (but I'm working on that).
I'm also doing more work on knee surgery for DePuy - confidential, I'm sorry.
Liverpool PCT asked me to help design a method of consultation for a £10m treatment centre they plan for the south of the city. They take stakeholder engagement very seriously (see this as an example); they have developed a few options for this centre but wanted to get the community to broaden these options and appraise them. They have realised that, even at its best, consultation places people at a distance from the design. Given the right facilities and skills, people can work alongside architects and health planners and input directly to the decisions. This was the approach we developed. It also helped overcome the sense that Liverpool is "over-consulted": they have been asked and asked, now they simply want to see well-designed change.
I'm working with the staff and people on dialysis at the Wigan Renal Unit. Well into this work now; most of my time has been spent getting to know the people there and understanding the dynamics behind their situation. I was directed to focus on their diet and management of phosphate, which is inefficiently removed by dialysis and can cause bone problems. I've been concentrating on developing ways of sharing good practice amongst people on dialysis, on empowering them to say or ask things they want but feel uncomfortable about, and allowing them to discover more about their food and its effect on their bodies.
One of the things I co-developed with the Wigan people was a "patient held care plan", a document that is kept by the person, that records all the information they feel is valuable to them and to their care team, and which is given to clinicians at the appropriate time - it helps transfer some of the authority for care to the "patient". In the new year we'll extend the work we've done on this and try to encompass the whole pathway - from kidney disease to end-of-life care.
I've just finished working with the NHS
Institute. The project started by being an exploration of the role of bedside terminals in the provision of information and entertainment for long stay patients. We quickly realised that their needs (for information and entertainment) are enormous and wide-ranging yet can be delivered in numerous, simple and cost-effective ways. We rediscovered the extent of the isolation and "de-socialisation" that occurs to people when they stay in hospital for a while. We're still working out the implications of this work, but one immediate opportunity seems to be to influence the Institute's work on "productive wards", which engages front line staff in providing solutions to questions they know about but haven't the time to deal with.
As part of a team from Leeds Business School, I am helping Bradford
Care Trust achieve Foundation Trust status in the next 2 years. My
role is to help them develop a governance model that is based on
good membership engagement and a clear channel between user needs and
service development.
Kent County Council is rightly proud of its "4 star" status
in the Audit
Commission's Comprehensive Performance Assessment (CPA) 2007 scorecard.
Staying innovative and close to their community's needs is fundamental
to KCC. To maintain this they have initiated a pilot development with
Sophia
Parker of DEMOS, establishing a Social Innovation Lab for Kent. I
am working with Sophia to help co-create a methodology for service development;
one that builds on best practice within the council and which engages
and empowers the public.
In August '07 I gave a presentation at the Health
Foundation's Leadership Fellows meeting in York. I talked about the
similarities between the BBC and NHS as they try to stay relevant in a
changing world. In particular I reflected on the methods
the BBC has used to engage people outside their organisation in first
having and then developing ideas; something the NHS places great
importance on but they seem to struggle
to achieve.
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