Co-producing new primary care service propositions

Grimsby is a smallish town in a forgotten area of Lincolnshire. It has the dubious distinction of being one of the most deprived areas in the country. Consequently it has high levels of obesity, substance abuse and chronic ill-health. Making matters worse, it has many groups who do not go to their doctors until they are literally falling apart.

The Primary Care Trust (PCT) is one of the best-managed in the country, and they wanted to develop a new service to give better access to healthcare to these vulnerable groups - problematic drug users, sex workers, offenders, economic migrants and asylum seekers.

I lead this 3 month project to co-design and help co-produce the service they need.

Clearly there is some reason why these people are not getting health care right now - it's available and accessible, so what is going on? The team felt we needed to get them on-side in some way, so we decided to co-design and co-produce the service with them.

The PCT were happy to explore this new approach; though the evidence is still being gathered, it is intuitively the right thing to do. Throughout the whole of the project, people were involved in doing the design research and in helping us to understand what we'd found out.

They helped us to see, for example, that there are key aspects of the NHS that simply distance people from the services they need, and their needs are really simple, deceptively so.

The co-produced service that emerged from this work is built around a place of safety - somewhere warm, safe and non-judgemental - that they can spend all day in if they wish. Almost like an after-thought, there just happens to be a nurse or doctor there too.

We developed this service as a social enterprise; the Department of Health are looking for good examples to promote their support of the social enterprise movement. They judged this project, out of several hundred applicants, worthy of "Pathfinder" status. This provides extra funding and expertise as the project moves into its implementation phase.

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