Why Co-Production Is Integral to the Future of Health and Social Care Tech With Helen Gillivan

In this interview, we had the pleasure of speaking with new HETT Steering Committee member Helen Gillivan where she delved into the role of co-production in the health and care sector. 

Helen is the Head of Innovation and Partnerships in Adult Social Care and Health at Kent County Council, leading transformative change within the region's health and care system. With over two decades of experience, Helen is a distinguished leader in commissioning, transformation, and innovation. Her passion lies in digital innovation, leveraging technology to enhance community well-being and streamline care delivery processes.

Helen is a strong advocate for placing coproduction and codesign at the heart of all innovation initiatives. She ensures that the voices of people, carers, and frontline staff are integral to the development and implementation of health and social care solutions, resulting in more effective, person-centered services that truly meet community needs.

What role does technology take in co-production? Why is co-production important?

In both health and social care settings, co-production should play a pivotal role in improving service quality, accountability, empowerment and probably most importantly, innovation.

By involving individuals, communities, and professionals in the design, delivery, and evaluation of digital services, coproduction ensures these services are more responsive to the diverse needs of the population we aim to serve.

For me, user centered design should ensure that technology solutions in health and social care are tailored to meet specific needs and preferences of people who draw on care and support, caregivers and professionals, leading to increased usability and acceptance of any technology.

The involvement of stakeholders should also enhance the effectiveness of technology solutions by addressing real world challenges and complexities within health and care environments and hopefully improving outcomes and experiences for all.

Engaging stakeholders from the start fosters a sense of ownership and investment, which helps increase the adoption of technology solutions. This approach maximises the potential benefits of technology across health and social care.

Finally, successful co-production facilitates continuous improvement through feedback and iteration. This allows technology solutions to evolve and adapt to the needs of the population and their context. This approach ensures that technology remains relevant and effective in health and social care environments.

What are the challenges in implementing co-production across health and social care?

I think we face many challenges in the implementation of co-production. We often talk a different language as professionals. It does feel like a shift is taking place. A shift from referring to people as ‘patients’ or ‘service users’ to ‘people who draw on care and support’, or ‘people who access care and support’, or simply ‘people’. This change is the cornerstone of a broader movement advocating for person-centered, respectful approaches that recognise the dignity and independence of each person, particularly coming from the social care lens.

Using the right language is crucial because incorrect terminology can alienate individuals. Adopting a person-centered approach is essential for effective communication and inclusion.

Another major challenge in co-production is addressing the power imbalance. Traditionally, professionals hold most of the power, but we need to shift this balance so that people who draw on care and support are seen as valuable participants and are actively involved in decision-making.

This requires a cultural change where professionals let go of some of their power to enable equal participation. True co-production demands a culture of trust, respect, and partnership, and we still have a long way to go in achieving this.

Resource constraints, both financial and human, are another significant challenge. Proper co-production requires time and investment, but we often rush due to the demands of the day job. We need to ensure we allocate sufficient time to implement changes, especially in technology, and engage people from the start, from inception to delivery.

Additionally, we often consult the same people during co-production, resulting in limited perspectives. We must seek diverse needs and views from the entire population, particularly addressing health inequalities. Ensuring that seldom-heard voices have an equal stake is a real challenge we currently face.

Where has co-production worked well?

In Kent, we are working hard on co-production, and although we haven't perfected it yet, we have made some significant strides.

Eighteen months ago, we embarked on a new Technology Enhanced Lives offer, shifting from traditional telecare to bespoke technology packages that enable people to live independently at home. This was co-produced with people in Kent and shaped around what’s important to people who draw on care and support. It aims to embed a person-centred approach to social care.

To support this, we appointed a Chair of our Digital Board who has lived experience and uses technology to live a full life at home. We also established a co-production group, who shaped the new contract’s design through to its implementation and delivery. This group helped design the service, draft the contract specifications, and participated in the procurement process, including being on the panel to select the provider.

The Chair of the board is now a member of our team, providing ongoing challenge and insights and to ensure co-production is integral to all innovations.

Peter, our Chair, has also presented Kent at several national forums, sharing his experiences and the impact of having his voice heard, and will be joining us at the HETT show.

I have another example under a slightly different lens, focused on research in practice. In Kent, we have a partnership between the University of Kent and Kent County Council, funded by the National Institute for Health and Care Research. This partnership aims to embed research into practice.

We have established lived experience groups that manage the work for us. Public involvement is integrated into every stage of the project, including design, delivery, dissemination, and implementation. We have also focused on equality, diversity, and inclusion, ensuring underrepresented groups are engaged in this strategy.

A co-production group has been developed to implement every part of the four-year program with us. This initiative ensures that people are embedded in all activities. We now have a coproduction policy that ensures people are compensated for their time, recognising their valuable contributions and expertise, rather than relying on voluntary participation.

What's next for co-production?

I believe there is still a significant journey ahead of us. As I mentioned earlier, the shift in language is crucial to making our approach more inclusive and person-centered, ensuring everyone feels included.

I see technology playing a pivotal role in advancing co-production, making it more accessible and inclusive through digital platforms. We are currently testing various digital platforms for this purpose.

For me, the challenge lies in scaling up and ensuring sustainability. How do we make coproduction best practice across all our initiatives, not just isolated examples?

Currently, we have pockets of good practice, but it's not consistently applied. The goal is to make coproduction the norm.

Addressing inequality is key. We need robust structural processes in place to prevent marginalisation and ensure equal opportunities for all.

While I believe coproduction is the right approach, further research is needed to understand its impact. We are currently undertaking research to evaluate the outcomes of listening to people's voices versus traditional professional-driven approaches.

Personally, I advocate for more involvement of people with lived experience in professional events. Their perspectives bring a unique lens to discussions and can lead to innovative insights, especially in developing new health and social care technologies. Increasing their presence at such events could unlock new possibilities.

Catch Helen’s session at HETT Show 2024

Helen will be speaking on an opening keynote panel at this year’s HETT Show on 24-25^th September on ‘Who is the Owner of Change? – Exploring Collaboration, Adoption and Culture Across the ICS System.’ Secure your free pass to catch this session and over 50 more hours of CPD-certified content covering key digital health and care topics.