Discussing co-production in wellbeing policy and practice

By sharing views from leading academics, our Measuring Wellbeing Series helps increase the visibility of key theoretical concepts, refine practical methodologies, and promote consistency of measurement. This helps build a strong wellbeing evidence base for people to understand and use to affect change. 

Today we publish a new paper in the series, authored by Dr Mark Fabian and Professor Anna Alexandrova, and developed with national anti-poverty charity Turn2us. The paper is part of our partnership with the University of Cambridge’s Bennett Institute for Public Policy. It analyses when co-production might be appropriate, why it is valuable, how to execute it, and what could go wrong. 

Here, we give an overview of the key points.

Addressing a gap in the evidence

In their introduction to When, why, and how to do co-production in wellbeing policy and practice, authors Fabian and Alexandrova observe a lack of existing documentation on co-production. They outline how the majority of expertise is locked up in the minds of practitioners or consultants, rather than shared in an agreed, clear guide.

Their resulting discussion paper is an initial attempt to collate co-production methodology with the aim of enabling others to undertake the process. It also offers the first steps to evaluate and improve co-production. 

The authors welcome feedback on their insights and work, and hope to stimulate others to catalogue their own insights in a public-facing way, producing a wealth of rigorous documentation. 

What is co-production?

Co-production is a deliberative, collaborative practice bringing together stakeholders, practitioners, and technical experts in a two-way learning process to design, deliver and evaluate place-based activity. 

It involves genuine power-sharing among these groups, especially with respect to decision-making, going beyond consultations or surveys. In this way, the practice is in contrast with top-down governmental approaches where policy makers have substantially determined the structure of engagement and the questions to be asked of citizens. 

Why and how to co-produce

In the paper, the authors identify three primary motivations for co-production:

1. Legitimacy – co-production is a way to ensure people have a voice in shaping policies that directly affect them, encouraging engagement with and trust in systems of governance.
2. Contextualism – co-production is a way to ensure that wellbeing policy is sufficiently tailored to different area needs and priorities.
3. Sensitivity – co-production is a way to harness granular, context-specific knowledge that can improve the effectiveness of policy through incorporating complexities into its design, measurement, and objectives.

They also cover several guiding principles and considerations when co-producing, such as:

• Clarifying the practical insights you need to harness when recruiting practitioner and technical expertise. It is crucial to involve those with time, capacity, temperament and drive to contribute.
• Using purposeful frameworks to support people with lived experience in a way that amplifies voices and perspectives in an effective rather than burdensome or tokenistic way. This can be achieved by using robust and that directly address knowledge and analysis gaps in policy. 
• Ensuring your sample of participants is diverse enough to generate rich qualitative data (conceptual saturation) while also reflecting the composition of your stakeholders more broadly (representativeness). 
• The ethics of appropriate remuneration.
• Treating all participants as authors on the project, to enable genuine power-sharing.
• Taking a reflexive, open-minded stance to qualitative research to build relationships, uncover greater insight and ensure that research is with people not on them.

A step-by-step guide

To illustrate the key stages in the co-production process, the authors use a recent co-production exercise concerning the development of a model of thriving for national anti-poverty charity Turn2us. 

The exercise was conducted by Turn2us alongside academics from the University of Cambridge and people with a lived experience of financial hardship. The charity is now applying the model throughout its operations. 

Due to a lack of suitable, established qualitative research methodologies the researchers combined qualitative data collection in an intimate setting with quantitative surveys at the beginning and end of the process:

1. Surveying
2. Working group
3. Half-day workshop
4. Final report
5. Feedback

The authors advise checking back at regular intervals or at key stages with the people involved in the co-production to ensure that they endorse the theories, measures, and objectives developed.

For full details of each stage, including how data was generated and analysed, read the full paper.

Current challenges

Fabian and Alexandrova acknowledge that co-production has limitations. Operationally it can be expensive, time-consuming and hard to manage. Additionally, there is the question of how generalisable and standardisable the outputs of co-production can be. 

The authors suggest that these challenges can be met in wellbeing policy by:

• working at smaller scales and then generalising results and scaling up as experience mounts;
• utilising less time-intensive methods such as citizens’ assemblies and other tools developed for deliberative democracy, iteratively building the knowledge of ‘what works’;
• using common definitions, measures, and objectives.

The methodology outlined holds promise as a means of creating generalisable wellbeing policy from the bottom up.

Key takeaways:

• A main objective of co-production is to give people with lived experience a greater role in policy making, so leave value judgements up to those who will be affected by policy.
• The co-production process will vary by context, but general principles for success are ensuring it is reflexive and collaborative.
• Often co-production is less about scientific consensus and more about stakeholder engagement.
• As a rule of thumb, have diversity at small scale with a focus on qualitative insights, and then check these quantitatively at large scale for representativeness.
• Co-production should be institutionalised within the policy making process using a bottom-up approach so stakeholders are contributing to policy decisions, designs, and evaluation on a regular basis.