Co-creating health in Abertawe Bro Morgannwg

Our Associate Director Andy Phillips is also Director of Therapies and Health Sciences in ABMU, he’s just about to finish his PhD, he’s in the middle of packing for a move to New Zealand, AND he has found time to pilot a ‘Co-creating Health Framework’ which is based on co-pro principles of equality and assets.

The Framework consists of nine elements that can be used by clinicians in establishing a co-creating health interaction with patients.  The framework supports clinicians to use all or few of the elements within the interaction and is intended to be iterative rather than prescriptive.  Here’s the poster that goes with the Framework, which outlines a very specific role for the clinician:

Within the co-creating health framework, the role of the clinician is to:

    • Prepare self and patient for interaction
    • Assess the ability of the patient to manage their own health and well being
    • Acknowledge patient expertise
    • Work collaboratively with both the patient and clinician agenda
    • Understand potential outcomes for patient according a number of ‘care aims’
    • Ensure patient understands their condition
    • Ensure patient understands benefit and dis-benefit of potential options
    • Support patient to make decisions about options available to them
    • Support the patient in managing their condition
    • Provide effective treatment or ensure these are put in place
    • Support patient to change their health behaviours where appropriate
    • Review patient outcomes and discuss further options as necessary
    • Ensure that the patient understands when no further progress towards goals is possible and then discharge or refer on as appropriate
    • Understand the likely outcomes for patients by undertaking routine clinical audit and review of the evidence base and findings of clinical research.
    • Continuous engagement in service improvement to offer new interactions
    • Report outcomes of clinical audit to service designers, engage in service redesign activities-particularly to prioritise prevention

So how on earth do we measure it?…
Evaluating co-production: pragmatic approaches to building the evidence base

Catherine Durose, Catherine Mangan, Catherine Needham, James Rees, University of Birmingham 

The authors of this 2014 paper suggest that co-production is ‘one of the few positive storylines in the public service narrative of long-term austerity’. They also acknowledge that we still lack compelling evidence base and suggest two reasons: ‘first, the breadth of the term, its lack of programmatic consistency and its focus on relational aspects of process in an era when performance measures focus on outcomes and impact; and second, the shifting parameters of what constitutes evidence-based policy within government, with conflicting messages about the value of qualitative and case study approaches making it hard for people working in co-productive ways to understand what kinds of evidence are required.’ The authors go on to discuss three potential responses to these limitations, with major implications for traditional approaches to the meaning and purpose of ‘evidence’.