The Leadership of Co-Production in Health and Social Care Integration in Scotland: A Qualitative Study

Abstract

The involvement of citizens in the production and creation of public services has become a central tenet for administrations internationally. In Scotland, co-production has underpinned the integration of health and social care via the Public Bodies (Joint Working) (Scotland) Act 2014. We report on a qualitative study that examined the experiences and perspectives of local and national leaders in Scotland on undertaking and sustaining co-production in public services. By adopting a meso and macro perspective, we interviewed senior planning officers from eight health and social care partnership areas in Scotland and key actors in national agencies. The findings suggest that an overly complex Scottish governance landscape undermines the sustainability of co-production efforts. As part of a COVID-19 recovery, both the implementation of meaningful co-production and coordinated leadership for health and social care in Scotland need to be addressed, as should the development of evaluation capacities of those working across health and social care boundaries so that co-production can be evaluated and report to inform the future of the integration agenda.

Perceived impact of formulating, implementing and enacting national mental health policies recommendations in practice: An exploratory qualitative study within child and adolescent mental health services in Scotland

“…To this end, more work needs to be done to create a ‘national lever’ that clarifies complementary roles and lines of responsibility needed to provide the necessary political and social basis for building a coherent mental health agenda. 25 …”

Can a local model for social prescribing be successfully recreated in different areas? Lessons from a co-production initiative in Nottinghamshire.

“…A key challenge at the start of any initiative employing co-design and co-production as methods of engagement is to define exactly what such approaches are both theoretically and in practice. Connolly et al, (2022) explored the meanings given to such approaches to stakeholder engagement in a review of co-production and co-design efforts in Scotland. They wanted to find out if there was firm evidence that such approaches could support the integration of health and social care services and if such efforts resulted in sustainable activity.…”

“…They wanted to find out if there was firm evidence that such approaches could support the integration of health and social care services and if such efforts resulted in sustainable activity. Connolly et al, (2022) concluded that co-design and co-production as approaches to achieving broad engagement across stakeholder groups have diverse meanings across different professional and practice contexts. Often these approaches were employed with no specific underlying theory or coherent framework, co-design and co-production were simply assumed to entail a "joint effort" and be regarded as offering unquestionable benefits (Connolly et al, 2022, p. 7).…”

“…In the context of social prescribing, co-production recognises that individuals in the area possess valuable knowledge and expertise regarding local needs and preferences, which can significantly contribute to the development of personalised, contextually relevant interventions. By actively engaging service users and stakeholders in decision-making processes, co-production facilitates a more inclusive and empowering approach to service delivery, fostering a sense of ownership, and promoting social accountability (Connolly et al, 2022).…”

Embedded and exterior practices of cross-sector co-production: the impact of fields

“…Cross-sector co-production involving volunteers in the production and delivery of public services has come to the forefront of many advanced welfare states across Europe and elsewhere (Voorberg et al, 2015;Brandsen & Verschuere, 2018;Connolly et al, 2022). Increasing pressure on public welfare economies has led to a new agenda of increased nonprofit and voluntary involvement in welfare policy fields, such as elderly care, childcare, labour market activation, and integration of refugees and immigrants (Christensen et al, 2009).…”