Post on 23-Jan-2018
transcript
Co-production in Secure Settings
Frank Reilly
Definition that works in forensic settings
Examples
Methods
Early results
Toward skills
Project Objectives
Background: High Secure Settings
•Restricted liberties
•Required programme of care
•Managing risk a high priority
•Dual purpose: protect the public/patients
and provide mental health care
‘Co-production is a slippery concept’ (Adults’ Services: SCIE Guide 51)
-in high secure settings it can also be threatening
Background: Definitions
Co-production assumes that individuals have:
*Assets that can be engaged in achieving self actualisation (Harrison et al 2004)
*Potential for increasing independence and ‘citizenship’ or social responsibility(Gershon 2004, Lyons 2006)
*Potential for the reduction of reliance on formal care and agencies(Boyle and Harris 2009, Leadbetter 2004)
‘To be truly transformative, co-production requires a relocation of power towards service users. This necessitates new relationships with front-line professionals who need training to be empowered to
take on these new roles’ (Realpe and Wallace 2010, p3)
Examples: Ward talking groups
•No explicit ‘rules’....but the participants create
them
•Hierarchy ‘suspended’
•Not ‘assessed’
•Engages
Co-production exists when trust, the support of autonomy and the sharing of knowledge as power (both from and to the patient) result in outcomes that are personal to the patient/client.
Issues
Importance of relational security
Managing complex and shifting boundaries
Reaction to failures/complacency
Potential Benefits
Reinforces hope
Improved understanding
Reduce violent incidents
Improve engagement in treatment
Project in action:Methods
•2x low secure sites (1x NHS, 1x private)
•1x High Secure site
•Potential comparison site in Ireland
•Staff focussed (ethical issues)
Project in action: Methods
•Purposive sample of recovery oriented staff
•6x semi-structured interviews each site (n=18)
•1xvignette focus group each low secure site
•2x iterations of Delphi questionnaire (‘wisdom
of crowds’)
Project in action: Early
results
•Relational security relies on apprentiship
•Private clinic restructured: values based for
relational skills
•Difference between staff who rely on structure
to those who build on it
•Organisation who value social therapy reap
benefits: lower assaults, better engagement
Where is the fit?
Relational security Co-production Recovery
The challenge?
Organisations that don't co-produce with their staff find it difficult to facilitate co-production with their consumers