Co-production in Research: Barriers and Solutions

By Vanessa Pinfold Here at the McPin Foundation, we are pleased to support the third year of the Social Care Institute for Excellence’ (SCIE) co-production week and its focus on learning. This year has seen the introduction of co-production in research principles from INVOLVE. Below are the key principles and features in the guidance:

•  Key Principles Sharing of power – the research is jointly owned and people work together to achieve a joint understanding
• Including all perspectives and skills – make sure the research team includes all those who can make a contribution
• Respecting and valuing the knowledge of all those working together on the research – everyone is of equal importance
• Reciprocity – everybody benefits from working together
• Building and maintaining relationships – an emphasis on relationships is key to sharing power. There needs to be joint understanding and consensus and clarity over roles and responsibilities. It is also important to value people and unlock their potential.

Key features

• Establishing ground rules
• Ongoing Dialogue
• Joint ownership of key decisions
• A commitment to relationship building
• Opportunities for personal growth and development
• Flexibility Continuous reflection
• Valuing and evaluating the impact of co-producing research

In my experience it is the “how to” part that is the most difficult, reports from Australia and UK (South West England) are particularly useful giving tips and case studies as well as exploring ideas that provide a conceptual foundation. McPin were interviewed for the INVOLVE guidance project illustrated above. We fed in our experiences of collaborative work with university departments for large multi-centre research trials of complex interventions for mental health. Something we emphasised was the importance of collaboration between three main groups: (1) service users and carers, (2) practitioners and clinicians and, (3) researchers; this is known as tri-part collaboration. We have used this model several times now for developing and delivering a research project. While it is not always easy, it does lead to work that draws on the expertise and experience of all three groups. The combined expertise of people who fall into more than one of these categories is useful in the promotion of sharing ideas and learning from each other. One example of this in practice at McPin is research on loneliness with a team at UCL, which bloggers Angie and Jackie describe in a summary about their involvement in recruiting staff to deliver a new approach. Drawing on the example of the same study, I recently spoke about the importance of relationships and building trust within working groups. At an end of study feedback session, expertise was shared, and different contributions were valued which included:

• The lead researchers talking about the key findings, having shared their slides in advance with other members of the research team;
• A discussion panel that was formed involving a research team member, a person delivering the intervention and practitioner working group member.
• Working group service user members deciding to talk about their work through a question and answer interview session, supported by some background information our co-production approach.

Nothing is perfect, and we all still have much to learn. Each project can be improved, and it is our intention to learn from each and seek to develop new ways of co-producing research. Openly discussing the barriers and looking together for collective solutions is key. Each project is different and how power is shared can be negotiated and each research project varies. Recently I have been trying to write a paper about co-production with twenty-one authors! This is not an easy task but a very important one.  Peer review journals are not set up for collaborative writing. Who is the ‘lead’ author? And who decides on the ordering of authorship? This is not a unique challenge, but in mental health, where too often those ‘in power’ have made decisions impacting on the lives of service users and carers, with negative and oppressive consequences, this really does matter. In our co-production paper, everyone is inputting into the writing, so should we write as a collective with no individuals named? No decisions have been taken yet. How such decisions are made in our experience is part of the co-production journey and careful thought is required. That is a familiar theme - thoughtful and careful working - because co-production in research needs to be well planned, time is needed to build and maintain relationships, honest and open conversations (difficult ones too) are necessary. I have learnt so much in the last five years of working at the McPin Foundation and continue to do so on every research project I am involved with. Thank you SCIE for putting the spotlight on co-production. Let’s keep sharing the learning as that will improve all our work.