‘To co-produce or not to co-produce? That’s not even a question….’

29.11.19: The highlight of this week was returning to our Centrepoint services in the north, specifically visiting Yorkshire (i.e. Bradford Foyer) and continuing our PIE co-production journey with another meeting with some of the young people currently living in (or having just recently left) Centrepoint services in the region; our ‘PIEineers’. The focus of the session was to continue to work with this amazing group of young people, who give up some their time to advise Centrepoint on the continued development of our Psychologically Informed Environment (PIE). The principle of ‘co-production’ is critical in a PIE, and is defined as; ‘a radical culture of trust, respect and valuing everyone to bring about a positive thriving change in a community’ (Homeless Link, 2017).

So what does co-production actually mean in practice? It is argued by Homeless Link (2017) to mean that staff working within a service as well as those that use a service work together, in collaboration, to design and run services. However, it is more than just a ‘buzz word’ or a ‘thing’ that PIE does without any specific purpose or end goal. Co-production has legitimacy and value because it is noted that ‘when services are genuinely co-produced they work better, because they make the most of the shared experience of the professionals that work there and the people who have experience of using them’ (p.3) (c.f. Homeless Link, 2017: https://www.homeless.org.uk/sites/default/files/site-attachments/Introducing%20Co-Production%20March%202018_0.pdf). This positive outcome happens because ‘services that are co-produced have better ‘buy-in’ from the people using them — if your service is more closely matched to what people actually want (as opposed to what professionals assume they need) then more can be achieved’ (p.5).

Co-production is however also a continuous process, and whilst we are still in the early stages within Centrepoint’s PIE, it has been something that I have focused on since I began this role as Centrepoint PIE Lead earlier this year. Readers of this blog will recall from my previous posts that when I began in post, I embarked on a ‘scoping exercise’ and visited all the currently open Centrepoint services to meet with staff (and young people) to introduce PIE and speak about what they would like and need in our PIE moving forward. I was encouraged and inspired greatly by these conversations, and met some wonderful passionate people from all around the country in the areas that Centrepoint deliver within (e.g. London, Bradford, Barnsley, Sunderland and Manchester). These discussions led directly to the formation of my ideas about what psychological framework or theoretical approach should guide our work with homeless young people (i.e. Attachment Theory; Bowlby, 1967) as well as what the format (and content) of staff PIE training and reflective practice would involve to ensure that it meets the needs of our staff (and young people). More recently (c.f. last week’s blog) the theme of co-production has continued with the generation of ideas for improvements to the physical environments of our services coming directly from our staff and the young people who are currently working or living within our housing projects.

The next step in co-production is argued to be moving towards full involvement of those with ‘lived experience’ in decision making (e.g. what activities they wish to engage in), service delivery, training, recruitment and governance, as well as representing the organisation externally in meetings and events (Homeless Link, 2017). Centrepoint has always involved homeless young people in decisions about local service activities or ‘outings’, sought feedback via our regular young people surveys, developed our wider Engagement Team offers based on the actual interests of current young people, and involved homeless young people at various high profile events. For example, young people performed at our recent 50th Anniversary Gala event (c.f. https://twitter.com/centrepointuk/status/1194706753805520897) and spoke about their experiences at our recent London #CentrepointSleepout event (c.f. https://twitter.com/centrepointuk/status/1197613091023921154). Consequently, I am pleased to continue this tradition of young people involvement by having a couple of ‘PIEineers’ who will be attending the British Psychological Society (BPS) Division of Clinical Psychology (DCP) national conference with myself to speak about PIE early next year.

Full co-production however, means ‘sharing power’ (Homeless Link, 2017); in other words giving the young people who use our services an equal chance to sit at the table and make decisions about how we can run them better. Importantly, it is noted that those in ‘power’ may need to build up the confidence and skills of those young people with lived experience or ‘Experts by Experience’, so that they can participate fully in the process. Consequently, it has been key to myself and other staff present at those meetings that we enable the young people present to share their views and experiences in a psychologically ‘safe space’ that has mutual trust and respect. This has involved being prepared to listen, to always try and see the ‘bigger picture’, to include everyone around the table in the conversation, to communicate clearly and to encourage and develop our ‘PIEineers’. Barriers to engagement (e.g. costs of attending) have been considered, so that we reimburse travel costs, have arranged meetings at times and locations to suit attendees and have provided lunch as appropriate. It has also been important that we have taken action when suggested and fed back outcomes of previous meetings.

This week’s meeting covered topics as diverse as discussion around issues to consider when responding to the PIE Physical Environment applications from a young person’s perspective (both positive and negative!), agreeing a specific question from young people (and ideas for an appropriate answer) for our forthcoming interviews for the new PIE Clinical Psychology roles within Centrepoint, generating ideas for further communication about PIE for young people (e.g. a service video), generating content for the staff PIE training that covers the real life experiences of homeless young people, and hearing the stories of the PIEineers experiences and what has worked well or they would like to see changed in the future. On the train back after the meeting I was truly inspired by the discussion, and impressed by the growing confidence of our ‘PIEineers’ to speak their truth and describe their experiences even over the short time we have begun our PIE co-production process. I left the session feeling motivated and positive, and hope that the homeless young people that attended the session felt similarly, as well as feeling valued and useful, which will support their ongoing journey to #changetheirstory.

I do however appreciate that meaningful co-production takes time, and is a strengths based psychological approach. I have reflected that I still need to do further work to involve homeless young people from our services in London in the PIEineers group, and to continue to recognise the strengths and build the confidence of the attendees so far so that they can act as their own catalysts for change in the future. This is critical so that as part of the Centrepoint PIE moving forward we ‘do with’ not ‘do to’ those that work within and use our services. After all, a core tenet of co-production is ‘nothing about us, without us, is for us’ and therefore, it’s not even an option to not consider the central role of co-production as Centrepoint continues on our PIE journey…