Over the past four years, the National #CoProWeek has been emblematic of an opportunity to celebrate the benefits of co-production, spread awareness of it across the fields of health and social care, and broaden the knowledge about its practical implementation. The theme characterising learning opportunities and social events available during the 2019 #CoProWeek (1-5 July) was ‘Sharing power’, which remains one of the key principles of co-production. It was also my first year of active participation; although my original intention was receiving answers to resolve doubts arising from my reading, I ended up with more questions than answers. In particular, listening to the myriad experiences shared by experts (by knowledge and experience) left me wondering whether I will be ever brave enough to co-produce.
The genesis of co-production can be traced back to research involvement opportunities often identified by many as PPI (Patient and Public Involvement) activities; however, the conceptualisation of co-production entails more than consultation and/or collaboration at various stages of research. Indeed, co-production provides the stakeholders relevant to the topic of inquiry with a credible voice besides offering them a seat on the coveted decision-making table. Put succinctly, anyone who accepts the researcher invitation to co-produce a research project will practically be seated at the King Arthur’s round table; as such, everyone will be entitled of equal status, given that the table lacks a head. If I think about co-production on these terms, I get excited already; however, getting back from co-producing research in the ideal world of King Arthur, and looking at the real (constructed) world of (unpredictable) research, I do wonder whether perhaps it is easier said than done.
During my experience as a nurse working within a multidisciplinary team, and as an early-career researcher currently collaborating with a research team, I learnt the importance of getting to know each other, respecting the opinions of each other, and trying to benefit from the personal and professional experiences that everyone is generous enough to share. Nevertheless, doing so takes a long time and team effort that is crucial to building a trustworthy relationship. In other words, I believe that, before the commencement of co-production, researchers and partners would do well to sit together at the round table and spend some quality time being clear and honest about what they can bring to the table; what are their expectations; and to what extent they are willing to share power as well as the accompanying responsibilities resulting from it.
Additionally, in order to promote real co-production in practice, researchers should start deconstructing the leading role they probably been taught about or simply, they are used to perform. Inevitably, that takes time, training, experience, and most importantly, courage. This is because to me, the opportunity to ‘say the last word’ in the unpredictable world of research has never really been a matter of power, but a timely reassurance that I would be able to cope with whatever comes my way, after giving due thought to the pro and cons of the underlying situation. As a researcher with limited knowledge and experience of co-producing research, and very much on a learning-path, this may explain why I strongly feel that:
Sharing is (s)caring!
It must take a lot of courage to exhibit the willingness to face the responsibilities and challenges that accompany the co-production practice and that need to be added to the already existent aspects related to the research study object of discussion. To this end, I wonder whether all researchers embarking on co-production are indeed fully aware of what this journey entails and then, whether they choose consciously rather than being encouraged by policy makers and funders. Also, are people who are involved as partners always informed about co-production and how it differs from other research involvement activities? If sitting at the round table denotes an informed choice, researchers would perhaps be more encouraged to share the decision-making power. This, in turn, would make all the people involved would feel more comfortable and confident in co-producing research.
Mentioning power among the key principles of co-production and considering it as a fundamental element of research practice makes me opine that the top-down model of research involvement is finally over. Co-production is essentially about achieving the latent potential of research that entails preferring mutual understanding and joint decision-making over the leadership of one or a few individuals. I truly believe that today, there are compelling reasons for being supportive of the #GoCoPro campaign (referring to a slogan that I created myself). Nevertheless, I would respectfully encourage my peers interested in doing so to carefully reflect on whether it is appropriate and what it takes to do it properly. Should any difficulties arise, perhaps, a different, well-calibrated involvement activity strengthened and illuminated by the presence of experts by knowledge and experience at its core is no less worthy.
Ester Bellavia is a Alzheimer’s Society funded, PhD candidate at Newcastle University. Currently conducting a research aiming to explore the role of Patient and Public Involvement in dementia research and explain how best to involve people living with dementia and family carers. A basketball player and fan, originally from Italy with a background in nursing both overseas and within the NHS, where she also completed an NIHR funded MA in Research Methods at the University of Nottingham.