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Co-creation, reflection and challenging the status quo! What’s next for the Centre for Co-pro?

ucjunhu20 December 2018

This blog is written by Niccola Hutchison Pascal, reflecting on the year since the Centre for Co-Production in Health Research starting on it’s journey.


Hey everyone 🙂 So I thought it was about time that I share some (of the many!) thoughts spinning around in my head! Sorry for those of you that have already been subjected to my reflective thinking!

Eight flamingos drinking from a lake, their image is reflected in the water they are standing in (Image credit: Scene360.com)

It’s been a little over a year since we started out on this journey to co-produce the set up of the UCL Centre for Co-production in Health Research… that went quick! As a Centre we want to champion genuine co-production of health research, services and policy development and build a case to support this way of working where there is genuine sharing of power and decision-making. What have we learnt so far? And, what specifically have I learnt? If I had to distil it down to one sentence, I’d say…

Co-production takes commitment but it is oh so worth it! If done in a genuine way the mutual benefit and the visible difference it makes to those involved (including you and me) is immense!

Group session with people discussing Centre development plans – posit notes and papers are all over the table

What are these visible differences am I talking about? As part of the Centre development work, we are working hard to build the ‘case’ for working in this way so that we can start to mobilise more support for the use of co-production in research. It’s early days but I would say it is becoming clear (from our work to date and previous work by others) that… co-production/co-creation improves the practical applicability of outcomes, it builds trust, it improves relationships between all groups involved, and it contributes to more cohesive communities. The communities that we are ALL a part of.

What are some of the challenges?

As with any project, there are always challenges. We are working hard to ensure we are embracing genuine, authentic co-production – we don’t get it right all the time but the key thing is that we are all learning from each other (plus some great projects that are already live) and developing as a team along the way. No judgement or target chasing here! One challenge in particular is ensuring the sharing of power and breaking down of hierarchies. Let’s be honest, UCL is a huge hierarchical institution, and the funding from Wellcome Trust for this project is sitting within it, which has resulted in challenges – people sometimes feel uncomfortable (perhaps due to preconceptions or past experience) to question the organisation and or the way public engagement and patient public involvement has previously been done. How do we break this down, level the playing field and ensure that shared decision-making can take place? Well, if you ask us we would say that we don’t always get it right but we are a team and are open and honest about the challenges, we work through each one as a team until we find a practical solution. We set up co-creation sessions (using facilitated group work) so that everyone in the team knows that their views are of equal importance and has equal chance to have their say. We each have a unique set of skills and experience that we bring to the team. Relationship building and us all feeling we can trust each other, is key to ensuring that we all feel comfortable in pushing the boundaries. In addition, we are regularly talking to people from across UCL and the local community of Somers Town (plus more widely) about the aims and objectives of this project in order to raise it’s profile (more work to do on this in 2019!). UCL are 100% committed to this work (and the large amount more that we need to do!) and as a team of collaborators, we are clear that we want to challenge the status quo within health research – full stop.

Illustration of the different roles in a co-production team (Credit: Beth Ingram, Common Room)

Back in August we assessed applications and chose (as a mixed group of Centre collaborators that included patients, carers, local residents, students, researchers, and healthcare professionals) to fund four pilot projects. As a Review Team we put our trust in each other and as a result came out with a cracking set of pilots that are helping us to address practical questions around how we go about setting up the Centre. The learning from all of these pilots will be fed back into the development of the Centre (you can read more about this in our last blog). I’m pleased to share that there is also one more pilot funded by partner organisation Moorfields Biomedical Research Centre (thanks Moorfields!) that is now part of the fold! Sorry it took me so long to share! I recently caught up with research nurse Jac (who is part of the pilot team) for the ‘We Ci2i – We Co-design interventions 2 improve’ project, for a chat. Here is what she had to say after she attended one of the Centre training programme development co-creation sessions…

It was so great to be in a room with like-minded people and being part of an innovative movement. It helped me understand more about the Centre, what it is all about and the direction it is heading. The session was fun and the facilitators were excellent at getting us all working together. We had really useful discussions on our tables about hurdles we may face trying to co-produce and thinking through what a successfully co-produced piece of work would look like.

It was really interesting hearing Common Room highlight how some people work in this way (i.e. utilising co-production) naturally, without even thinking about it; these types of people wouldn’t approach a project in any other way. I identify with this approach and perhaps naively assumed everyone would be on board with a project developed in this way. However, it is not until you start trying, that you realise some constraints in the bureaucracy of research, act as difficult barriers to navigate.

Co-creating a learning programme and supporting resources

Around the same time that we funded the pilot projects, we also took the same collective approach to deciding which organisation to appoint to help us in co-creating a training programme and supporting materials to help us learn. As a mixed group of Centre collaborators the organisation that we took on is…. Common Room!

Common Room logo

Meet the team at Common Room

Hi. I’m Kate. I run Common Room, an organisation which seeks to bring together people who have lived experience of disabilities and health conditions, researchers and healthcare providers to improve services and ensure that people have more choice and control in their lives.

Hi there, I’m Beth. Because of my own experiences of serious mental health issues and being a carer, I now run a peer support charity called Hearts & Minds. I am also a young advisor for Common Room and have a YouTube channel called Community Conversations (make sure you check it out!) about all things to do with youth work, mental health, disability & lived experience. I am passionate about improving the situations that marginalised or ‘vulnerable’ people often face and believe that the best solutions come from community, collaboration & honesty.

So… what’s next for the Centre?

The holiday break! Yes! 🙂 And, after this… well, we will be getting back on it of course! There is plenty to do. We are going to be doing some big picture thinking, we have plans to bring together a group of funding bodies, from health research and wider, to start to tackle the ‘bureaucracy of research’ as Jac put it. We want to kick start a conversation (and action!) about the constraints current funding application methods and processes put on groups who want to co-produce and how we might change these. In addition, we will be starting work on a website for the Centre and exploring names, logo’s etc. Exciting times!

One other thing…. have you heard about the UCL Provost’s Public Engagement Awards? As you may be aware, the Centre development is part of a wider culture change piece of work to bring UCL together as an institution and to ensure it is more outward looking. To work towards embedding public engagement, patient public involvement and co-production as a standard part of research/way of doing things within the university. Therefore, the awards are a perfect opportunity to amplify our message by highlighting some of the great co-production/co-creation work going on! They are open for applications from both community partners and UCL staff and students – go for it! If you have any questions feel free to contact me, Niccola.

The Centre is very much open to all who want to be involved, please feel free to get in touch if you want to join us.

Thanks for an amazing 2018 everyone, happy holidays! Looking forward to 2019!!
Niccola

Our trip north of the wall: reflections on 2018 Engage conference

Lizzy Baddeley12 December 2018

“Twas the month before Christmas, when all through the UK
The public engagement professionals were coming out to play”

Every November, the UCL Engagement team makes a yearly pilgrimage to the Engage conference, a national gathering of engagement professionals organised by the National Coordinating Centre for Public Engagement (NCCPE).

It’s a chance for us to take some time out and reflect on our year in engagement, hear from others about their successes and failures, and to think about the future. This year, it was also a great chance for some of the newer members of our team to learn more about the public engagement sector as a whole.

In 2018, the conference was held in Edinburgh over the final two days of November, which was a great setting and meant that there were lots of different faces to the last few years’ location of Bristol. It was also the 10th anniversary of both the NCCPE and much of our public engagement activity, which is highlighted in our series of blog posts on the UCL 10 year public engagement anniversary. As such there was much reflection on what has gone before, and where we might be in another decade.

Here are some team reflections on what we learnt:

Lizzy Baddeley – Project Manager in Community Engagement (East) team

The highlight for me was a really interesting session about ethics and public engagement, co-hosted by Sarah Anderson (University of Edinburgh) and Dawn Smith (Edinburgh Napier University). Ethical engagement is something that our team has been thinking about a lot this year.

In the university sector, research involving living participants or data coming from living participants must gain ethical approval to ensure that the research conforms with general ethical principles and standards. This involves submitting the detail of your research to an ethics committee for review.

Public Engagement activity naturally involves working with living participants, but if this engagement is not directly feeding into research, then where a researcher might need to seek ethical approval for their public engagement project is not clear.

But what if an engagement activity does turn into part of the research further down the line?

Even more importantly, what guidelines should a researcher follow when it comes to thinking about how to ethically run their engagement, regardless of whether there is an official board to review their practice?

And above this, who is saying what is ethical? Whose ethics are we conforming to?

All these questions were raised and as a group we thought about some of the implications of these questions, and possible solutions.

For me, this was a fantastic opportunity to think about how we could involve external communities in the process of setting ethical standards and the review of activities. So watch this space!

Louise Dredge – Public Engagement Manager, School of Laws, Arts and Humanities, Social and Historical Sciences and the Institute of Education

There were a couple of things I experienced that stayed with me. Firstly the discussion and examples in the session between Val McDermid (best-selling crime writer) and Niamh Nic Daéid, (Leverhulme Research Centre for Forensic Science, University of Dundee) on Learning by Narrative and using stories as a means of explaining complex things.

Secondly, in the Facing the Future plenary session, Nike Jonah‘s spoke about Standpoint Theory, an important concept in thinking about where knowledge lies in communities. This theory posits that the further you are from the centre of power, the more you know. As an outsider to the dominant group you have to understand the viewpoints of that group or groups in order to get by, whereas those at centre of power don’t necessarily have to reflect on orinclude more marginalised groups.

Finally, I was very interested in the statistics shared by Jennifer Wallace from Carnegie UK Trust around the trust in academic evidence vs how much it is used. Their evidence suggests that 63% of public policy and practice professionals trust academic evidence, but only 35% actually use it. We need to rethink how we share academic outputs as well as co-create research to allow this figure to change.

Helen Craig – Public Engagement Manager, School of Life and Medical Sciences

I really appreciated the session on training with Helen Featherstone (University of Bath); Heather Lusardi (NCCPE). There were some good discussions on co-producing training with external communities and what that would look like, as well as sharing methods to produce a cohort, which is something we would like to do better.

The Science Theatre session was also very interactive and involved mime, which was a fun change on a Friday afternoon!

Georgia Pitts – Public Engagement Manager, School of Bartlett, Engineering, Mathematical and Physical Sciences

Day two was a bounty of good practice and useful ideas to take forward into what we do here at UCL. I also attended the session run by Helen Featherstone and Heather Lusardi, which was all about public engagement training for researchers. I’m responsible for leading on our training provision this year, so this was top of my list of sessions to attend – and it didn’t disappoint. We talked about how we can ‘practice what we preach’ and co-produce the training we offer with researchers, with a learner-centred model. This would ensure that our training is really hitting the mark in terms of addressing needs in the researcher community. A hot topic of discussion was how we can match skills development through training with opportunities to try out engagement – something which we have been mulling over here for some time, and as a result of this session I’m excited to have some points of reference to draw on. Watch this space!

Briony Fleming – Community Engagement Manager (East)

I personally enjoyed learning a bit more about Affirmative Inquiry – a process of thinking of things in a positive light from delivery to design to destiny, as a tool for both forward planning and strategising. This helps to move you out of situations where people can often default to being negative when reflecting or planning.

I also enjoyed Edinburgh itself, not just because of the food, but because I think it’s good to move away from the south of England where often big conferences are based.

Finally I enjoyed the ‘Public Engagement Card Deck’ creative project planning tool from University of Birmingham – which I have been telling everyone about. It allows you to think about scenario-planning and taking perspective in the form of a game, which allow you to collectively think through some of the challenges and opportunities in a scenario you have been dealt from the pack. It was good at highlighting how often public engagement activities have to respond to things beyond their control! Hopefully we can think about ways to include this in our training

Marie Xypaki – Curriculum and Public Engagement Consultant

I enjoyed the Engaged Learning session delivered by Bristol University and Bristol Green Capital. It was very interesting to see existing approaches to public engagement in university teaching and learning and it seems that there is great work on embedding a real-life challenge to dissertations.

There doesn’t seem to be concrete work around embedding engagement into the whole of the curriculum which gives space for innovation.
It was also very interesting for me, as someone new to my role, to see how diverse the practice around Public Engagement is and that there isn’t one definition or approach. Engage gave me the opportunity to reflect a lot around public engagement and how we deliver it in the sector. I’m still pondering…