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A Year of Co-production: What Have We Learned and What Is To Come?
By Rory, on 17 December 2020
Publications from 2020 confirm that interest in co-production is gathering pace. But from some perspectives, this approach to research is unwanted, unhelpful, or unrealistic. In this review, Rory takes a critical look at co-production and the new frontiers we can look forward to as it continues to develop.
What is the role of the past in our lives today? Can we achieve any meaningful change in the culture of healthcare research without profoundly challenging traditional views of what research is supposed to be? Photo credit: Mika Baumeister
‘…the assumption of reaching consensus through co-production […] poses a challenge to academics who see the role of academia as providing dissent and critique, rather than consensus’ — The Impact Agenda: Controversies, Consequences and Challenges (2020)
This year, researchers of the University of Edinburgh and the University of Strathclyde brought us a book (The Impact Agenda) that discusses a great many issues around the role of research and the UK Research Excellence Framework (REF). For anyone involved in co-production, the book’s focus on research impact is very useful, as are the discussions in it. Is it still true, as the traditional view suggests, that impact is the benefit of research to society? Are there alternative methods for research to serve society, and if so, how do individual academics feel about those alternatives?
‘… focus on co-production additionally calls attention to the idea that social science can itself affect the social and political world, imagining and enacting new social problems; an idea that stretches rather beyond current approaches to research impact.’
Stretching beyond the current approach is a very touchy subject because, for one thing, it questions the autonomy of those who firmly believe in what is traditional. The book reports that co-production appears problematic to those who, instead of collaboration, favour an approach of improving from within by ‘igniting change in the existing systems and institutions’. One academic saw the co-production approach as ‘very transdisciplinary’, challenging of academic independence and what the role of the academic is.
Co-production is indeed very difficult to do while holding on to autonomy and separation. This isolated work model certainly lines up neatly with the traditional view of academia, but does not mean that this type of productivity serves the greater good in a meaningful way. This dilemma between being productive on paper and being helpful to society in a more genuinely charitable way is explored at length. Reading the quotes, I got the feeling that there is a real gulf between choosing to ask yourself how well your work will serve society and how well it ticks off the right boxes on funding applications.
‘Over half of the participants differentiated between what they considered to be a “genuine” impact and the impact produced or reported as part of the REF impact assessment exercise or articulated prospectively in grant funding applications.’
This “genuine” impact, described as ‘emerging almost spontaneously, without steering, control or monitoring’ was sometimes perceived as having greater substance. To me, that sounds a lot like the beginnings of sharing power and going down the trail of co-production. But the problem is not that many don’t go down that “genuine” impact path, but that this differentiation even exists in the first place. What’s even more concerning is that the choice between the two might not even be available in some people’s minds, because, as one participant said, it lies ‘somewhere else in the university’.
Meeting the Challenge
Particularly interesting are the points the book makes about intermediary organisations. The Collective plays sometimes contradicting roles as we support those within and beyond academia, and as the book suggests, this does create tension. Doing right by each stakeholder is impossible to do, as a one-person team. But we don’t have to make decisions alone if we practice co-production in everything we do. Tension is unavoidable but it’s not a bad omen. Especially in the case of co-production, it is a sign that preconceived notions are being tested and may have to be changed. Anything worth learning comes at a cost of some discomfort, letting go of some concepts to make way for new ones. This is what makes co-production valuable, the continuous learning cycle that it requires to function.
Out with the old, in with the new? Not necessarily. Even something as traditional and old as the British Museum was revolutionary at one point: being the first to belong to neither king nor church. It has retained its cultural relevance by embracing its past and acknowledging that its beginnings were at least partly financed through enslaved labour. Photo credit: Yuya Hata
Putting our ideas into practice is of course a challenge in itself. A 2020 case study of co-production in research communication found it unlikely that academic institutions would provide researchers with enough time for co-production because the time that is available is ‘ultimately tied to professional structures and culture, with researchers feeling pressured to demonstrate high scholarly output in academic journals’. For most projects, co-production must be scheduled towards the start of the project and decisions should be co-produced at the grant application stage. So, while it is possible to incorporate co-production into even a randomized controlled trial, it ‘adds time to a research project’ and ‘despite best intentions, may become tokenistic if those conditions are not met’. Another study advocating for co-production (Drawing straight lines along blurred boundaries) also warns us to take time and effort to ‘move beyond tokenism and overcome the gap between language and practice’. This collaborative process can create wonders but it requires arguably more time than the traditional, linear forms of knowledge production, as it’s pointed out by Sara A. Kreindler in her comment When Co-production Is Unproductive.
‘Even when co-production is undertaken, barriers remain that impede this enterprise from generating knowledge that is useful and/or used. The better the barriers are understood, the greater our prospect of creating conditions for success.’
Knowing all this, is it unrealistic to embark on different approaches to research especially now, amidst all the chaos of an ongoing pandemic? In their editorial for the BMJ (British Medical Journal), Tessa Richards and Henry Scowcroft argue that in 2020 the ‘co-design of services is still uncommon and co-production of research is not widely achieved’. Yet, they maintain that this is exactly the time for more involvement. Commenting on the specific challenges that the pandemic has and continues to present, their conclusion is that while the outlook is gloomy, the way is forward, not backwards.
‘Despite decades of activism, public and patient involvement is still largely seen as “nice to have” but non-essential—a second step to be carried out after an initial round of consultation with academic, clinical, public health, and policy experts. […] The knowledge to confront these challenges needs to be co-produced. Patient and public involvement must be taken seriously, embedded robustly, and never side-lined again.’
And in light of the UK Research & Innovation ethnicity analysis of funding applicants and awardees published this week there is clearly still a MASSIVE amount of work to do in moving towards a situation where genuine co-production can be common place. As UK Research & Innovation Chief Executive Professor Dame Ottoline Leyser, outlines:
‘These data spotlight the stark reality of the persistent systemic racial inequalities experienced in the research and innovation system. They are profoundly upsetting, but perhaps the most upsetting thing about them is that they are not surprising.’
A scary thought to leave this blog on but one that we hope galvanises a lot more people, departments, institutions and organisations into action. The lack of equity in the research and innovation system needs tackling before co-production can truly become more widespread. This inequity is something that we remain committed to challenging and changing as we continue to develop as a Collective.
Are you with us?
Continuing the Conversation
Please get in touch with us at Co-Production Collective and share your ideas about the future of co-production. You can comment below or feel free to email us at coproduction@ucl.ac.uk
We are aware that not all of the resources listed are free to access – if you would like to read any of the included articles or books but are unable to access them please get in touch with us and we will see what we can to do to help.
One other thing to mention… we are very excited for our first event of 2021, on 7 January at 14:00 (UK time) we will be co-creating our new website, so come along to our online session if you have creative ideas to share or just fancy getting involved! Email us at coproduction@ucl.ac.uk to register.
Fancy reading more?
If you would like to read more on the subjects of this blog, have a look at these suggestions:
Chapter 9 is especially relevant, exploring how co-design/co-production and quality improvement can come together to improve healthcare services, proposing that though these three elements have developed in parallel, more closely aligning them is to their mutual benefit, and giving practical consideration to this exciting get-together of approaches.
‘Participation, user involvement in one sense, is not rocket science. It doesn’t demand vast amounts of specialist knowledge or special qualifications. Some might say it is mainly a matter of taking trouble and common-sense. That might in one sense be true, except many service users might conclude that there is a very common lack of common-sense around if that is the case, because they have so many experiences of poor and unpleasant involvement.’
