A year has passed under lockdown measures, and commissioners are balancing business as usual with managing the impact of projects mothballed at the start of the pandemic. One such casualty of the first lockdown was our carers’ support service, a collaboration between adults’ and children’s services across two local authorities and the local clinical commissioning group. The contract, then about to expire, was extended by a year to allow commissioners to focus on immediate, Covid-based pressures. Planned co-production with children, young people and families was rescheduled for the 2020/21 academic year, when we anticipated those pressures would have passed.
TOP TIPS FOR CO-PRODUCTION
- Review and utilise feedback that already exists before planning further engagement.
- Be prepared to go back to the drawing board if the outcomes of co-production do not meet your expectations – this may involve planning for a longer commissioning cycle but will ensure the service is designed around needs rather than assumptions.
Challenges to traditional engagement
As Christmas approached it was clear that we needed to fundamentally rethink how we co-designed the young carers’ element of the specification and outcomes framework. Social distancing and school closures meant that face-to-face access to young people was restricted, and the engagement of this cohort with virtual activities was increasingly limited by the additional strain that Covid-19 placed on their caring role and feeling unable to speak freely when a parent (often the cared-for individual) has control of the home internet. Families where parents were shielding or caring for a disabled child also had more urgent priorities than responding to calls for co-production.
Simply designing a specification based on practitioner knowledge of users’ needs was not an option. Section 19 of the Children and Families Act 2014 makes clear that local authorities, in carrying out their functions under the act, must have regard to the importance of children, young people, parents and carers participating as fully as possible in decisions about their individual care. Authorities must also ensure that these service users are involved in decisions about local provision.
In addition, co-production was the right decision ethically, to foster a culture of children and young people’s ownership of the services they use and commission better outcomes grounded in their needs, wishes and feelings. As the impact of the pandemic on councils’ financial situation became clear, we knew we had to develop a better targeted service that would avoid costs in future by delivering the support that was most needed.
Assets-based approach
In early 2021, and with time running short before the contract end date, we were able to engage with the newly appointed NHS carer and patient experience lead for the region and build a co-production approach focused on filling the gaps in our knowledge. We already had extensive qualitative data from Bedford’s Parent Carer Forum, schools, early help practitioners and children and young people from previous engagement around developing the commissioning options appraisal that we could draw on.
The council’s children’s participation team had also been working directly with the incumbent provider and young people to develop a series of podcasts about their experiences of being young carers, and were able to share this powerful first-person narrative with commissioners.
Working with operational and communications teams in both local authorities, we developed a set of web-based surveys for parents whose children cared for either them or a sibling, with questions focused on support currently received and where the gaps were.
To reach as wide an audience as possible, these were shared directly with families engaged with the current provider, adults’ social care and children with disabilities teams, as well as publicised by both authorities’ parent carer forum and internal and external mailing lists.
To reach children and young people, we channelled engagement through the provider’s social media networks and concentrated on the support young carers found most helpful and the outcomes they achieved as a result.
By making the effort to reach out to young carers, we were able to develop a specification that meets their needs and rises to the challenge of delivering effective services under pandemic conditions. Due to wider than anticipated provider interest, the new contract is now planned to commence in April 2022.
- Toni Badnall is senior commissioning officer, children and public health, Bedford Borough Council
FURTHER READING
- Young Carers – Welcome To My World, Bedford Borough Young Carers, March 2021
- Today on Young Carers Awareness Day – How can you help a young carer in just 5 minutes? NHS Blog, January 2020
- Co-production in social care: What it is and how to do it, Social Care Institute for Excellence Guide 51, October 2015
