How to manage risk when co-producing services

Many charities, healthcare providers and other non-profits are involving the people who use their services when designing or improving them.

Co-production is a widely recognised way of developing services or policies in a way that meet the needs of users. However, co-production can bring additional risks and perceived risks.

At NCVO 2019, Matt Hardwick, a Zurich strategic risk consultant, gave a presentation about managing risk. He explained how developing a positive risk culture can create the right environment to embrace the uncertainty associated with co-design projects and help achieve positive results.

What is co-production?

Co-production is not simply another way of referring to consultation, collaboration or partnership working.

Co-production is where people who use services work in an equal partnership with professionals in the design and delivery of those services or associated policies. It refers specifically to people with ‘lived experience’ of the service or policy in question.

Find out more information at NCVO’s KnowHow website.

Co-production in action

The Social Care Institute for Excellence (SCIE) has people with lived experience on its board, who are paid and involved in the business of the organisation.

At the NCVO conference, SCIE shared its co-production values:

• Equality (power-sharing)
• Diversity
• Access
• Reciprocity – if you put something in, you get something out.

SCIE has many resources on its website about co-production. It will also be celebrating the benefits of co-production, during co-production week (1-5 July 2019).

NCVO 2019 also heard about Terence Higgins Trust’s Amplifying our User Voice project. This is a three-year large-scale pilot that seeks to involve beneficiaries more deeply in the organisation.

Understanding risk in co-production

Aversion to risk is often a barrier to co-production, and it can be hard to get internal buy-in about trusting non-staff members. Running projects in this way can create actual and perceived risks.

Risk management and risk culture is key to adopting this method of working.

• How would you describe your organisation’s risk culture?
• How do senior staff and leaders approach risk?

How is risk discussed and managed in decision-making processes?

Reviewing your risk culture

Here’s how to understand aspects of risk culture in your organisation using four themes.

• Tone at the top – is ‘risk appetite’ something that your board, CEO, CFO, CRO and managerial staff are aware of? Has the risk culture been defined, debated and agreed, and has it been communicated to all managers, decision-makers and project leaders? How is it being monitored, measured and reported? How is it being reviewed and updated? Are decisions being made based on risk information? How do leaders respond to bad news? Do leaders welcome the disclosure and challenge?
• Governance – are risk accountabilities captured within managers’ job roles and descriptions? Are performance targets identified for risk management? Is there transparency across the organisation in relation to risk management? Do all staff have access to risk information?
• Competency – is there a support structure for the person responsible for risk management? Have risk champions been identified? Is training provided on risk management?
• Decision-making – is the organisation’s risk appetite known and understood, and is the willingness to take on risks understood and communicated to all staff? Are decisions being made with a sound understanding of the associated risks and their consequences?

Risks in co-production

Some specific risks that require consideration in co-production projects include:

• Safeguarding – what additional safeguarding standards do you need to maintain while working with different groups of people?
• Conflicting messages – these can arise internally and externally, from end-users. What can you do to avoid this?
• Accountability – who is accountable if the project or activity goes wrong? Who is supervising the project?
• Cost – management of costs is key, both the direct costs of new services, and the indirect costs of the time spent establishing them
• Staff capacity – what will be the impact on staff time? Will you stop doing other projects or take new staff on?
• Representation – have you involved a representative mix of people?
• External pressures – these can come from other charities starting their own projects and from service users forcing organisations to radically change their delivery models
• Reputation management – how can you mitigate all the potential ways a co-production project could damage your reputation? Addressing many of the other risks mentioned above should help.

How to make co-production projects work

Some tips emerged through discussions at the conference:

• Don’t label co-production as an ‘advisory group’. Use terms such as ‘peer support’ or ‘champions’
• Get better input from people by helping them move beyond their own experience and the services they use
• Don’t think of co-production as a separate thing – have service users/beneficiaries on your board, build them into your CPD, recruit them as staff

Provide support and training to ensure people feel valued. Give them the skills so they can use their lived experience in the most effective way.