Working on the TP-CKD project I have been struck by how exciting the vision of the programme is. The underlying message that imbues the whole programme is that patients have skills and knowledge that are an asset which is currently going to waste, and by working closely with them a service can be delivered that both professionals and patients benefit from. The NHS has come a long way in recognising the value of the ‘patient voice’ through consultation with patient groups, and the encouragement of patient representation. But perhaps there is still an element of ‘it is the professional who is capable of doing the work.’ One of the innovative aims of this programme is about unlocking the practical skills, knowledge and confidence of everyone – equally – including people who receive services.
What is co-production?
Co-production ultimately means equality. Equality is gained by valuing and sharing skills, knowledge and experiences from people using the service and professionals delivering the service. Taken to its zenith co-production can create opportunity for professionals and patients and their families to work together planning and delivering services.
However we mustn’t be confused that co-production just means service user design or user voice initiatives and consultation exercises – they are part of the picture and then some more.
Co-production is about more than involving and engaging people, or asking for views, opinions and perspective. It’s about truly working together to create something new and different that meets everyone’s needs and improves the lives of those who are affected by the disease, as well as the service overall. In a spirit of partnership and equality and by valuing everyone’s contribution, the TP-CKD programme has the potential to have an impact and improve many lives.
What does this mean for the TP-CKD programme?
The programme held an important kick start event in November last year which unit teams, comprising patients and professionals involved in the project, were invited. We had spent many weeks planning this event but it was only when I was aware of the diversity of the audience did I realise that we were right at the beginning of the journey of co-production. Whilst is easy to say that everybody has an equal voice, it is not always easy to achieve and everyone needs to reflect upon the skills required to develop this relationship. Ultimately the relationship will be radically different with people with CKD gaining confidence to share their experiences and knowledge with their professional colleagues to plan their individual care and future services. From the other perspective professionals have to be prepared to change too and develop a range of skills that support such transformational change resulting in a rebalancing of power and control.
This is a different approach to healthcare that we might believe we already do, but at the heart of it is mutual respect and realising people living with CKD are in themselves the significant asset that is currently undervalued.
Rachel Gair
Rachel is the Person Centred Care Facilitator for the Transforming Participation in Chronic Kidney Disease programme and in this role she works closely with the clinicians and patients involved in the programme. She is the Expert nurse Specialist on the Programme Board and is also on all three of the workstream groups and the communications sub-groups. Rachel is a Registered General Nurse and trained at Hammersmith Hospital in London.
Rachel has worked at several large renal units and was the matron for renal services in Plymouth for 10 years. Following this she was the nurse director for the Peninsula renal network where she developed a special interest in improving services for young people with kidney problems, linking it to the concept of person centred care. She set up and currently coordinates a national network for professionals interested in young people’s services and how these can be underpinned by person centred care. She was also involved in developing a generic draft service specification for the transition of young people from children to adult services during her time at NHS Improving Quality.
When Rachel isn’t travelling the country meeting renal teams and patients she’s looking after or riding her horse, gardening, running (up to a half marathon) or reading and she enjoys the occasional real ale.