Peter Beresford: ‘“Co-production”: say it enough and you can believe you are doing it’
For Peter Beresford, co-chair of Shaping Our Lives, a service users’ network, social care leadership needs to rediscover some of the humanity it has lost over the past 40 years, during which it had moved towards an approach that is more hierarchical and less collaborative.
“We have ended up with a very narrow idea of what leadership is all about,” says Beresford, who is also professor of citizen engagement at Essex University.
“We try to do things in a more humanitarian way at Shaping Our Lives: we have a board, and they have responsibilities, but we try to work in ways that are respectful and acceptable, and that includes how people behave. We want people to be properly rewarded for what they do.
“It’s not like ‘leaders and followers’. It’s much less top-down than that– trying to work altogether in a more egalitarian way.”
Beresford is sceptical of the vogue in care management for co-production of services, by which they are supposedly designed and planned in partnership with their users.
Although he concedes good examples exist, such as the Lambeth Collaborative in south London, he suspects there is a great deal more talk than action.
“‘Co-production’ is one of those words like ‘partnership’ or ‘involvement’,” he says. “Say it enough times and you can make yourself believe you are doing it.”
Mike Adams: ‘The answer to all Essex’s problems is probably leadership’
Get the leadership right and pretty much everything else will fall into place. That’s the view not of a management guru, but of someone who speaks for people who use care services.
Mike Adams, chief executive of the Essex Coalition of Disabled People, has a bottom-up perspective on sector leadership – both through the experiences of the people his organisation supports and through his role as chair of Healthwatch Essex, the voice of the county’s users of health and care services. Whichever hat he’s wearing, he sees room for improvement – and the solution is the same.
“The answer to all Essex’s problems is probably leadership,” says Adams, who is himself disabled. “You can hide behind structures, resources and everything else, but if they got the right leadership in place they could solve a lot of the problems they currently have at a stroke.”
The principal failing, he believes, is a reluctance on the part of social care and NHS leaders to give ground – to make the necessary concessions to provide effective and efficient integrated services that people want. He likens meetings of the Essex health and wellbeing board, which brings the leaders together, to sessions of the United Nations.
“People behave like they are China or Russia,” he says. “No one is prepared to concede any sovereignty for fear others won’t follow. It’s like who blinks first.”
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