Author: Fiona Munro

Danielle Kelly, a researcher at Yunus Centre on the MRC funded Common Health project recently attended an Iriss workshop I ran at the Scottish Co-Production Network Event – Co-production: Making it Happen.

During this workshop, I took participants through a series of design tools and activities that I’d developed as part of Iriss’s Hospital to Home project. These tools were specifically designed to support a co-design process in which a range of people come together to tackle service problems.

Partly inspired by this workshop, Danielle wrote a post for the Common Health Researchers blog. Please read this below.

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Last week’s blog looked at the relationship between art and social enterprise, and what particularly stood out to me was the idea that art can facilitate community expression.

As academic researchers we may strive to collect information from communities that can be objectified and rationalised, using mediums like interviews, focus groups, or perhaps even a bit of participant observation. The community talks to us, we write it down, then we display this in fancy reports or papers for peer reviewed journals in our quest for institutional credibility. However, the combined effort of using big long words and academic jargon can serve to isolate the very population we may be looking at, and they may be left feeling underrepresented by our own bias. This leaves us asking how we can fully represent communities through our outputs, and who is this for? This is a conversation that keeps springing up between Yunus Centre staff, most recently at the Unusual Suspects Festival and our CommonHealth Knowledge Exchange event.

The CommonHealth projects Growth at the Edge and Age Unlimited will both be applying participatory research approaches (design thinking and action research) to measure the effects that social enterprises can have on health and wellbeing. This will allow the research to be guided by the individuals and communities that we will be working with. In using such approaches we hope to potentially encourage creative thinking and the collection of data and documentation using non-conventional visual models, such as drawing, mapping, photography, and maybe even sculpting things out of plasticine, who knows?! Yet this will be ultimately up to the communities themselves to explore the most appropriate ways to express themselves and communicate with the research team. Of course we will be using interviews and focus groups to provide further data, but one of the most important things is to find ways to incorporate the visual outputs from the community members themselves into our findings.

Some social enterprises in the Highlands of Islands of Scotland, like ATLAS Arts in Skye, exist to allow community members to create art pieces that represent their landscape, histories and traditions. These visual art projects are used as a form of individual expression, and represent a persons’ subjective understanding of their culture and the world around them. Therefore in researching the people within such social enterprises, surely we need to utilise the visual artwork they have produced as ways of understanding their culture and context.

This got me thinking about how we can possibly analyse and disseminate the visual data we may collect. Ethnographers have faced this problem for decades of how to understand and aesthetically interpret tangible documents and art pieces to understand the culture from which they emerged. Visual anthropologists use methods of collecting cultural artefacts such as photographs, films, artwork and sculptures and then allow individuals from that particular society to both describe them and place them within history. This may still be viewed as pretty niche in academia, yet we could learn a few lessons from this approach on a wider level.

In terms of dissemination, it may be questionable whether visual arts have a place in academic conferences, perhaps displayed as ‘pretty posters’ alongside theoretical case studies and novel ground-breaking policy contributions? But this could just serve to further isolate research participants from their outputs. Or should we encourage community members to organise their own events that display the visual arts they produced within research projects, with academics in attendance? Hopefully our own CommonHealth Knowledge Exchange events will encompass this viewpoint going forward.

In terms of my own participatory study and the use of action research, my view is very much that we must work with communities not on them, so in fully engaging with individuals their problems become our problems. This goes all the way to research outputs; my papers become our papers, in the same way their art becomes our art.

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Thanks, Fiona

On Friday last week I was pleased to present our Hospital to Home project at Scottish Care’s Care at Home and Housing Support Conference.

The conference, entitled ‘My Home, My Rights, My Care’, focused on how we can deliver person-centred care through partnership working in an ever changing sector and work force.

The event was attended by over 200 delegates. There were only a handful of speakers (detailed below), meaning that delegates could take time to move round the stands on display from a range of organisations – including IRISS where we were able to share resources from our Fit for the Future project – network and ask questions. I much prefer events like this rather than ones that shoehorn too much into their programmes with no time for reflection!

The event had a strong focus on personalisation and working with people. I was pleased to hear ‘listening‘; ‘partnership‘; ‘working together‘ and ‘person-centred‘ repeated as common themes throughout the day.

Jamie Hepburn, MSP for Cumbernauld & Kilsyth, set the tone for the event when he said

“better outcomes for older people relies on listening and partnership working with older people and their careers”

Followed by Ranald Muir, Scottish Care, stating

“Personalised care will require people having the right to control their care package”

It was also really refreshing that Scottish Care had invited Agnes Houston, a woman with early onset dementia, to present her personal story including details of where her care had failed her. This was an inspiring presentation and so valuable to have insight from people with lived experience. Well done Agnes and Scottish Care!

Most inspiring of all was the fact that the word ‘love‘ came up so many times in the presentations throughout the day and the importance of care providers showing love. This relates to other work we are involved in and it is encouraging that the importance of love, compassion and care is spreading across the sector at various events.

In the afternoon I was joined by three other presenters to talk about our work under the theme of “Getting it Right for the Whole Person: Partnership and Personalisation in Practice”.

I was inspired to hear about a project in Dundee – Meal Makers – “a free, local neighbourhood, food-sharing project that connects people who like to cook and are happy to share an extra portion of a delicious home cooked meal, with older neighbours living close by who could really benefit from a hot cooked meal.” The highlight of this presentation for me was listening to the personal stories of the people involved in this project and how it has supported them. I hope to hear more about this project spreading in Tayside in coming months!

I also really enjoyed the presentation from Tracy Steel at Care watch about the “Social Media Revolution” and the importance of us understanding how this will change our care delivery in the future.

Tracy encouraged the care providers in the audience to spread the word about the care and support they offer by tweeting about the ‘little things’ they do for the people within their care so that people can hear about these and help spread the word for the care sector. After all, it’s the little things that add up to big things that make a difference for the people they care for and their families and carers!

The day ended with a panel discussion about ‘the right to fair pay and conditions’. This focused on zero hour contracts and whether they were acceptable or not. The general consensus being that they should only be used if chosen by the worker and not fostered by the local authority.

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Over all I found this event extremely valuable and enjoyable. It is encouraging to see such importance and value being placed on lived experience and personal stories and I hope to see this as a continuous theme within future events I attend.

Thanks, Fiona

Yesterday I attended the 4th National Co-Production Conference in Glasgow’s Royal Concert Hall. I was joined by colluegues at IRISS and Hot Chocolate (who are involved in IRISS’s Relationships Matter project).

This event was hosted by the Scottish Co-Production Network:

The Scottish Co-production Networkis free and open to anyone who is interested in co-production in Scotland. As a member of the network, you will be invited to learning events, network meetings and be able to take part in discussions and information sharing on the website. In order to ensure the network is effective in developing practice around co-production in Scotland, members are encouraged to contribute to the network by sharing their learning and experience through the online discussions, attending meetings and sharing useful information and case studies.

If you would like to join the network you can sign up here – it’s free and only requires basic information.

Across Scotland people and communities are continuing to work with local services to achieve positive change through co-production. This event sought to bring it all together, allowing delegates to learn from each other and plan for the future.

It was an energetic and inspiring event with evident passion for change from the people in the room.

Welcome

The day started with a welcome from Catriona Ness (co-chair of the network) who set the scene for the day by discussing the importance of involving people who use services if we are to make positive changes in Scotland!

This was followed by discussion from Fiona Lees (Chief Executive East Ayrshire Council) about positive examples of how co-production approaches are working locally with great outcomes.

There was a buzz in the room and everyone was clearly excited about the possibilities as they went to their first workshop.

Workshop 1 – What Can Scotland Learn From International Approaches to Co-Production: What to do and What to Avoid? – Governance International

The first workshop I attended was facilitated by Tony Bovaird of Governance International.

In this session we were split into 8 groups to explore key questions around co-production and share learning amongst our groups.

Some of the topics we explored, and may be useful for you to consider in your own work,  were:

• Do we have more power as a group to collaborate and co-produce? Is this due to more confidence when working as a group?
• Which of the “four Co’s” [co-comission; co-design; co-deliver; and co-assess] are strongest in our areas?
• Is the focus of co-production right? How can we get the best feedback on citizen priorities?
• What tools have you used to successfully co-design in your area? How have you found the right people for co-design?

Discussion in our group focused on a need to move from just co-designing to also co-assess and involve people who use services throughout our work as equal partners – not just in one of the four “co” phases.

Facilitated Debate

Following this session we had a facilitated discussion from Gerry Power (Deputy Director, JIT) about the frustrations we all face when working together on co-production projects.

Common themes included: fear; money; time; only working with those who are already ‘converted’ to the idea of co-production; not being able to engage the “unusual suspects”; undervaluing people’s skills and expertise.

Lunch

Following this session, it was time for lunch were I was pleased to catch up with a number of people who had been involved in IRISS’s Plan P, Hospital to Home and Experience Labs projects. It is encouraging to see they are all continuing to embrace co-production!!

Comedy

After lunch we were in for a treat with a hilarious session from Gillian Grant from Universal Comedy. It was brilliant, clever and funny! It was a pleasant surprise to be at an event that values this kind of input in their program! It was certainly well received by the delegates!Workshop 2 – From Patchwork to Supportive Net; Developing a Future pathway for Respite and Short Break Provision in Dundee

For my second workshop I wanted to learn from the work in Dundee by Animate who were discussing their evaluation of Dundee Carers Centre’s decision to provide short breaks/respite for adult carers in Dundee.

This was brilliant discussion about Dundee Careers Centre embracing the voice of their carers in deciding what ‘respite’ meant to them. We heard from one young woman whose ‘respite’ was a pair of waking boots that she can now use whenever the person she cares for is being cared for by someone else. She spoke with passion of the difference this had made for her as she can keep benefiting from them in a way that a standard one day trip wouldn’t have allowed.

We spent the second half of the session discussing all the people involved in co-designing a service of our choice. With my suggestion, the table I was at chose to explore the pathway from hospital to home for an unplanned admission.

It was really useful to map all the people involved in the pathway and how the pathway would change if one person was removed – i.e. a carer, or district nurse for example. I found this process really thought provoking and useful and would definitely use it again with others.

Final Plenary

The day concluded with an overview from Dr Margaret Whoriskey (Director, JIT) and Sir Peter Housden (Permanent Secretary to Scottish Government). They spoke about the discussions and sessions from the day with hope for co-production in Scotland and the Network as a whole.

Catriona Ness concluded the day with reference to Mother Teresa and the notion that, by all working on our own co-production projects, together we can make a difference in Scotland for the people who use and provide services.

We ourselves feel that what we are doing is just a drop in the ocean. But the ocean would be less because of that missing drop.

Mother Teresa

Thanks, Fiona (@fkmunro)

**You can read the Co-Production Network’s Case Study about our Hospital to Home Project on their website**

In April 2015 The Scottish Co-production Network* published a series of case studies about projects in Scotland that were demonstrating how a co-production approach can take different forms to improve outcomes for people in Scotland.

*The Scottish Co-production Network is a voluntary network of people who are interested in co-production and its practice with the aim of improving outcomes for individuals and communities in Scotland. We want to ensure that members of this network have as much ownership as possible of this site, and so we ask that you agree to the following terms of use to ensure that the site remains a useful and productive space for the exchange of practice, learning, ideas and debate.

One of these case studies was about IRISS’s Hospital to Home project and can be found on their website.

Thanks, Fiona

On 15th January 2015 IRISS ran a Relationships Matter JAM, where people with an open, enquiring mind, came together to work through a design process to challenge barriers that prevent the continuation of relationships with young people leaving care.

Below Keira Anderson, a participant at the JAM, reflects on her experience:

Working for design agency Snook, I have been embedded within Includem for six months, as a service designer. Recently, alongside a team from across Includem, I attended IRISS’s one-day hack event, The Relationships Matter Jam. The event brought together 5 organisations from across Scotland to explore ways in which young people can continue to be supported as they move away from child, support and care services.

In attendance were representatives from Care Visions, Falkirk Council, Hot Chocolate Trust, Includem and Kibble.

Includem offer support to young people who have often been excluded from mainstream services. We focused on a barrier that had been identified by young people themselves, when I explored Includem’s Transitional Support Service with them.

When young people exit Includem’s service, they are reassured that they can still use the Helpline – a service which is available to provide support to young people 24/7. However, experience shows that in practise, young people are reluctant to do this. Even those who have made good use of the Helpline whilst working with Includem fail to use this service after exit. We wanted to understand why this might be, and how Includem can best support young people beyond their initial service delivery, whilst not imposing on the independence (or interdependence) of the young people in question.

We were able to bring together a great pool of Includem brain power on this issue: two young people who have been working with Includem in Fife; sister/brother team Alana and Gavin, their Transitional Support worker Kathleen, frontline Core worker in Glasgow Kim, Briege who has been undertaking PhD research with Transitional Support and myself, Keira, Includem’s embedded service designer from Snook.

Alana and Gavin had helped me look at this issue during the first phase of our project, and took this opportunity to share and discuss their experience of the issue with the wider group.

Fuelled by pastries, tea, coffee and Parma Violets, we delved deeper into what some of the underlying reasons might be for young people feeling reluctant to pick up the phone at the very moment they need help most.

The Jam gave us the opportunity to reach a little deeper into the issue – we began investigating all of the hurdles or aspects of the current system which might be discouraging young people from calling the Helpline. We even spent some time analysing the word “Exit”, which is currently used to describe the disengagement process from Includem. Young people and workers indicated that this word seems very final; “You don’t go back in a door marked ‘Exit’” as one frontline worker put it.

In the end, the solution we developed was the same one that had been identified during the first phase of the project; but now we were confident that it really was the most supportive and progressive way of preventing young people from slipping after regular support has stopped. There is a commitment now to offer some young people “Helpline only support” as they exit Includem, on a prototyping basis. As always, they will be able to call the Helpline if they need a little more support, or aren’t sure where else they might find support for a particular issue. Additionally, Includem will commit to a series of call-backs, as necessary to each young person (say after two weeks, one month, two months) – to check that they are still doing as well as when they exited Includem and to give them reassurance that they can always access the service again if they find that they are slipping back.

With one of our team members, Gavin, currently studying acting at college, it was only right that we put our ideas across to the rest of the Jam with a short play, which will be available soon (check back here!)

At the end of the day, IRISS also made a commitment to keeping the conversation going between all of the organisations in attendance. Most were concerned with supporting young people after they exit from care or other support services, and recognising the very real relationships young people build with the workers who care for them. A variety of ideas were generated, which lay within a wide range of feasibility and completion. We look forward to learning how these ideas have grown within each organisation over the coming months.

Thanks again to all who attended the event, helpers and mentors, and to the Fiona and Gayle of IRISS, who made sure the day ran smoothly and kept us fuelled with sweets and soup.