How co-production and co-creation is understood, implemented and sustained as part of improvement programme delivery within the health and social care context in Scotland – Research Study, Scottish Improvement Science Collaborating Centre, and University of the West of Scotland.

Co-production and co-creation in the context of health and social care integration in Scotland:

One of key policy instruments driving the public services reform agenda in Scotland is the National Performance Framework (NPF), which presents a number of high level outcomes for public services to demonstrate their performance against. Refreshed in 2011, 2016 and in 2018 it has become ‘a single framework to which all public services in Scotland are aligned’ (Scottish Government 2018). Within this broader context the Public Bodies (Joint Working) (Scotland) Act
2014 became the legislative framework for the integration of health and social care. This created new public organisations (‘Integration Authorities’) which aimed to break down barriers to joint working between NHS Boards and local authorities. This resulted in the establishment of 31 health and social care partnership areas, each led by a Chief Officer. As part of the integration agenda co-production and co-creation and have become recognised by public and third sector bodies in Scotland as important as it is based on a general view that these approaches can lead to the achievement of positive outcomes for citizens (Evaluation Support Scotland, 2017; Alliance Scotland, 2018; Healthcare Improvement Scotland, 2018). However, little is known about how co-creation and co-production is understood, implemented, and sustained within health and social care in Scotland. Given the normative centrality of co-production and co-creation for improving public services, it is timely to investigate the extent to which these approaches are understood, operationalised and sustained as part of the integration of health and social care based on the occupational experiences of those tasked with leading and undertaking integration. An Audit Scotland (2018) report and the Ministerial Steering Group (MSG) report (2019) (Scottish Government, 2019) both called for quicker progress to be made on integration and strongly encouraged innovative approaches for going so (such as adopting co-productive approaches). In this light, the research also links to the broader theme of public sector governance and reform in Scotland (i.e. how the approaches to public sector reform present barriers or facilitators to the adoption and sustainability of co-production and co-creation) based on the perspectives of those leading integration in health and social care in health and social care areas and within relevant national agencies.