More about Co-Production

What is the ladder of co-production?

The ladder describes a series of steps towards co-production in health and social care. It supports greater understanding of the various stages of access and inclusion before full co-production is achieved. It was created by The National Co-production Advisory Group (NCAG) a team of people who draw on services, carers and families, based on the original idea of Arnstein SR. a ladder of citizen participation.

Co-production - is an equal relationship between people who use services and the people responsible for services. They work together, from design to delivery, sharing strategic decision-making about policies as well as decisions about the best way to deliver services.

Co-design -People who use services are involved in designing services, based on their experiences and ideas. They have genuine influence but have not been involved in 'seeing it through'.

Engagement -Compared to the consultation step below, people who use services are given more opportunities to express their views and may be able to influence some decisions, but this depends on what the people responsible for services will allow.

Consultation -People who use services may be asked to fill in surveys or attend meetings; however this step may be considered tokenistic if they do not have the power to influence or affect change.

Informing -The people responsible for services inform people about the services and explain how they work. This may include telling people what decision have been made and why.

Educating -The people who use services are helped to understand the service design and delivery so that they gain relevant knowledge about it. That is all that is done at this stage.

Coercion -This is the bottom of the rung of the ladder. People who use services attend an event about services as passive recipients. Their views are not considered important and are not taken into account.