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Prevention through co-production
When people are actively involved in designing and delivering services, they bring invaluable insights that help shape interventions to better meet their needs and aspirations. Coproduction principles including equality, diversity, accessibility and reciprocity, allow for equal opportunity participation and contribution, fostering a sense of ownership and empowerment, increasing the likelihood of sustained engagement and positive outcomes. By placing people at the heart of decision-making, local authorities create services and support that are more attuned to real challenges and opportunities within communities, leading to more effective and personalised support.
The Working Together for Change approach to co-production highlights the importance of decision-making driven by people drawing on care and support in close partnership with service and system partners. Rather than being passive recipients, they are active contributors, helping shape both the support they receive and the wider system. Many local authorities report that using this approach has helped to foster trust with people and families as well as identifying approaches and actions most likely to lead to a “win-win” for residents and public service sustainability.
To effectively embed the voice of people in proactive prevention, local authorities that are successfully implementing targeted, proactive prevention models for older people adopt the following strategies:
Engage people early and regularly: Many authorities have established regular channels for input through surveys, focus groups, or community forums. This ensures that perspectives are woven into service design and delivery from the outset and throughout.
Co-design services with people drawing on care and support: Some local authorities have created planning groups led by people in the community to actively shape and review prevention services and support. This ensures that support models directly reflect community needs, priorities, and lived experiences.
Create feedback loops for continuous improvement: Many authorities integrate structured feedback mechanisms that allow people drawing on care and support to evaluate the services they receive. This ongoing input helps refine and adapt interventions to ensure services remain relevant and impactful.
By implementing these strategies, proactive prevention becomes more than just delivering services—it becomes a process of co-creating solutions that are meaningful and effective for communities. Authorities that embrace this approach foster trust, enhance engagement, and ultimately achieve more sustainable and impactful outcomes.
Codesigning with system partners
In addition to working in partnership with people drawing on care and support, local authorities effectively implementing targeted, proactive prevention models for older people also prioritise co-design with system partners. Collaboration with healthcare providers, community organisations, voluntary, community, and social enterprise (VCSE) organisations, local support providers and other stakeholders is essential to ensuring a holistic and coordinated approach to prevention.
System partners bring valuable expertise, resources, and networks that enhance the support available, making interventions more comprehensive and aligned with broader community goals. Strong, collaborative relationships enable authorities to co-design and deliver services that meet both individual and community-wide needs.
By prioritising coproduction and codesign with system partners, local authorities can:
Foster collaborative decision-making: Some authorities have successfully brought together cross-sector teams to jointly design services, ensuring that all relevant perspectives—including people drawing on care and support, social services, healthcare, care providers and community organisations—are embedded in the prevention process.
Build stronger partnerships for integrated support: By building on existing relationships and forging new ones, authorities connect people to a wider range of support services, ensuring that interventions are seamlessly integrated. System partners help address complex needs through a coordinated, multi-agency approach.
Create shared goals and metrics: Authorities align their prevention efforts with system partners by setting common goals and using shared performance metrics to track progress, ensuring all parties are working towards the same objectives.
By working in partnership with both people drawing on care and support and system partners, local authorities ensure a more collaborative, comprehensive, and effective approach to proactive prevention, driving better outcomes for individuals and communities alike.
In 2023, Oxfordshire County Council’s Live Well commissioning team developed a new model for Learning Disability Short Breaks Service (previously known as Respite). Initially the team drew on management information and business intelligence to develop the proposals, combined with engagement activity, including individual conversations with people direct experience of the existing service, staff delivering the service, and a survey of stakeholder views. The aim was to offer greater flexibility and access to activities and would have offered improvements to the service, based on the feedback received.
However, when this model was presented to a wider group of experts by experience, their families and carers, the Live Well team heard more clearly that they felt they had not been properly involved in new developments. This prompted a change in the approach to engagement and co-production.
The commissioning process was paused. The team extended the existing contract to allow time to develop a new plan that incorporated far more time for meaningful co-design activities.
Between January and February 2024, weekly working groups were established to redefine the service model as “Short Breaks”. These working groups were attended by experts by experience, the current provider, the self-advocacy group My Life My Choice (MLMC), and the Oxfordshire Family Support Network (OxFSN), a not-for-profit organisation run by and for family carers of people with learning disabilities.
OxFSN agreed to lead a face-to-face co-production and co-design workshop, where a wide range of stakeholders were invited to influence the new delivery model.
Following this work, a revised set of service requirements and outcomes were co-produced including:
- enhancing flexibility and choice in respite options, with a shift from “nights” to “hours” allocations
- a clearer rebooking policy and proactive solutions for cancellations
- improving coordination and communication regarding transportation
- improving marketing of the service, with consistent guidelines for eligibility and a dedicated webpage with comprehensive details on all adult short break options
- improving family and carer wellbeing via better support for families with adults who have complex health needs
- standardising booking systems, food menus, and other procedures across providers.
Feedback also highlighted the need for a thorough review of the properties where the service would be provided. Property visits helped to explain why some people had stopped using the service and instigated a review of the provider’s role in this.
As a result of this feedback, there was a total reset of the approach, leading to the development of a new specification and model moving forward. The draft specification was shared with OxFSN and MLMC who reviewed and provided feedback, refining the specification to better meet people’s needs.
People drawing on the support have contributed to setting the questions for the tender process and there will be an Expert by Experience on the evaluation panel.
The difference it’s making
In conclusion, although the recommissioning process did not initially meet the Council’s coproduction aspirations, after listening to feedback, the commissioning team quickly acknowledged the need for a different approach. This has ultimately led to a significantly improved outcome, and a sense of ownership and collaboration among the community of people who draw on care and support.
