Seminar 3: Contemporary Developments in Healthcare Practice


Seminar 3 Schedule

9.30 Registration (with tea and coffee available)
10.00 Opening with John Walsh, Leeds Community Healthcare NHS Trust and Pamela Fisher, University of Leeds: co-production and power-sharing
10.30 Presentation by David Crepaz-Keay, The Mental Health Foundation
“Co-production and peer support: the challenges of moving from survivor led to co-produced”
11.15 Discussion of arising themes (with tea and coffee available)
11.45 Martin Webber, University of York
“Co-producing mental health care: introducing the Connecting People Intervention”
12.30 LUNCH
13.15 Presentation by Rebecca Hutten followed by questions and comments
“[Co-]Producing professionals and patients within the IAPT system: can it be done?”
13.30 Identification and discussion of key points arising from presentations and discussions
14.15 Tea and coffee
14.30 Round table discussion introduced by presentation led by Tina Coldham and Pete Fleischman, Social Care Institute for Excellence
“Towards co-production? Reflections on 20 years of activism”
15.30 Summary of key points and co-production poem, based on the day’s presentations and discussions by the spoken work artist/poet Adam Montgomery (aka “Ad-verse”)
16.00 Additional Networking opportunity


April blog post – some ideas on co-production

Dear All

Below are some bullet point type notes relating to the final discussion at St Catherine’s on 17 February. Do let me know via email if you’d like to add anything or change anything.  It’s great that the seminar has generated much interest. Since February I’ve been contacted by a number of people/organisations who are interested in getting involved in order to take this initiative forward. More on this later.

I want to write a little here about research and co-production because it is very much an emerging paradigm. Generating knowledge co-productively challenges accepted research practices. The researcher no longer defines clear objectives but instead engages with stakeholder groups in a dialogical process. Whilst University researchers normally adopt a linear approach to research, co-production requires an expanded view of research which blurs traditional boundaries whilst being open to uncertainty and ambiguity. While some may see this approach as unfocussed, I see it as a driver for research which is thoroughly interrogated, socially useful, and, crucially, co-productive. A colleague recently expressed the view that I should have started with clearer ideas about co-production at the outset. But, stating clear ideas about what co-production should be at the beginning would in itself be irreconcilable with co-production. The seminar series is about developing a position on co-production whilst at the same time (however imperfectly) enacting co-production. My only non-negotiable when I wrote the proposal for the ESRC was that co-production is not the same as patient and public involvement, it is about power-sharing, and power-sharing requires new approaches to professionalism. Otherwise, for me it’s a journey.  If anyone thinks this sounds like the road to nowhere, I say ‘watch this space’…

Just one other thing, I shall be developing a book proposal for an edited collection. I’ll be circulating more information on this in the summer, but you might want to start thinking about the possibility of contributing a chapter.

Pamela Fisher, April 2016

Key Words: Power – Space – Peer Support

 Research power imbalances

Dichotomy of paid and unpaid work in a context of shrinking budgets

Unpaid service users/researchers               paid professional researchers

Imbalances in the legitimacy/status of different forms of knowledge (experiential, personal, lived experience, and professional)

People are expected to ‘inhabit’ one ‘role’ or another: either service user, volunteer/peer support worker, paid professional

Co-production involves parity of esteem for all type of knowledge/’roles’

This requires external voices to ‘raise hell’. Reform cannot be achieved from the ‘inside’ only


 Asset based approach, based on community wellbeing. Should involve multiple partners across core services/economy working towards the promotion of wellbeing with a focus on the prevention of mental distress and the development of resilience

 Many resources in the community (800 organisations in Kirklees), but recognition that ‘the community’ can be a hostile as well as enabling. More opportunities in community than anything a service can offer.

 More blurring of roles needed: ‘allow people to give back when they are well’. This is a feature of Recovery Colleges.  Peer supporters also need peer support

Investment in education needed in volunteer and peer support ‘roles’. Recovery colleges are harnessing the expertise and skills acquired through lived experience

ZIP (Leanne) and commissioning training for co-production

Flexibility of using services when needed rather than being ‘service user’

Co-production of commissioning is working in some CCG’s – particularly Leeds. The environment needs to be right for this. How can co-production in commissioning be facilitated?

Key questions: How is the ‘right’ environment created? What forms of governance are required to ensure that service user perspectives are incorporated?

Protected/shared ‘recovery’ spaces required in order to develop the capacity for co-production?

Education, Training and Workforce

Accountability requires service user and peer-led governance

“People with power please listen!”

Commensus – Community Engagement and participative process at UCLAN

Education, Training and Workforce

Professional training didactic, little space for critical political thinking

Involvement of service users is tokenistic rather than core to education and training

Professionals are generally reluctant to share power: a need for some ‘unlearning’ before they are able to facilitate co-production.

Collaborative risk training involving service users, peer support workers, professionals is needed

Ian McGonigle and Kim Woodridge and others have developed resources, but these are under-utilised.

More formal representation of service users required as unionised workers, but this also raises risks.

Need to resist power without becoming what you are resisting (need to consider theory on how power reproduces itself in new forms)

Co-production is a methodology applicable to all age groups, including children

Do we need something similar to Schwartz round in mental health?

Ward rounds

Can be overwhelming for service users and professionals

More space for the wards needed for the facilitation of better conversations in order to overcome boundaries between ‘roles’

Space a recurring theme;

  • To talk
  • To feel safe
  • To think
  • To innovate
  • To do things differently
  • To help blur roles/demarcations

A significant body of theoretical perspectives on space

Need to introduce theory on democracy/citizenship into the area of mental health

Project TOGETHER provide training for peer support workers and ward staff.

Drug and alcohol addiction/Recovery

Services have moved from statutory to third sector, and models have been developed which could have wider application in mental health

Values developed around mutual aid and an asset approach

Recovery approaches developed within build on the idea of Patricia Deegan

Co-production in commissioning very important

Use of digital/social media to facilitate co-production

The Voicebox’: simple to use technology which hosts stories

Inappropriate gatekeeping of people’s perspectives

Digital media may mitigate the tendency to find out what people want but only report ‘safe’ ideas

Maybe ‘let go’ of some approaches to defining research questions, and allow themes to ‘emerge’ directly from service user voices. However, difficult to secure funding this way in current context.

Job Opportunity in London for Open Dialogue UK

From the Open Dialogue UK website:

We are now looking for more administrative support, primarily to help us meet our objective of opening a centre in London for training and practice in 2016. This is an exciting opportunity to be a part of the development of a centre which will in time offer training and therapeutic work in a variety of approaches, including Open Dialogue, Hearing Voices, psychotherapeutic work for people experiencing psychosis, and Intentional Peer Support. As well as this we will be running events in the evenings at the centre including debates/dialogues, film screenings, performance arts, and other creative/social gatherings, related to therapeutic practice, but also wider social/political issues. Our hope is that the centre will also provide vocational opportunities on a voluntary and paid basis for people with lived experience of mental distress/extreme states who are interested in contributing to the development of the centre and learning new skills, and we welcome interest from people with such experience for this administrative role.

Initially we are looking to involve someone with administrative skills on a temporary basis, with a view to this becoming a permanent position once the centre opens. There is flexibility in terms of the basis on which the work would initially be undertaken (employed, self-employed) as well as the hours involved (full-time/part-time). Amongst the administrative skills required are the ability to use Microsoft Office, edit content on our (WordPress website), monitor email accounts, research issues related to the development of the centre, etc. Training will be given where necessary.

If you are interested in this administrative role, please complete the form on this page on our website by 14th February 2016, or contact us if you have any questions.”


Open Dialogue UK 2016 Conference – London – 2nd February

Not long until this event in London. We hope to see some of  you there.

Our 2016 conference brings together many of the leading developers of Open Dialogue internationally. Keynote speakers will be Jaakko Seikkula, one of the founders of the approach and Volkmar Aderhold and Petra Hohn, who have been leading the development of the approach in Germany and also in the Parachute Project in NYC. We are delighted to also welcome three key members of the Parachute Project team from New York, as well as members of the Peer supported Open Dialogue project in the UK.  As well as addressing the key themes of openness and democracy, the conference will provide a unique opportunity to get an overview of the current state of development relating to Open Dialogue nationally and internationally. There will also be a panel of leading clinicians/experts from a variety of backgrounds in the UK who will be reflecting on the presentations: James Davies, Peter Kinderman, Anne Cooke, Sarah Carr, Sami Timimi, Jacqui Dillon, Julie Repper and Rachel Waddingham.

We are now delighted to confirm that there will be three additional presentations from those developing the Open Dialogue approach internationally. Iseult Twamley, who is leading a project in West Cork, Ireland, Rafaella Pocobello, one of the co-ordinators of a project covering 8 districts in Italy, and Amy Morgan, from Advocates in Massachusetts, USA, will all be giving brief presentations on how they are developing Open Dialogue within their service.

We have a range of price points for these seminars, in the hope that everyone who wishes to attend will be able to, including group discounts:

  • Organisation Rate: £125
  • Organisation Group Rate: £112.50
  • Independent Practitioner Rate: £85
  • Student/Carer Rate: £35
  • Service User/Benefits Rate: £25

Group rates for 5 or more people

For further details of the conference and to book places please visit our website by clicking here.