Contextualising co-production and complex needs: Understanding the engagement of service users with severe and multiple disadvantages

Published date01 April 2024
DOIhttp://doi.org/10.1177/09520767221122277
AuthorKate Broadhurst
Date01 April 2024
Subject MatterArticles
Article
Public Policy and Administration
2024, Vol. 39(2) 259277
© The Author(s) 2022
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DOI: 10.1177/09520767221122277
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Contextualising co-production
and complex needs:
Understanding the engagement
of service users with severe and
multiple disadvantages
Kate Broadhurst
School of Business and Economics, Loughborough University, Leicestershire, UK
Abstract
Much has been written about co-production in mainstream services but less is known
about its applicability to service users with severe and multiple disadvantages (SMD).
Given the sometimes-precarious relationship between providers and users with SMD,
the paper argues that co-production should not be approached in the same way as
conventional user engagement because of the degree of marginalisation, stigma and
exclusion users with SMD face. Through a thematic analysis of evidence systematically
collated via a rapid evidence assessment, the author proposes a co-production
framework comprising a series of organisational principles to create an enabling
environment for co-production with vulnerable service users. The application of the
model is encouraged across a range of sectors and settings so that all service users can
become empowered participants in the design and delivery of services that affect their
lives.
Keywords
Co-production, severe and multiple disadvantages, complex needs, experts by
experience
Corresponding author:
Kate Broadhurst, School of Business and Economics, Loughborough University, Epinal Way, Loughborough
LE11 3TU, UK.
Email: k.broadhurst@lboro.ac.uk
Introduction
Co-production is situated within the f‌ield of citizen participation and public management
where collaboration is promoted as a means to enhance service quality (Park, 2020;
Brandsen and Honingh, 2015). It has been associated with a range of outcomes, including
enhanced effectiveness and eff‌iciency, increased user satisfaction, and improved user
provider relationships (Bovaird and Loeff‌ler, 2013;Alford, 2014). First introduced to
policy and academic f‌ields in the 1970s, Ostrom def‌ined co-production as the potential
relationships that could exist between the regularproducer (street-level police off‌icers,
schoolteachers, or health workers) and clientswho want to be transformed into safer,
better educated, educated, or healthier persons(1996, 1079). Ostrom identif‌ied a series of
conditions necessary for the promotion and achievement of co-production. These in-
cluded a synergy between the different contributors where each has something the other
needs(1996, 1082), options available to both partners, credible commitment based on
reciprocal and mutual contributions, and incentives to encourage and enable inputs from
off‌icials and citizens.
Inspired by Ostrom, the co-production literature has evolved with a revival of scholarly
interest over the last two decades (Bovaird et al., 2019;Sicilia et al., 2019;Osborne et al.,
2021;Park, 2020). This interest has primarily been inspired by shifting paradigms of
public management that have moved away from New Public Management (NPM)
ideologies of the 1980s and 1990s which applied private sector techniques to achieve
greater value and eff‌iciency (Hood, 1991). New Public Governance and more recently
Public Service Dominant Logic evolved in reaction to the unsuitability of the product
dominant, private value logic of earlier paradigms and ushered in a recognition of the
increasingly multi-sectoral nature of governance where public services are based on inter-
organisational relationships, networks, collaborative partnerships, and other forms of
multi-actor policy making and public action (Anttiroiko and Valkama, 2016).
The shifts in ideology towards public value creation have cemented the popularity of
co-production amongst the non-prof‌it sector actors, think tanks, and policymakers to
enhance the value of public services. Whilst public value remains something of a catch-all
phrase for multiple aspirations about public service, its def‌ining features comprise what
the public values and, what adds value to the public sphere (Benington, 2011). In the UK,
co-production has secured cross-party appeal; f‌irst as part of the political discourse under
Labour Party control in the early 2000s, and subsequently through the 2010 coalition
governmentsf‌lagship Big Societypolicy and the Conservative government civil society
strategies (Lowndes and Pratchett, 2012). Public servants across a range of service areas
have faced a renewed drive to develop co-produced, innovative delivery models triggered
by the recognition that publicly desirable outcomes rely on the contributions of multiple
stakeholders, not just those of providers. Furthermore, f‌iscal constraints resulting from the
global f‌inancial crisis have renewed interest in co-production as a means to compensate
for reductions in investment in public services by leveraging civil society resources and
capacity (Liddle and Murphy, 2012).
The inclusion of service users has become an integral element of the development and
delivery of public services. Advocates argue that co-production is greater than citizen
260 Public Policy and Administration 39(2)

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