Co-creation implies new skills in re-humanising services
Co-creation as a practice in welfare services is guided by specific moral aims, such as individual’s well-being, care, independence or empowerment. These are moral goals and co-creation becomes a moral-led practice. For such services to gain value it requires redefining the established relationships between service users and professionals. More specifically in means being aware of individuals’ who are supported by the service rights, power dependencies and recognizing their unique lived experiences. Further, it implies a commitment to and trust in sharing of power and control over services with these individuals. It is all about rehumanizing services.
The contribution of professionals thus is very important for establishing rehumanized relationships with individuals supported by a service. Yet, it has been undermined in much thinking about co-creation (see for example in Osborne and Strokosch 2013; Hannon, 2019). Service professionals will need to develop new types of skills to successfully engage in co-creation.
Please reflect in relation to your context:
What are the kind of skills service staff need to develop to ensure a more pro-active and open minded attitude toward the contribution of the beneficiaries in making decisions about their services
Taking co-creation seriously often involves developing following skills: asset-based approach, rethinking risks and de-learning.
1: An asset-based approach. Strengths or asset-based approaches normally involve ways of working or relating to an individual supported by a service that differ from ‘business as usual’ where the focus is on managing needs and fixing people’s problems (Wilson et al, 2017; Cottam, 2018). Strengths or asset-based approaches focus upon people’s goals and resources rather than their problems (Price et al. 2020). These include both their current intangible resources (perhaps skills, experience or networks) and their potential to develop new community and personal assets.
Co-created public services are premised on people exercising agency to define their goals in order to meet needs they themselves judge to be important. CoSIE experiences evidence that co-creation is informed by versions of ‘deep personalisation’ (Leadbetter 2004) inspired by social activism among stakeholders who are driven by social justice for people who are marginalised and lack power.
PILOT EXPERIENCES: Strengths-based working is always possible in the delivery of public services but it takes time and resources. CoSIE pilots demonstrate that it is possible to legitimate the knowledge of people who receive public services, and nurture their participation in service innovation and decision-making. This has proved to be so even in contexts that look highly unpromising, for example in services where people are compelled to receive the service (work activation, criminal justice as in Hungary, UK) and in places where there are longstanding traditions of patriarchal attitudes and top-down provision (Hungary, Poland). Engaging people unused to having their voices heard demanded hard work, sensitivity to their needs, and sometimes extra resources. All the pilots achieved this to some extent. Outstanding examples were in the Estonian, Finnish, Polish and Dutch pilots.
2: From risks to needs. Seeing a person as a whole with a complexity of needs rather than as a collection of predefined problems to be addressed is especially important skill in rethinking risks. Yet it is surprisingly hard to do, given the tendency of many services to work in silos.
PILOT EXPERIENCE: A municipal employee who took a lead in the Dutch (Houten) pilot observed that, “despite all my good intentions, I discovered that in the end I was fulfilling our agenda not the agenda of the citizens. In fact, I did not even know what their agenda was! I missed the broader perspective and the person as a whole”.
Professionals who work in public services often struggle to develop meaningful relationships with people who use services, constrained as they are by rigid thinking about ‘risks’ associated with certain individuals and ‘safeguarding’ established solutions and being restrictive with ‘resource allocation’. This stands for a deficit-based approach.
Moving from ‘deficit-based’ approaches to ‘strengths-based’ ones require front-line staff and their organisations to fundamentally re-think their concepts of risk, from the way they assess it, to the language they use to describe it, to the ways they respond to it. This doesn’t mean ignoring risk, but it almost certainly means addressing people’s underlying needs rather than just the ‘risk’ that they are presented with. It also means drawing on people’s wider assets that reside in their relationships with their families, friends and communities when responding to ‘risk’ (needs).
Here it is important to remember that needs may be seen differently by targeted service beneficiaries and the professionals. Sometimes professionals need to shift their perspectives to accommodate the one’s of the service beneficiary and sometimes it means that both sides can arrive at a shared perspective. This is illustrated in the animation below.
3: Discarding cherished assumptions by de-learning. Ideas have to be unlearned as well as learned. Actions that were once thought essential may have to cease. Practice has to be reflective, self-critical and emphatic.
PILOT EXPERIENCE: As one individual in a pilot ‘catalyst’ role in Valencia, Spain reported, when people at a distance from the labour market were asked what they wanted from entrepreneurial training they said they did not want entrepreneurial training, there was already plenty of it around already and it did not help them. As a result of hearing this, “our preconceived ideas came tumbling down around our ears”
4: Being able to include peoples’ lived experiences. This implies that the professionals are aware of the importance of people’s lived experiences about services or their lack and are able to include them in developing service practice or new services. It also implies an ability to listen deeply to understand what individuals are in fact communicating, both verbally and un-verbally.
PILOT EXPERIENCE: Often in the CoSIE project it was more meaningful for service actors to hear individual lived experiences (often through community reporting method or by extracting knowledge and insights in extensive thematic dialogues, workshops (Social Hackathons) or focus groups with the help of neutral facilitators.
Developing these skills has implications not only for the front-line staff but also entire service and organization management. It requires new approaches and strategies. This is illustrated in the animation below.
5: Using transparency and understandable language. Co-creation implies being transparent about the aims and being able to use accessible language so that individuals receiving services may better understand what is being talked about and to seriously engage in conversations about their needs and desired services or improvements.
PILOT EXPERIENCE: For example, after some less successful trials in the Estonian pilot experienced mentors were hired to help access and engage targeted individuals. In the Swedish pilot, the language of communication about disability services such as on municipal website communicating service offer and the co-creative aspects was totally changed to be clear and more accessible to people with disabilities. Jönköping Municipality, Sweden, also exposes its assessments of social service status and self-critique publicly.
Changing mindsets however is only a partial but not complete recipe for change. There is a need of broader organizational work with structural (high workloads, fragmented teams, rapid staff turnover) and cultural (morale, professional ethics, openness to learning challenges.
Understanding service ethics
In CoSIE project, we understand ethics in general as what is the right thing to want and to do in relation to service users to enable co-creation.Moral issues and ethics are essential in all co-creative activities with service beneficiaries along the service circle.
- Moral bone:Service ethics is a moral bone inherent in professional service approach and practice in relational services. Ethics represents the moral constraints of social relationships.Ethics on a collective level means achieving some kind of consensus about shared norms of conduct and values in concrete practices and contexts. Ethics can be found on professional or service or network (meso) and societal level (macro) perhaps more appropriately seen as ethos.
- Context dependent: Being culturally situated, ethical determinations are context dependent and involve the active interpretation and application of principles rather than the passive following of rules and procedures. Such interpretations often involve dilemma and the choice between contended or conflicting values.
- Value conflicts: Given this conflictual nature, ethical principles become stratified into hierarchies of precedence and power. For example, professional ethics might be overridden by wider cultural ones or personal ethics might be subsumed by the ethics promoted in an organisational ethos and culture. Professional ethics is also different from and may be in conflict with personal values. It is sometimes about choosing between right and wrong and sometimes between two “wrongs” or “rights” that is dilemmas.
- Practice driven: Ethics may be seen as a moral that is translated to service practice adjusted to concrete contexts. Co-creation as a relational normrelates specifically to the values and the approaches needed to realise co-creative acts with service end-users and other stakeholders. While some of these are specific for particular service contexts and user groups there are still some generic parameters important in relational services.
Sustaining ethics
Sustaining collectively agreed ethical principles in practice requires effort. It is a matter of commitment, skills and managerial support.
- Influence: The agreement on shared professional/service ethics might be influenced by laws or policy norms, organizational and even individual values. Yet no laws can enforce ethics without individual and collective commitment.
- Need of reflexivity: The value dilemmas and complexities mean that ethical practice must be reflexiveand the subject of continuous collective governance.
Below your find a conversation on the need for rehumanising public service
Immerse yourself: