Nescha Blog

Participation and co-production – but by how many?

Date: 8th August 2017

Participation, or co-production, are important parts of every health and social care organisation – but how many people are engaged in these processes?

NESCHA (North East Social Care and Health Advisors) core members especially are involved in many other networks where representatives are usually a very small proportion of the group they represent. Many representatives are volunteers who are ‘selected not elected’ often with no wider group to draw upon but the wider NESCHA network provides a way in which a bigger constituency is drawn upon and best practice in participation is shared.

Our project, ‘Well-Being – it’s in our hands’ helps us as we are interested in making connections with other organisations that succeed in getting significant participation of the people they engage.

Do participation, engagement or co-production really count if there are only a small number of people proportionately?  This question applies to numerous groups and organisations in the NHS and social care, and indeed beyond, and we are interested in others’ views.

Patient Participation Groups (PPGs) for GP practices,  for example,  these often have a few patient representatives but the practice might have more than 8,000 patients in total.  Are they able to represent the views of other patients without a mechanism for speaking or reaching out to them in some way? In such a practice even sending a letter to all adult patients is a very expensive exercise and email has its limitations too. How do other groups deal with similar issues?

Of course, continuing with this example, the GP practice has a certain amount of control of its resources but the Clinical Commissioning Group (CCG)plays a crucial part in determining budgets. Many of our members are PPG members too. In North Tyneside, they take representation a stage further with each PPG sending a rep to a PPG Forum with an elected Chair who is on the CCG Board.

Do the managers of the services patients want to influence really take notice and bring about change that people seek? Or is participation a new form of correctness?

Obviously, there are objections to, for example, closing community hospitals and at our Forum in July ( see events and news) we saw evidence of these changes and the influences patients had in engaging with some very challenging issues with the CCG in order to provide better services.

These may be challenging questions but we would be interested in others views and experiences and make connections. See also


We have started holding a series of Forums, and workshops, culminating in holding our second conference early next year and will be seeking others, who share our vision and aims,  to join us as members, or simply as collaborators, or people to share views with.

Wade Tovey

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