Citizen Co-Production in Public Services: Building Together for a Better Tomorrow

1. “If you want to go fast, walk alone. If you want to go far, walk together”: citizens and the co-production of public services Dr. Elke Löffler, Governance International

2. The boundary between service providers and service users has shifted Increasingly we are seeing greater involvement of users in services, for example • E-government solutions all over Europe • The use of expert patients in UK hospitals • Parents of teenagers patrolling the streets at night to prevent riots in ‘hot spots’ in Denmark • “Citizens drive buses for citizens” to complement the offer of public transport in the small-sized local authority Brieselang (near Berlin)

3. Why co-production has become an issue in the public sector Expected benefits of co-production • Cutting costs • Making public services more responsive to users, building in users’ holistic perceptions of what quality of life outcomes they desire • Providing more differentiated services and more choice • Improving public service quality by bringing in the expertise of service users, and often of their families and communities as well

4. There was a wide range of views from our focus groups… • “Professionals across all sectors have woken up to the fact that they need to do things with people rather than for people” (UK focus group) • “Most doctors appreciate better informed patients but about one third of doctors prefer to be the only ‘clever participant’ in the care process” (Czech focus group) • “…Danish society is a bit different. Somehow we gave all social affairs to the public sector and people do not want to get involved…” (Danish focus group)

5. A slight difference of opinion ... Public official “Well, I don‘t really know ... but not very, I would say” Interviewer How important is the role of citizens in public services? Citizen“VERY important – I’m active on on environmental and health issues, a bit less active in safety”

6. The project: a representative citizen survey • Telephone survey of a representative random sample of 4,951 adults (18+ years), about 1,000 interviews each in Czech Republic, Denmark, France, Germany and the UK • Focus on three different sectors: • Community safety • Local environment • Public health • Issues to be explored: • How big a role do citizens play in public services? • Does involving citizens change their attitudes and expectations towards public services? • Is the role of citizens in public services likely to be more important in the future?

7. Definition of co-production used in this study “The involvement of citizens in the delivery of public services to achieve outcomes, which depend at least partly on their own behaviour”

8. A European picture of the role of citizens in public services: What we found out • There is no typical “European citizen” - levels of co-production vary between different countries • Levels and forms of co-production also vary between sectors – when it comes to improving the local environment (index 61) and health (index 54) - we are now around mid-way in the scale from “zero” to “hero”, however, citizens are less active in improving community safety (index 45) • Citizens best like co-producing alone and with little effort • Citizens who are elderly, female and not in the labour market are most active • 70% of citizens, in particular, young people are willing to do more • Citizens who co-produce only show a weak tendency to be more satisfied with the performance of public agencies • Do citizens believe that their co-production can make a difference? Have you found the answer in the report? …

9. A European picture of the role of citizens in public services : What this implies for government • The ‘ageing society’ means increasing levels of ‘co-production’ • Government needs to target young people, who are generally interested in only one single issue • Citizens do not need to be educated to co-produce more since 70 % already want to do more • Government needs to provide citizens with more opportunities to co-produce as individuals • Co-production means professionals are no longer the only experts

10. Issues for discussion: what co-production implies for the European public sector quality agenda Some thoughts from a recent Roundtable discussion in London - “Given that 60%–70% of health care is around long-term conditions, We have probably reached the limits of what the NHS can achieve without co-production from its users. Co-production is no longer just a possible option – it is now a material necessity”. “Co-production isn’t a ‘yes’ or ‘no’ decision – its about a spectrum of increasing involvement in different types of co-production.” “We must map our carefully the limitations to co-production – for example, we must not assume too much about citizens can do and what they want to do. And we must not let the public services off the hook, suggesting that co-producing service users should themselves have to make up the deficiencies of poor quality public services.”

11. Possible projects to take the 4QC and 5QC agendas further • Co-production Toolkit: put more flesh on the Co-Co-Co-Co framework, illustrating how co-production can be organisedFocus: HOW TO DO IT? Target group: front-line staff and middle managers • Good Practice Guidance: The costs and benefits of co-production in key service areas– exploring co-production in different sectors to identify where it most likely to be cost-effective and its limits Focus: WHY DO IT?Target group: top managers, budget managers • Policy brief: “How can central government promote co-production and scale it up to much higher levels?” - why does co-production not scale up naturally but often remains at local, neighbourhood or even individual level? How can it be embedded in government policy and managerial practices? What skills need to be developed among professionals to exploit the potential of co-production? Focus: WHO SHOULD DO IT?Target group: Policy makers

12. Contact and further information • Email: Elke.Loeffler@govint.org • The report is available (in French and English) at • http://www.5qualiconference.eu/fr/contenu/nouveau/109.html • http://www.5qualiconference.eu/en/conference/news/108.html