Shahid Islam shares history about the value of co-production!

right. Hi. Thanks for agreeing to take part in this project. Would you be able to introduce yourself? Yeah

Hi. My name is Shia Islam. I'm a senior research fellow with the Actorly Consortium, which is part of, uh, Bradford Institute for Health Research

Could you tell me what a senior consultant does senior research fellow. So I'm responsible for leading on some research projects. Um, so a senior research fellow is somebody who conducts research, publishes research, disseminates the findings, and in our context, in the world of Preference, Institute of Health Research tries to do applied research

In other words, conduct research, which is useful to society and helpful and will improve things for people. So that's what that's what I do. Brilliant sounds really interesting and important role

Can you share me with me? An experience of co production? Yeah. So, um, I'll just reflect on the most recent one. So there's an area in Bradford South graphical Homewood, highly deprived in the socio economic sense of the word higher rates of crime and employment, etcetera

And we had recently done some work with the people in homework to understand. What is it that's causing food insecurity and problems with food poverty in that area, Um, and within that with the community rather than two of the community. So they were involved in, You know, the question should be how they ought to be asked, Um, and even how the data from that should be analysed

And by doing that in a co productive way in a core design way where members were influencing what the research should. Intel, Um, it led to very open and honest and frank conversations about what it is that was leading to some of the problems with food insecurity. And it turned away from those things which are systems based, you know, like people not being able to buy and people not having enough money in their pockets to sort of being able to get the right calories more towards people

Talking about, um, members of the public Residence Inn Homewood, struggling to get to certain areas because of fear of crime and the fear of crime, made people not good to cheaper places to be able to afford their food but stick more closely to where they live because they didn't have to face the prospect of being hit or attacked or mugged or anything like that. But also it was a case of Because of that crime, buses and taxis were not coming into the area. And so people were pretty much left to only being able to buy locally, which was more expensive

So, um, that work resulted in people residents who were involved in the research organising the community meal, a series of community meals to talk about. How can we fix this? Because this is not to go away and it's on. So what should we be doing? And all sorts of ideas came out such as, you know, the police doing more beach in the area

The council was taking response seriously, more investment locally so people can buy locally. All of those sorts of things came out. Um, and I thought was a really fantastic piece of co production because it was really raising the issue, researching the issue, finding the problem and then finding solutions so that that is a that is a recent example, which I used to ask questions like this

Thank you for showing that. So what do you think? The difference is working in this way. So, um, there's a lot of work that we've done in the institute recently, which are really pinpoint what makes co production different from, say, other forms of engagement, of participation or consultation or in other involvement

And ultimately, you could be an engagement means, you know, you can just put an event and let people come and learn about participation. Is recruiting in two studies. So you know they become, um, we're able to take a day or two and do something with that involvement is where the shape or design questions might be

Your considerations we should make the co production is about partnerships. Ultimately, that's the key difference, and the partnership means that they have. People who are affected by the research are key partners in what that research is and what the questions are and how the data is gathered and how the data is analysed and, ultimately, how it's presented and reported

And even then, after that, what gets done with it? And I think that's what separates co production from other forms, and the issue for me often is people get these things a little bit. All model looks. Everybody calls, for example, consultation

We call it corn production where it's nowhere near that. Yeah, thank you. That's a really clear Um, you know that that really shows me that you kind of what you did in co production

So I'm thinking about you personally. So did you change your perception or behaviours as a result of working in a go produce way? Yeah, One of the one of the things that I think, um, every practitioner and researcher and policy America should be open to is changing their opinion about things or the views of our things in light of new evidence. Otherwise, what's the point of producing new evidence if we stick to what we have always done? And I think what we have done in Bradford and in Tower Hamlets, uh, is a partnership approach in, actually has gone and asked lots and lots of people who are involved in this space

What do you mean by co production? And what we found is co production essentially is made up of three very important values. These these are the pillars of co production on which the the the whole mantle of co production rests. And one of those is equality

How do you how do we make sure that those who are affected by whatever it is that going to be doing, whether it's research for implementation, how do they get to have a saying is in a partnership where with their needs being addressed rather than just doing things and then hoping they'll fit somebody because we thought was a good idea? So that's equality and equality has so many different dimensions. Include includes race, ethnicity, gender, identity, all of those sorts of things. How do we make sure those things affected? Then it's about agency

So how do we make sure it's not all those policymakers or researchers who set the agenda and say, This is what we want you to not do? This is about you being able to shape it from your point of view. That's the second bit. And then the third one is reciprocity

What's in what's in it for the communities? Because we know what's in it for us, because we need to meet certain targets. So we need to deliver on certain budget. So we have to meet certain criteria as well as communities

Don't think like that. They want the best for the areas of the issue. That is that

And and I think if you satisfy those three values, you can then make a strong case that this is co production. Without that, it might be other things, but it may not be co production. And so, having done this work to develop a strategy of co production strategy, which I'm happy to share with you, I'm happy for you to share with anybody

Um, you know, we found that this is what makes co production. And that's where we changed our mind about what we call co production. Thank you

Really a love thing about the pillars and values. So the research and the co production you've talked about, so I'm wondering about that kind of a lot of times, in coproduction or within research, people will talk about how to reach groups co production, like, Does it work better like you know how you've done it? Yeah, yeah, so that there is a There's a lot of words in terms out there which get used, but if you impact them, you'll find that there's usually something wrong with how we framed it. So, for example, when we use the term hard to reach

What we really mean is the people out there who are not as easy to reach as everybody else who is very easy to reach and what what we need to do is be a bit more inventive to make sure that we do what is right to speak to those communities and get them involved. So they might actually see us as hard to reach, you know, if we reframe it either way. And so, um, my view is, nobody is hard to reach

Everybody is different, and therefore your approach must not be a one size fits all. I think the thing about co production is you'll never go from just like cars and then our pledge. You'll never go from North 60

And also there's a There's a speeding up process, and some of that involves building up relationships. Some of that involves people being able to understand what your purpose is for engaging with us. So, for example, just to sort of pick any example, I could pick the gypsy in local communities as well

Example. High levels of mistress based on historic experiences from whatever they may have been, particularly if they've come from Central and Eastern Europe where they faced, you know, measure hostilities over many, many centuries. Um, to expect those communities to suddenly get into the room with us and share everything that is useful tools is disrespectful because when they have done that in the past, the back to face all sorts of discrimination

So we have to be mindful that communities are not all at the same stage. But we have to find ways of building up that trust and confidence and showing to them this idea of reciprocity, what is in it for them, because that must be satisfied to as much as what is in it for us. And I think once we've got those sorts of conversations dealt with, we then can start working with communities who are who we ordinarily may have struggled to engage with

The co production gives us that in a way that perhaps engagement doesn't in a way that perhaps say participation doesn't. But it's all to do with how skilled the person who's doing it is. So I have lots of questions

So in terms of what kind of skills do you think that people that do coproduction need? Yeah, So, um, one of the things that we found through the strategy building exercises that we did in the workshops and the focus groups was, um, power is something that organisations and individuals may possess but struggled to accept that others who are on the receiving end of services may struggle with. So, you know, if you've been disenfranchised and have no voice in anything and then your brought to attend a meeting and contribute when there's lots of professors and doctors and surgeons and others in the room, um and just expect members of the public to contribute on the same level. You know, you're you're ignoring that, that our power differences, which are probably gonna make it difficult for such and such people to be able to participate fully

So one of the things that we have to recognise is how do we make it easier for people who in the past have not had those powers and may not have had the confidence that comes with that? How do we make it easier for them to contribute? How we making a Are we shooting ourselves in the foot by depending too much on meetings? Because if we are. Then how about we go to communities and talk to them? Whatever they meet to talk to them about, This is what we're doing. And how do we do this? How do we make this work? How do you what difficulties you envisage? Because it might

You know, you and I have been in meetings where people have been more powerful does and we will have felt a little bit intimidated. So can you imagine? We've got to sort of think like that for members of the public to So there's a skill in doing that, and the skill is recognising that. So that's the first thing

And then doing something about recognising that. So, for example, one of the things that we encourage as part of the strategy is meet people before and after meetings. So do a briefing before and say, Look, these are the agenda items

This is what we might discuss. Um, feel free to, you know, feel free to contribute. And after the meeting, you know, have a chat and have a coffee and just talk to them

Over time, people build confidence just like anybody, and that that's a skill and that skill is a people still do this skill, I think we found through the work that we did is recognising that there are different types of knowledge. Now, this is a key thing that I think has been missing, and our strategy does acknowledge it, and we're going to do quite a lot of work with, and you can ask me about that in a minute. But one of the things that we found is knowledge is that there are four different types of knowledge

So there is a proposition, all knowledge, which is usually born through the ideas of theory and learning. And, um, you know, academic teaching in books. So you know, you learn that through theoretical frameworks, then you've got practical knowledge

So that's how do you do things, whether it's taking blood pressure or whether it's taking blood or whatever it is practical knowledge that must say occupational therapists or doctors or speech and language is have they have that then the knowledge that communities have is neither of those things. Usually they have what is experiential knowledge, so that's knowledge that comes from belonging to a certain group, and understanding the cultures and customs of that and how that affects how people behave and think. And once you've got that sort of knowledge, um, influencing any systems that you're creating so you can have the proposition of practical

But then you also have the experiential why people might not engage in a obesity reduction exercise or why people may not take part in smoking cessation or whatever it is. You get that from talking to people and they'll, they'll happily contribute that. But you've got to respect that, and the practitioner has to respect that

And then there's, um so these are these are the types of these are the types of knowledge. These are the types of things that make skilled. I've been able to, you know, put coproduction into use

So you've talked a lot about sort of co production, the skills and what's needed to do co production. So I'm really interested in the co production, so co producing what impact that has on the individuals involved, maybe the organisations and also society. Yeah, So whenever anybody has done research on things like, for example, social capital, they found people who are engaged in areas where people know each other

Look after each other contribute to health services. Um, you know, support the police or support. You know the council's

Those areas tend to enjoy better health, those areas that tend to enjoy better outcome from services, and they are better funded. So by virtue of social capital alone, we can see that that has enormous benefits to society. And and so co production is a vehicle to achieve social capital

And it starts because if you've got people who live in a certain neighbourhood or in any city who are bothered about what's going on in that city who vote who, Um, you know, talk to the police about what needs to be done to cut down crime and who sit on G P panels to tell them about what the health issues are, who are supporting researchers with ways to cut down on, say, obesity or air pollution. All of those sorts of things. It's communities who are taking ownership of issues with the providers and the implementer, which gives it a better chance of it working

And any society where social capital has been sort of pushed into the right direction has always found that it there's an amazing fruit and I think for that reason alone, we need to try and work out ways to make that happen more and more especially for people, Um, and for societies which have not had those opportunities to influence services, programmes and research. So for you, professionally and personally, what is the value of co production? Uh, health, But more evidence based practise, which comes about through the research that we do because we all know we're asking the right questions and we'll know we're collecting the questions in the right way. We can then feed that into policy, um, and have a better chance of communities being ready for whatever changes we make

Um, there are a multitude, a range of benefits that come from co production and not least those who take part in contradiction exercises. Whether they're volunteers, you know, help us. We're designing whatever it is that we're doing or data collection

They feel enormous benefits for themselves because, you know, it gets into the C V. It makes them feel positive about what changes have made in their society. They can take the messages positive health messages to their families, to the communities as well and influence others

It has potential for behaviour change in a way that I think we're only beginning to wear cook too. Now. Thank you

Did you have anything else you wanted to show about your experience of production? Uh, no, I think I think contradiction is, uh is something that's time has now come, and we need robust and rigorous systems for it being implemented. And so I'm glad in both Tower Hamlets and in Bradford who have done this work which has culminated into a strategy. And we're now working with our partners to see how can we implement this? It's all good and well, having this in the form of a document, how do we achieve real change? And that's going to happen through working with people who, working with grassroots organisations and working with interested communities

So that's where that's the genuine on. Thank you very much. I'm gonna stop difficult in there

Let me. I know.