Co-producing public services: the case of health and social care services for older people

Abstract

This thesis develops our understanding of the roles and processes underlying the co-production of public services. The co-production concept encapsulates the joint contribution made by service users and service providers to the delivery of services, acknowledging the expertise, inputs and role of service users. There has been an expanding stream of literature within the public management field focusing on co-production, recently enhanced through combinatory insights drawn from the service management literature. The thesis builds on this perspective, and addresses a current gap in understanding regarding the processes and roles that underpin the concept of co-production. In particular the research questions consider: the factors that facilitate co-production; the features of co-production that are evident within everyday service interactions; how service users and employees interact within the processes of co-production; and how these impact upon the delivery of public services at an individual level.

The research for the thesis is undertaken within the context of community health and social care services for older people, at two locations in Scotland. An interpretivist, constructionist approach is taken to the inductive study which adopts a qualitative case study methodology. The research findings are drawn from semi-structured interviews with managers, older people and employees delivering services, together with observations of meetings and service interactions.

Extant research has often conflated the roles of employees and public service organisations, and equal attention is rarely paid to the co-productive roles of service users and employees. The study makes a theoretical contribution by: developing the concept of active co-production; highlighting the complexities of the roles and processes underpinning co-production; revealing the different types of learning occurring within co-production; and developing a model to explicate the processes that combine the expertise of older people and employees, during the delivery of public services. On a practical level the study also highlights how more advanced and ‘active’ forms of co-production have developed, and the impact this has on the delivery of health and social care services for older people in Scotland.