Diane Plamping says...

"The language will have become mainstream but not devalued and collapsed back into old processes like consultation. The consensus will be that co-production is primarily about effectiveness not just a moral imperative for a public service

There will be many more processes in which people have recognised that ‘doing or making it together' produces a better outcome. This will mean we know that we put more effort into these productive relationships and conversations because what happens, happens quicker and with more resources than if we had to do it ourselves.

We will be clearer about the cost of a deficit model towards our clients and communities. We will have some experiences where we assumed they have assets and are resourceful so they were able to contribute to the resources available to support solutions.

They will tell a story about how fortuitous it was that they found out about this concept before the "credit crunch" hit public expenditure...

In 2009 there was the launch of a 5 year dementia strategy; it only came with £150 million extra. In most places they went the usual way of developing new specialist services (memory clinics) with the emphasis on professional diagnoses of disease processes and lots of costly training for professionals. This used up all the financial resources but did not help them meet the 16 other strands in the strategy many of which could only be achieved through co-production and not the usual professional services. When we looked at our information it matched the Royal college of Psychiatrists (2005) estimate that 70% of acute beds are occupied by older people and up to half of these may have cognitive impairments. Their outcomes are worse and they cost the NHS in terms of length of stay an estimated £6 million per DGH, so seeing the problem as solved by a new ‘bolt on' specialist service was unlikely to generate a whole system approach in which ‘we all care about people with dementia'.

We took a functional capacity approach in which patients, carers and communities can be expert. They can 'diagnose' capacities for everyday living as well as co-creating solutions; often without specialist teams. The GP, the family members, neighbours, the third sector have a role to play and commissioning services might not be the approach and not all these behaviours did happen within the usual ‘contract' relationships. So we sometimes contracted from services from unusual providers. Sometimes we commissioned capacity building services as invest to safe programmes and we worked out a system of small grants. Rather like the micro-credit movement we found people can use very small sums of money to make big benefits for individuals and communities."

Martin Bontoft says...

The 'Baby Boomer' generation were always the people to complain and organise and create change; they tackled sexism and racism, and in the last few years have gone a long way towards challenging the ageist view we had of our elders.

Of course, you could say they were forced into organising. Trapped between the financial demands of their children and their ageing parents, with their dwindling pensions, surrounded by care homes run by avaricious and uncaring organisations, and yet supported by personalised health and social care budgets, it seems now the logical choice but when the co-produced care home movement started very few believed it was sustainable.

What did make it sustainable was people's enlightened self interest - what was in the interests of their parents, was very much in their interests, too. Looking forward to a long retirement without the cash-rich pension was enough of a spur. Combine that with their realisation, now supported by evidence, that working together to look after each other maintains and enhances the personal and professional skills of a lifetime, and creates a strong community. It is this combination that has proved successful, co-produced care homes are now being opened at the rate of one a day and co-production mentors are criss-crossing the country spreading the word.

Extract from Society Guardian, 20th March 2014