The community was concerned there had been little chance to shape the options, were angry about the potential loss of services and felt there was little they could do to shape the outcome.
The NHS heard this loud and clear and when it made decisions, it included a commitment to involve people in shaping the implementation of the changes and in any future planning.
Since then there has been a commitment to work together – through co-production – to make changes utilising everyone’s ideas and energy.
Where services have changed the community has in some cases remained very angry and mourned the loss of some parts of the service.
Sometimes the NHS has felt that involving people in change has given some people licence to put the organisation under attack.
The NHS has also learned that involving people and sharing information early can be helpful.
Some issues are beyond all our control. There is only so much money, recruitment is a national challenge and safety is regulated.
Sometimes new ideas have developed and something special has been created.
Some problems are so deep rooted no easy solutions can be found.
We are still working together.
We have had people working together who disagree about the decisions and potential solutions and who remain worried about their healthcare.
We haven’t been able to look in a textbook when we have faced problems, we have worked through them together.
We have also found, particularly in service improvement as against strategic change, engaging the public, patient and carer voice has been highly productive
We don’t have all the answers but we have put together a toolkit which may help people as they get involved in co-production.
Please tell us what has been helpful, what we are missing and give us some feedback
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If you want to hear more about our experience or talk further also email: firstname.lastname@example.org