Equality of respect, recognition, rewards and representation

What this means 

The Sharing Power As Equals group were clear that there were four ‘Rs’ that underpinned work to reduce power imbalances. 

If there is not mutual respect between services and people with care and support needs, there is no effective basis for sharing power. It is a prerequisite for effective work in this area. 

If there is not recognition of the strengths, intelligence, opinions and experiences of people with care and support needs, there will be no change to the current power structures. 

If people are not rewarded fairly for their contributions (both in terms of money and in terms of credit), then it is a sign that those contributions are not valued as highly as professional contributions.  

If there is not fair representation, this can lead to tokenism, and it means that the rich diversity of identities and opinions among people with care and support needs will be excluded from contributing to change. 

It can feel that our contributions are valued as long as it is a limited challenge to the current system, rather than something more wide-reaching and critical.

What is the one thing you would most like to change about social care if you had a magic wand?

In this clip, Katie Clarke describes the one thing she would change:

The research 

People with care and support needs are often highly motivated to make things better for others in a similar position (Weaver, 2019; Poland et al., 2019). According to research, for people to share their own experiences in order to improve services – just as everyone in this project did – is a common impulse. In one recent survey, 93% of people in the UK who access services would be interested in opportunities to get involved in making services better (Batty et al., 2022). 

Having something to give can powerfully lift a person’s sense of self. Feeling that your own experience can make it better for others in the future can make a difficult process feel more worthwhile (McMillan, 2019). This positive intent from people can be further enhanced by equal recognition, reward, and representation. Fair payment in exchange for expertise, along with prompt payment of the full costs incurred, is cited by Batty et al. (2022) as vital for this equality to happen.  

In order to avoid tokenism and increase the recognition and representation of people with care and support needs, there is learning that can be taken from the academic world and its experiences of co-research and applied to co-production more broadly. Embregts et al. (2018) considered how tokenism can be avoided when collaborating with people with learning disabilities. The following was found to be important:

  • Building a mutual relationship
    This included establishing trust, stressing equality of opinion, and avoiding paternalism. For example, highlighting the equal need for everyone to commit, whether they have learning disabilities or not – but ensuring help is available to help this happen in practice. 
  • Communicating 
    Listening, meeting the communication needs and preferences of the person with learning disabilities, and paying attention to non-verbal cues. For people in the project without learning disabilities, not being defensive when receiving feedback was essential
  • Achieving a collaboration in which everyone can contribute  
    Being aware of different lengths of time needed for preparation, practicing, planning, adjusting the working pace, and, for those in the project without learning disabilities, to consciously resist ‘taking over the lead’. 
  • Being aware of skills and developmental needs 
    Recognising and valuing the skills of people with learning disabilities and supporting the growth of other skills (such as reflective capacity). 
  • Being aware of impact 
    For all in the project to be aware of emotional and practical impacts, including that people may find the experience intimidating. 

What you can do 

If you are working on (or about to start) a participation or co-production project: Consider how equal it is in terms of respect, reward, representation and recognition. 

Respect. Consider the relationships that underpin the project: 

  • Have you spent some time talking with people before the project formally begins? This is not only to find out about them, but to give them the opportunity to find out about you and your experience in co-production. 
  • Have you enabled people to co-produce the project’s proposed outcomes, as well as contributing to its process? (You may find the section on Pre-produce, co-produce, evaluate helpful to refer to here.) 
  • Have you collectively set ground rules together, rather than imposing a ‘professional’ set of ground rules? 

Reward. Consider the payment terms you offer for people’s work on the project. 

  • Who set the payment rates? Did they have lived experience?
  • Are they equal to (or more than) those you offer to professionals?
  • Do you have a set amount of money for expenses, or do you check with people individually about the expenses they incur?  

Reward isn’t only about money. Do you support reward in other ways, such as skill development? Do you provide continuous feedback as to how people’s work will be used, and gain their ideas for how the work can maximise its impact? 

Representation. Consider the breadth and depth of experience on the project: 

  • What is the ratio of people with lived experience to professionals on the project? If fewer than half of the people on the project have lived experience, this may not adequately avoid tokenism. 
  • Does the co-production group represent the local population in terms of its diversity? Are a variety of identities, needs, experiences and opinions represented? 
  • Are you sensitive to different communication needs, styles and preferences, so people can contribute in a range of ways? 
  • Do you invest time in relationship-building throughout, and truly welcome challenging feedback? 

Recognition. Consider how people’s contribution is recognised: 

  • Are people fully credited (unless they wish to remain anonymous) in any published material, on an equal par to professional contributions? 
  • Do they have opportunities to promote the work? 
  • Can everyone celebrate and document the project via blogs and social media? Can you offer people with lived experience the opportunity to write blogs and create audio/visual material to support the work? 

Finally, do not underestimate the intense, and sometimes emotional nature of co-production for everyone involved. You might consider, as a group, how difficult and emotional issues may be tackled, and – if you are a professional – reach out to your own organisation to understand what support may be available for the citizens and professionals who form the co-production project. 

Further information 

Read

It’s important to be clear with people that payment for co-production or any form of service improvement may affect any state benefits they receive. SCIE has a guide on the rules around this. 

Read and watch

As part of this project, there are some reflections on the process from everyone involved. You can watch, read and consider how you can learn from our experiences for your own project.

Return to the supporting resources for 'Sharing power as equals'.