Co-producing care services in rural areas

Abstract

Purpose – Current policy context in the UK promotes the “co-production” of health and care services – with service users and providers working in partnership. However, the assumption that all individuals and communities have the personal resources, skills and willingness to get involved in co-produced services may have implications for social and geographical equity of access to health and care services. The paper presents the results of a nine-month action research project with a remote and rural community in Scotland to discuss the implications of co-produced health and care services for remote and rural community members – particularly those with ageing populations. Design/methodology/approach – The research project worked with community members, health care providers and commissioners to develop a community social enterprise model for home care delivery. Textual resources collected during this action research process were subject to thematic analysis in order to explore community perceptions and experiences of service co-production development in the remote and rural context. Findings – The qualitative analysis showed that community members identified some positive aspects of being involved in service co-production relating to sense of community, empowerment and personal satisfaction. However, negative impacts included increased feelings of pressure, strain and frustration among those who took part in the co-production process. Overall, the community was reluctant to engage with “transformative” co-production and traditional provider-user dynamics were maintained. Originality/value – The example is used to demonstrate the types of resources that rural individuals and communities draw on in order to create social enterprises and how the potentially negative impacts of co-produced services for different types of social and geographical community may be overlooked in contemporary policy and practice.