Co-production is working together.

We know the NHS doesn’t have all the answers and we want to harness the energy, ideas and enthusiasm of our community to help us tackle the issues that are challenging our services. Services are better when the voice of the patient, the community and the staff help shape the delivery of our health and care.

After the Healthcare For The Future consultation, health leaders promised to work with our communities to implement changes and improve and develop our services. It is open to everyone who cares about our services and wants to work constructively to develop them.

We are learning as we go about effective ‘working together’ and will share best practice as it develops

Download template document here.

This was developed by members of our community and health and care professionals working together to establish a framework for working together successfully (Cumbria Way Co-production Toolkit 2018)

[Release from July 2019]

Consultant-led services will remain in west Cumbria following a decision by NHS North Cumbria Clinical Commissioning Group’s (CCG) Governing Body on 3 July 2019.

It follows a 12 month period of review of progress to sustain and develop services and the recommendations of an Independent Review Group (IRG) made up of independent clinical specialists chaired by Dr Bill Kirkup CBE.

The review was commissioned following the Healthcare For The Future public consultation in Autumn 2016, and follows the decision made in March 2017 to continue services and test them while working with the public.

The report acknowledges the hard work of staff in the service and the innovative work by the community to support services through the Working Together Group.

Dr David Rogers, medical director for NHS North Cumbria CCG, said: “The CCG has been committed to providing sustainable consultant-led services and we are pleased to see the hard work of a lot of people over a number of years being recognised.

“The Trust has faced problems recruiting and it is clear that is improving, and there has been considerable commitment from the staff to make things work.

“I also want to thank the people who have given up their time and got involved in ‘working together,’ they have made a real difference. It is clear when you read the Independent Review Group’s report, that three years on, we are now in a very different place.”


Stephen Eames, chief executive of the North Cumbria University Hospitals NHS Trust and Cumbria Partnership NHS Foundation Trust, said: “I am pleased the Independent Review Group has recognised the hard work of our staff at the West Cumberland Hospital as well as the work we have been doing to recruit staff. Our medical vacancies are significantly reduced from 2016, although we know there are still challenges in key areas.

“We have come a long way since the consultation and trying new ways of working with our community is making a real difference. It is good to see the impact of this innovative and constructive way of working.  We now have an end to the uncertainty that has been surrounding the future of maternity services in West Cumbria that has inevitably caused anxiety for our staff and communities, and we can now get on with the job of providing good quality services to women and babies across our hospitals.”

The review by the Independent Review Group (IRG) noted the challenges faced by the service but were “impressed by the commitment shown to overcome the recruitment challenges, including some innovative approaches.”

The IRG report says:  “The services are being maintained, and given the same commitment and ingenuity to overcome future challenges, they can be sustained in future. The Independent Review Group therefore recommends that a commitment should be given to sustain the current pattern of consultant-led units in both Whitehaven and Carlisle.

“In addition, we recommend the continuation of both alongside midwifery-led units to offer a choice of birth setting in line with the Better Births report.

“Finally, there will be future challenges to these services, but they also need stability. It is important that there is a commitment to maintaining vigilance and supporting innovative measures to counter these, continuing the collaborative Working Together approach between the community and the NHS.”

In November 2018 the CQC reported maternity across the Trust was rated as ‘good’ and a CQC review of patient experience saw it score highly.

The Venerable Richard Pratt, the Archdeacon of West Cumberland, the independent chair of the Working Together Group said: ““I am very grateful to all those – from the community and the NHS – who have been so committed to the Working Together process.  I think it has had a huge impact in two ways.

“First, it has supported the NHS Trusts as they have changed the way in which they work, so that they have been able to think of and implement innovative ways to tackle the difficulties of providing maternity and other services at West Cumberland Hospital.  Second it has helped to give Dr Bill Kirkup and his group confidence in what we – the community and the NHS – are doing in west Cumbria.

“As the report of the Independent Review Group makes clear, Working Together must continue so that maternity and other services are sustained into the future, and indeed so that both the NHS and the community change for the better so that we have a Health Service (not an illness service) and healthy communities.

“In Working Together we are tackling not just maternity but also telehealth, children’s health, recruitment and retention, experience of care at a distance, and so on – and there is a real excitement about this and lots to do!

“Our next Working Together Steering Group Meeting is at 6pm on Wed 17 July at the Oval Centre. If you are interested in being part of health services for the future, you will be very welcome.”

Today’s decision by NHS North Cumbria CCG – on behalf of our health and care system – will mean consultant-led services will continue at West Cumberland Hospital, along with midwifery-led care, offering more choice for women.

Cllr Stewart Young, chair of the Cumbria Health and Wellbeing Board, said: “I welcome the decision to accept the recommendations in this report. It secures the future of services which are vital for west Cumbria.

“The process that has led to this point has involved a commitment to listen to local people and work with them to design services which is to be applauded.

“It is important that this dialogue continues and that all parties work together to ensure local people receive the best possible care.”

Work to support services will continue and more information about Working Together and Co-production can be found here.

The Cumbrian Way Towards Co-production
View the image full size here 
Being clear about the scope of co-production and what can and cannot be achieved Providing people with the training, support and resources to participate Knowing who is involved, why they are involved and what they do
Ensuring everyone involved has the information they need at the right time Creating an environment that ensures mutual listening, hearing and understanding Showing sensitivity and mutual respect in language and actions
Ensuring there is openness and honesty within the relationship Treating each other with the dignity and respect with the aim of achieving outcomes that will benefit the community Valuing and making meaningful use of the input of people who use services
Being creative and flexible and being prepared for change and difference Being open minded towards ways of doing things Doing not just talking
  Measuring the impact of the power of working together  

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co-production-working-together-toolkit-4.jpgThe Toolkit has been developed thanks to the hard work, honest conversations and energy of:

People across our community; members of the Working Together Groups; members of the Community Alliances in Alston, Maryport and Wigton; the West Cumbria Community Forum; the Third Sector and public sector staff.

All the staff and patients of our North Cumbria Health and Care System

Developed by Healthwatch Cumbria and Cumbria Learning and Improvement Collaborative CLIC

& Thank you for the vital support from NHS England