Guidance on co-producing a research project

April 2021

Foreword

I first heard the word ‘co-production’ a few short years ago. I have been embroiled in the ‘involvement’ agenda as an activist, and working as a consultant on it for many years, and all of a sudden there was this new word and perhaps aspiration? I have had the privilege to chair a Co-production Network at the Social Care Institute for Excellence (SCIE) since 2012, as they saw this as a way forward in their work, making sure what they do is grounded in the lived reality of ordinary folk with social care needs. So, it is very exciting to introduce this guidance on co-production in research. We all move forward together. Going the Extra Mile (2015) set out a compelling vision and clear objectives for NIHR’s (National Institute for Health and Care Research) leadership in public involvement. That included “Recommendation 6 – Co-production: The public, researchers and health professionals should be empowered and supported better to work together in the future…” INVOLVE has led on establishing the principles for co-production in research, as a simple way to understand their possible importance in delivering research excellence. Indeed, this guidance has been a true co-production effort in itself, an iterative process, worked on by many people together, including and valuing lots of perspectives. I hope this helps you in your research endeavours.

Tina Coldham

(former) Chair of INVOLVE Advisory Group

February 2018

Note: INVOLVE was the NIHR’s national advisory group to support active public involvement in NHS, public health and social care research. INVOLVE was superseded by the NIHR in April 2020, and as such does not exist anymore.

Summary

Co-producing a research project is an approach in which researchers, practitioners and the public work together, sharing power and responsibility from the start to the end of the project, including the generation of knowledge. This guidance is a first step in explaining what we mean by co-producing a research project. It sets out the key principles and features of co-producing a research project and suggests ways to realise them. It also outlines some of the key challenges that will need addressing, in further work, to aid those intending to take the co-producing research route.

Key principles

• sharing of power – the research is jointly owned and people work together to achieve a joint understanding
• including all perspectives and skills – make sure the research team includes all those who can make a contribution
• respecting and valuing the knowledge of all those working together on the research – everyone is of equal importance
• reciprocity – everybody benefits from working together
• building and maintaining relationships – an emphasis on relationships is key to sharing power

Key features

• establishing ground rules
• continuing dialogue
• joint ownership of key decisions
• a commitment to relationship building
• opportunities for personal growth and development
• flexibility
• continuous reflection
• valuing and evaluating the impact of co-producing research

Introduction

Going the Extra Mile (a strategic review of public involvement in the NIHR) suggests co-production could be a means of evolving and improving public involvement in research. This guidance identifies some key principles and features involved in co-producing a research project.

The term co-production can be difficult to define and pin down, reflecting the wide range of disciplines from which it emerges and the often loose way it is applied. Some people use it to describe a particular methodology. For others, it is a term applied more loosely to the seeking of input from public members. Frequently, this means consulting the public, or the researchers deciding in which particular aspects of the research process the public can be invited to collaborate. But co-producing research means much more than consultation or collaboration.

This guidance was written for the public, researchers and health and social care practitioners. When using the term ‘public’ we include patients, potential patients, carers and people who use health and social care services as well as people from organisations that represent people who use services. Also included are people with lived experience of one or more health conditions, whether they’re current patients or not. We also recognise that people can wear more than one hat, for example, the public can also be researchers.

It has a focus on co-producing research projects and in particular, how co-producing relates to public involvement in health and social care research. We recognise that some people may only want to co-produce parts of a research project. The guidance here is about co-producing a whole research project.

So what is co-production and what does it mean for public involvement in research?

Co-producing a research project is an approach in which researchers, practitioners and members of the public work together, sharing power and responsibility from the start to the end of the project, including the generation of knowledge. The assumption is that those affected by research are best placed to design and deliver it and have skills and knowledge of equal importance. Our approach is that co-producing research is principles- driven rather than being a fixed set of tools or techniques. It requires that relationships are valued and nurtured and that efforts are made to redress power differentials. People should be supported and enabled to realise their potential in carrying out their roles and responsibilities in the project.

It is not the intention of this paper to provide a blueprint or ‘one size fits all’ guide to co-production. There is no single formula or method for co-production and to assert one would be counter to the innovation and flexibility that is implicit in co-produced research. Co-producing research can include partnerships between academia and organisations representing the public as well as individual public members working with organisations, for example universities, which undertake research. Nor is it the intention of this paper to provide solutions to all the challenges involved in co-producing research. Co-production does challenge how we think about and do research, and how we build relationships between organisations, practitioners, researchers and the public.

This guidance is a first step in explaining co-production in research. It articulates key principles and features, and some suggestions – by no means an exhaustive list – for how these might be put into practice. The guidance concludes with some of the challenges that need to be addressed to aid those intending to take the co-producing research route.

Key principles

Sharing of power

The research is jointly owned and people work together to achieve a joint understanding

This is the key principle and the one from which all others lead. Research becomes a shared responsibility rather than the preserve of researchers and practitioners.

Co-producing research means that relationships and systems are horizontal rather than vertical. Often there are differentials in power between researchers and practitioners on the one hand and public on the other. This inequality in power can be rooted in wider social and economic differences which need to be recognised and this inequality needs to be continually addressed in the ongoing relationships.

It should also be noted that ‘sharing of power’ does not mean that everybody is involved in every decision and every part of the project. People working on a project will still have different roles, for example there will still be a ‘leader’ on a project – and this can be a member of the public. Sometimes this leader, for example the Principal Investigator, may be the person who is ultimately accountable. However, they can still share the responsibility and key decisions with others.

During a project, power between individuals might fluctuate depending on the expertise required at any particular stage. But the aim is to ensure that power relations are more equitable than hitherto and that there will be joint ownership of key decisions on a project as people work toward a shared understanding.

With shared power and ownership of key decisions comes responsibility. There need to be defined roles for everyone, with each team member holding real responsibility.

Including all perspectives and skills

Make sure the research team includes all those who can make a contribution

Co-production requires a research team to ensure that all necessary views, experiences, skills and knowledge are included. These encompass the different types of expert, for example, members of the public who have knowledge and expertise about their own experiences of services or a condition, and researchers and health and care practitioners with their own relevant skills and knowledge.

Co-production also involves embracing diversity and developing structures and practices to enable the involvement of all those people required for a particular project, including underrepresented groups. To be inclusive, the research must be accessible – for example meetings need to be physically accessible and documents and other information available in an appropriate format and language.

Respecting and valuing the knowledge of all those working together on the research

Everyone is of equal importance

The starting point is that everyone working together on a research endeavour is of equal importance. Everybody on the team is recognised as an asset. Traditionally practitioner/ research expertise carries greater value than other forms of knowledge, for example experiential knowledge. Co-producing research requires that the different knowledge bases, experiences and perspectives of all involved in the enterprise are afforded equal respect and value. Additionally, we must provide the space and opportunity for all voices to be heard.

Reciprocity

Everybody benefits from working together

The contributions of people should be recognised. Everybody working together on a research project should get something back from contributing to that project. This could take many forms, not just financial rewards. For example, the development of social networks, increased confidence, new knowledge and skills and access to courses and training.

Building and maintaining relationships

An emphasis on relationships is key to sharing power. There needs to be joint understanding and consensus and clarity over roles and responsibilities. It is also important to value people.

The evolving relationships between the various people working together on a research enterprise are key to co-producing research. It is the evolution of these relationships and of trust that enable co-production to happen. In order for trust to develop, individuals need to reflect on the knowledge, assumptions, preconceptions and biases that they bring to a research project. There needs to be an acknowledgement and mindfulness of the complexity involved in ‘power differentials’.

Key features

This section outlines some of the key features that you might expect to see in co-produced research. Each key feature is followed by some suggestions as to how it might be achieved. These are some pointers rather than an exhaustive list.

Establishing ground rules

Establishing ground rules at the beginning of the project can help create an environment where all voices can be heard and treated with respect. These ground rules, developed by the group working on the research, can help clarify the expectations of everyone’s roles, responsibilities and behaviours.

How might this be achieved?

A useful starting point would be the work NIHR, along with partners, has been doing on values, principles and standards. Getting consensus on the values and principles will provide guidance on behaviours expected, while the standards provide more detail on how these values and principles might find expression.

Continuing Dialogue

There should be dialogue between all those working together on the research project. This dialogue should begin before the start of the project, to help identify different types of knowledge, roles, responsibilities and expectations, and to establish relationships.

How might this be achieved?

Dialogue needs to be built into the governance of the project. It should continue throughout the project as project plans, ideas, research tools and knowledge that emerge from the project go through various iterations and are influenced and shaped by those involved.

Joint ownership of key decisions

It is the ‘joint ownership of key decisions’ which helps differentiate co-producing from collaborating. It is not that everyone needs to be involved in every decision or every aspect of a piece of research but rather that the group, working together, decide and agree who should be involved and when, in all the aspects of the management, governance and conduct of the research.

How might this be achieved?

One approach is for everyone ‘around the table’ to outline, at the beginning of the project, what they do know and what they don’t know about a given topic area – the intention is to pool the collective knowledge and move researchers and practitioners away from being the arbiters by default of what is and isn’t important knowledge. If researchers and practitioners put themselves in the role of ‘experts’ then the inference is that others are not. This sharing and enabling everyone to have a voice creates a sound platform from which to progress.

A commitment to relationship building

Embracing these principles requires a coming together of the organisations which host research projects and the communities within which they exist. Addressing power differences requires the development of open, honest, trusting and reciprocal relationships. This can be challenging to the cultures and behaviours of organisations, and take time to implement. Co-production won’t ‘just happen’. Organisations and researchers need to shift from being t ‘doers’ of research to proactively facilitating public involvement and developing relationships beyond the research community.

How might this be achieved?

Sometimes there will need to be a commitment to relationships beyond the lifespan of an individual project. One approach, which may not be appropriate for every research project, would be to establish and cultivate a research reference group, which is attached to the organisation undertaking research (rather than just an individual project). This reference group could meet regularly with staff, and its members could undergo any necessary training and be regarded as an asset in the development of research ideas. The membership of a reference group is not static and will, periodically, need new members to ensure diversity and inclusivity

Over time the reference group could help shape, for example, the research strategy of the organisation, and members could work on individual projects. Organisations which undertake research could provide induction training to their research staff and public members on co-producing research. This would, at the very least, raise awareness of what co-producing research entails and the likely challenges. Safe spaces could be created to enable people working together to step outside their official roles, develop good and trusting relationships and share information about themselves that is not project related, for example, their interests or activities away from work. The key is to change group dynamics and communicate on a more equal basis.

Such an approach requires the investment of time and funding- – which must be built into individual projects and/or become part of the ‘way of doing things’ in those organisations which undertake research.

Opportunities for personal growth and development

There is an emphasis on supporting individuals and unlocking the potential of individuals to contribute to the project. In this way people are treated as assets with the skills, knowledge and experience to help develop solutions to issues. Project leads need to facilitate the involvement of the public effectively and manage the flexibility and uncertainty that are often involved in co-produced research projects. Members of the research team need to be willing to relinquish power and accept reciprocity of experience and expertise. This may require a cultural change in the research team and/or the organisation hosting the team.

How might this be achieved?

An obvious mechanism is the provision of training and support – for the public, researchers and practitioners. Researchers might need training and support to work in a co-productive way. The public may require training and support to equip them with the knowledge, skills and confidence to be able to play a full and effective role. This support will enable their voice to be heard, take responsibility and facilitate their involvement. There is a shared responsibility to be alert to training and support needs, and to address them as necessary.

Flexibility

A research project usually has a predetermined project plan. However, a co-produced research project should provide opportunities for an iterative, fluid, open-ended, experimental and interactive process; there should be opportunity for solutions and innovations to emerge from the relationships developed.

How might this be achieved?

Devolution of decision-making power is required. Co-producing research challenges the top down approach to research; in co-produced research, decision-making is devolved and shared. It is important to provide opportunities for discussing ideas, assessing progress and reflecting on the research project.

Valuing and evaluating the impact of co-producing research

It is as important to value the impacts of a co-productive research process as it is to value the research findings or outputs. Some of these impacts will emerge rather than be planned: for example, new relationships, expanded social networks and increased confidence of members of the public who are involved. The eventual knowledge, research findings or outputs that result from co-producing research might also differ from those produced in a conventional academic process.

How might this be achieved?

In order to build up the evidence base for co-producing research, it is important to put in place mechanisms to evaluate, measure or assess the impacts. Using reflective processes (see section below) is one example. Another may be keeping a co-production log throughout the project. You can read the Public Involvement Impact Assessment Framework (PiiAF) resources for evaluating impact. Although the responsibility for co-producing research – and evaluating its impact – should be shared and owned by all members of the team, it is helpful to have one or two people whose particular role in the project is to focus on evaluating, measuring and assessing impact.

Continuous reflection

Reflection is a process whereby research team members have the opportunity to look at and reflect on how they are working together, how they might be using their particular expertise and perspective in the project, and how this might impact on the research process and findings/outcomes.

How might this be achieved?

There are many different kinds of reflective approaches. Research teams should think carefully before the start of the project and agree on what approach might best fit both the type of research they are doing and the way the team is structured. For example, team members might keep individual reflective diaries pegged to each research stage or there might be team meetings held every few months with a specific reflective focus.

Using reflective approaches such as these can be a helpful way for a research team to keep continually and collectively aware of how they are working together, what is working well and where there are tensions or sticking points. Creating safe and supportive spaces which enable team members to openly and honestly reflect on challenging issues such as power dynamics and inequalities is an integral part of co-producing research. This kind of reflective process should not be confused with supervision or an annual review/appraisal provided by a line manager as a part of someone’s role and career development.

Conclusion

Co-producing a research project has profound implications for organisations’ cultures, ways of working relationships with the public. Indeed, it has the potential to transform how we ‘do’ and think about research.

Efforts to co-produce research will often build on existing public involvement frameworks in organisations. Indeed, some readers will recognise in this guidance principles and key features which feature in public involvement frameworks with which they are familiar.. Sometimes these involvement frameworks will provide firm foundations for building co-produced research while at other times they will require modification.

This paper highlights a number of challenges that will need to be addressed in order to fully realise the potential of co-producing research. Though by no means an exhaustive list, below are some of the key ones:

1. how can we ensure that power is shared in a research project (given how research is currently funded and organised)?
2. how can we allow for the greater flexibility often required in a co-produced research project (given the way that research is usually governed)?
3. can we develop criteria that would enable funders/reviewers to determine if a project has been co-produced?
4. can we develop tools or guidance on how to co-produce knowledge?
5. how do we assess and evaluate co-produced research? And how do we ensure that it is regarded as ‘credible’?

In short, this guidance is the beginning of our work on co-producing research. It is not the final word.

Updated resources since original publication

BMJ: ‘Co-production of knowledge: the future’ Collection of articles (2021)

NIHR Co-Production in Action (Number One)

NIHR Co-Production in Action (Number Two)

NIHR Co-Production in Action (Number Three)

The Co-Production Collective is a community of patients, carers, researchers, practitioners, students and anyone else who is interested in co-production (in the health context or more generally). They work with individuals and organisations including universities, charities, funders, NHS bodies, local authorities, housing associations and grassroots groups.

How to cite this guidance

NIHR, Guidance on co-producing a research project, April 2021, [URL], (Accessed on: [DATE])

Acknowledgements

This resource was reviewed by NIHR in March 2021 for accuracy and currency. The NIHR endorses this resource.

The previous version was referenced as: Hickey, G., Brearley, S., Coldham, T., Denegri, S., Green, G., Staniszewska, S., Tembo, D., Torok, K., and Turner, K. (2018) Guidance on co-producing a research project. Southampton: INVOLVE. The 2018 guidance was co-produced by Gary Hickey, Simon Denegri, Gill Green, Doreen Tembo, Katalin Torok, Sally Brearley, Tina Coldham , Sophie Staniszewska and Kati Turner. Important contributions were also made by Tracey Johns, Jonathan Paylor, Stan Papoulias, Nigel Cox, Gill Wren, Sam Goold and by a wider group of research institutions and public contributors.