Co-production with marginalised workers: working with homecare workers and managers caring for people approaching end-of-life

Background

Co-production is important due to its effectiveness in creating relevant and meaningful outputs for use in social and healthcare practice, however, frontline staff such as homecare workers (also known as aides, personal assistants or domiciliary care workers providing paid care within the home) are a key group within the social care workforce who are under-represented in this approach. Here, we report our coproduction process engaging with this workforce to develop training resources for workers providing end-of-life homecare.

Aim

To co-produce training resources with homecare workers and their managers to support and educate workers delivering end-of-life homecare using evidence from our larger qualitative interview study.

Methods

We conducted a series of 12 co-production workshops with UK-based homecare workers and managers (partners) to design training resources and recommendations for homecare providers informed by research findings. We adopted the five key principles of co-production: Sharing of power; Including all perspectives and skills; Respecting and valuing knowledge; Reciprocity; and Building and maintaining relationships. A co-production advisory group of homecare workers as well as the workshop partners gave valuable oversight throughout the workshop series.

Results

77 partners (31 homecare workers, 46 managers) participated in 12 workshops (one face-to-face; 11 online). Our approach enabled power-sharing, inclusivity, respect, collaboration and reciprocity, relationship-building, and identification of effective flexible approaches to co-production. Specific forms of training resources were co-created. Training recommendations (content, delivery formats, access during working hours, etc.) were also developed together. Challenges were non-attendance and lack of engagement by some partners during sessions.

Conclusion

These workshops are the first, to our knowledge, to successfully co-produce end-of-life care training resources with homecare workers and managers, a poorly represented workforce in co-production. Challenges included inconsistent attendance and poor engagement by a minority of partners. The five key principles of co-production enabled true engagement with the process, thereby enriching the final outputs.