The key is through co-production; a powerful yet too often overlooked strategy, says Kathryn Marsden of the Social Care Institute for Excellence (SCIE).
This is the second article we’ve published within the last week that focuses on co-production. Previously, Jon Soros of SCIE outlined how it could be transformational for care staff. While echoing a similar view, in this article Kathryn explains the method could improve the longstanding, fragmented relationship between the NHS and social care.
The publication of the government’s 10-Year Health Plan was broadly welcomed for its emphasis on a more preventive, digitally enabled and community-based NHS. Its vision to shift focus upstream—towards early intervention and localised models of care—represents a potentially transformative moment.
Central to the plan is the ambition to transition towards a more patient-centred NHS delivered at neighbourhood level, where choice, autonomy, and control are placed more firmly in the hands of the individuals using its services. This marks a significant reorientation of the system, aligning with broader efforts to personalise care and promote shared decision-making.
That said, a notable and concerning omission in the plan is the lack of clarity regarding its interface with the social care system—despite social care’s potential to reduce demand on hospitals and the government’s ambition to join-up services.
The entrenched fragmentation of these sectors—operating in parallel but often disconnected pathways—has long hindered effective responses to individuals with complex and overlapping needs. We must reimagine the partnership between health and social care through innovative approaches that go beyond conventional collaboration.
What do we mean by partnerships?
Partnerships, in the context of health and social care, should not refer merely to closer working between the sectors—but to the design and delivery of services that are experienced as joined-up by the people who draw on them. This involves aligning objectives, funding mechanisms, information systems and—crucially—cultures across traditionally distinct sectors to provide more holistic, person-centred support.
The need for such partnerships is especially acute for older people and people with complex, long-term conditions. These populations frequently navigate a patchwork of services and bureaucratic delays that compromise outcomes. The consequences of this are well documented: delayed hospital discharges; revolving door admissions and unsuitable care plans that fail to ensure quality of life and independence.
Challenges of top-down efforts
Despite widespread recognition of the need for more joined-up and person-centred systems, efforts to partner health and social care have historically been led through top-down approaches—often conceptualised in terms of institutional efficiency—rather than by the needs and aspirations of people who draw on care and support. This has rarely translated into services that feel coherent or seamless to those navigating multiple points of care.
Crucially, integration efforts have not treated both sectors with equal significance. Social care has been positioned as supporting the NHS’s aims—such as a crisis response mechanism rather than as a core component of a holistic, preventative system of support. This unequal positioning is further exacerbated by imbalances in funding, influence, and strategic priority.
Co-production and innovation
If top-down partnerships have reinforced unequal power dynamics and sectoral imbalances, then the solution must begin with a different kind of partnership.
Co-production is about working in equal and genuine partnership with people using services, carers, families and citizens to design, test and implement new ways of delivering care and support. It represents a shift away from professional or system-led decision-making towards shared ownership of services. At its heart is a recognition that those who draw on care and support possess invaluable expertise rooted in lived experience.
The keyword here is genuine. While co-production has become an increasingly familiar term in policy and practice, it is frequently used to describe forms of engagement that fall short of true partnership. Genuine co-production requires more than inviting people to comment on existing plans—it means building relationships, redistributing decision-making authority, and embedding lived experience as a central, ongoing influence at every level of system design.
What’s more, co-production can help deliver innovative ideas and new approaches to integrated health and care services. Innovation plays a critical role in bridging traditional silos by re-orienting services around what matters most to people. By centring lived experience, co-production ensures that care is shaped around the real-world needs of those navigating both health and social care systems.
From theory to practice
Co-produced innovation is not merely a theoretical ideal; compelling examples are emerging that demonstrate practical ways to bridge these long-standing silos. This momentum was exemplified during the Social Care Institute for Excellence-led (SCIE) Co-production Week, with this year’s theme, ‘Innovation through co-production’, focusing on exploring how genuine partnership can drive meaningful and sustainable innovation across the sector.
In this context, we launched our new report, ‘Embracing Change: Scaling Innovation in Social Care in Practice’, at Westminster. Drawing upon SCIE’s direct engagement with over 120 local projects funded through the Department of Health and Social Care’s Accelerating Reform Fund (ARF), the report offers invaluable insights for the wider sector. It provides a clear understanding of the approaches employed and, critically, what works in practice to deliver co-produced innovation at scale. Notably, many of these projects are explicitly addressing the challenge of siloed working by fostering cross-sector collaboration grounded in lived experience.
For example, over the past six years, Worcestershire family carers have consistently highlighted that their primary concern with health and social care services relates to the hospital discharge process of the person they support. Frequently excluded from discharge planning, carers report uncertainty about what the transition will entail and the nature of support required at home. This lack of involvement often results in significant stress and anxiety.
In response, Worcestershire County Council has convened a coalition of partners, including the Worcestershire Association of Carers (WAC) and the technology provider Taking Care. The project, based in the stroke unit of a local hospital, embeds a dedicated Hospital Discharge Carers Adviser who works closely with carers from the outset—identifying them early, guiding them through discharge procedures, and connecting them to community resources.
Complementing this personalised support, the initiative has provided 60 free technology-enabled care kits, featuring devices such as emergency alert buttons and fall monitors, designed to increase carers’ confidence and reduce hospital readmission rates.
Next steps
These lessons make it clear that the government should regard the 10-Year Health Plan not as a definitive, exclusive strategy but as a foundational framework that involves social care partnerships. Only by embracing this broader, more inclusive approach can the plan’s ambitions be fully realised.
Furthermore, projects like Worcestershire’s demonstrate that local and national leaders should be looking to build and embed co-produced innovation into local reforms. SCIE’s workshops, conferences, and live discussions during Co-production Week also revealed the need for this. The solutions are there; all that is needed now is a commitment to deploying them.
Photo by Nick Fewings via UnSplash
Other features:
Child and adolescent mental health: five learnings for social care professionals
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