Spurred on by the publication of the National Institute for Health Research (NIHR’s) Going the Extra Mile and the subsequent NIHR Guidance on co-producing a research project, co-production has become somewhat of a buzzword in the health research field.

The term has been the focus of many articles, blogs and events, such as:

And as RDS London public involvement advisers we increasingly see researchers referring to co-production in their research grant applications.

Despite, or perhaps because of this growing interest, there seems to be some confusion surrounding co-production.

For some, it’s merely a fashionable term for describing very good public involvement. For others, it’s categorically different, i.e.  a distinctive approach to citizen participation in health research. It’s perhaps no surprise then that we are frequently asked, “What’s the difference?”.

There is no simple or quick answer to this question. Any attempt to draw clear and conclusive definitional boundaries starts to come unstuck when confronted with the diverse ways in which public involvement and co-production have both been understood and put into practice. Recognising such complexities, however, only takes us so far. So, we’ve put together some pointers to help you navigate this conceptual minefield.

NIHR’s conceptualisation of co-production

In their Guidance on co-producing a research project, the NIHR put forward a conceptualisation of co-production that has been developed for the purposes of enhancing public involvement in NIHR-funded research. While this understanding shares many similarities with other conceptualisations of co-production, there are important differences.

What is important to bear in mind is how the NIHR specifies particular principles and features of co-producing a research project, which are captured in the following definition:

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.

NIHR, Guidance on co-producing a research project, p.1

While this definition allows room to interpret and implement co-production in different ways, it constitutes a more narrowly defined conception of co-production compared to those often found in other settings.

For instance, other research funders such as the Economic and Social Research Council (ESRC) describe co-production in more general terms, referring to it as knowledge production that involves collaborative relations between academics and non-academics.

There is a notable difference between the NIHR’s conceptualisation and these more loosely-framed definitions of co-production. The latter tend to encompass a wide range of ways of thinking about and enacting collaboration, some of which exemplify ‘conventional’ approaches to public involvement, such as ‘consultation’. 

The key point being, while in some settings it maybe to appropriate to describe your research as co-produced, in a NIHR context this may not be case.

Co-production as an approach to PPI 

Public involvement is commonly defined as, “research carried out ‘with’ or ‘by’ members of the public, rather than ‘to’, ‘about’ or ‘for’ them” – a definition that can be traced back to the 2004 edition of INVOLVE’s Briefing notes for researchers. This definition has historically functioned as a general category, encompassing a wide range of approaches to involving members of the public in research. For instance, in these briefing notes for researchers, promoted approaches to public involvement include ‘consultation’, ‘collaboration’ and ‘user-led researcher’.

If we work this general categorisation, it follows that co-production is a particular approach to public involvement. In this way, rather than asking, “What’s the difference between public involvement and co-production?”, we should ask, “What’s the difference between co-production and other approaches to public involvement?”

Again, there is no quick and simple answer given the various and overlapping ways in which public involvement and co-production are understood and applied. However, a useful way to address this question is to consider the forms of public involvement that have been most common, and to draw a distinction between co-production and these tendencies. This brings us on to our next point.

Co-production is more egalitarian than conventional public involvement approaches

While there has been much talk about democratising health research and working ‘with’ members of the public, in practice public involvement has often taken the form of consultations and/or advisory groups. In such settings, power remains in the hands of researchers – they are the ones who ultimately set the agenda and make decisions. Co-production, as conceived by the NIHR, represents a more collaborative and egalitarian approach – one where the agenda-setting and key decisions are shared between researchers and public contributors. In this way, we can think of co-production as offering an approach that is different to how public involvement has tended to be implemented, i.e. an approach that is situated more firmly towards the collaborative/horizontal end of the public involvement spectrum.

Is co-production always appropriate?

As co-production continues to gain currency and be lauded as the gold standard, it is understandable that researchers may feel compelled to co-produce.

There is a risk that researchers may build co-production into their research plans without thinking carefully about the appropriateness of this approach and what it will mean in terms of resources and time. Worse still, researchers may have little intention to co-produce, but throw terms like co-production into their grant applications to simply impress funders. What’s at stake here is that such ‘performances’ of co-production may feed into a culture of impression management that can leave public contributors feeling disempowered and tokenised.

So, before proclaiming co-production, we encourage everyone to carefully consider what is means to co-produce.

co-production, public involvement