Sian Lockwood’s excellent piece in July started our series on ‘Best Mistakes’. We wanted to help break the taboo about mistakes and failure. We’ve had a great response and hope to build lots of positive stories. We thought we should demonstrate our willingness by writing our own pieces. So here is mine.

It’s about an incident that probably planted the seed that led, via a circuitous route, to the Ideas Hub. It was where I learnt how ‘not to do’ co-production.

The Mistake

About 15 years ago now I was a new consultant, a paediatrician doing general work and helping with the children and young people’s diabetes service. Our adult colleagues had arranged a meeting where two patient representatives were coming, to talk about diabetes services in the hospital and how we could improve them. I had been working with the adult diabetologist in our transition clinic where young people were moving on to adult services, so I was invited.

The meeting had the diabetic specialist nurses, our dietician, various others and a couple, one of whom had diabetes. About 85 of the 90 minutes of meeting time was taken up with us professionals talking at speed and interrupting each other about how we do annual reviews and other aspects of the service. We talked about blood pressure, eye checks, foot care, kidney blood tests, insulin, diets and blood sugar. The man and woman who were the patient representatives watched us, bemused. Then someone turned to them and asked if there was anything they wanted to say. The woman spoke “The thing that worries us most is his depression. It’s the hardest thing.” We hadn’t mentioned mental health at all. We hadn’t even thought of it.

What did I learn?

Two things hit me between the eyes at that moment.

One was that if you are going to ask people to give up their time to come to something like that, include them from the beginning. I was embarrassed that we were talking away, ignoring our guests. We were so keen to impress each other, we had forgotten the voices of those who really matter.

The second was that the insights from people from outside your own bubble can be so helpful. I was fully aware of the difficult emotional journey for children and young people when they are have diabetes and the impact on their families. I hadn’t made the leap to those much later in their life. With my biomedical training, I certainly didn’t have mental health or carer support at the top of my list of issues for people with diabetes. But I did after that meeting.

And now?

It must have been a very frustrating experience for the couple involved and it was deeply uncomfortable for the rest of us. Yet it formed so much of my thinking back then about involving people – properly involving them. I found it tough though as not many of my colleagues had had or ever would have, the same epiphany or believed they had anything to learn from people who had experience of the services they provide.

Much more recently I’ve worked with people who genuinely do want to listen and learn. I hope that I’ve played a part in persuading people to be more co-productive, more open minded and keen to seek views and ideas from people with lived experience and others.

Without that meeting, I like to think I would have got there in the end, but it certainly helped accelerate things for me. It remains memorable and I often use it as an example to be avoided.