Using alliance contracting to put co-production at the heart of transforming substance use services in South Wales

| Helen Sharp

We have been given the immense privilege to be working alongside some pioneering commissioners and partners in Swansea and Neath Port Talbot as they transform the substance use services in their area. They wanted to have co-production and collaboration at the core of this work, and we’ve been able to guide and support them through a co-design and engagement process which is culminating in a collaborative form of procurement called alliance contracting. 

Alliance contracting is a transformative way to work together and realise shared ambitions. It contractually formalises collaboration between service providers and commissioners without the need for new organisational forms and can become the mechanism to drive cultural shift within the sector towards strength based working and co-production, where people with lived experience have a full role in service design and delivery from the beginning.

Over the last eight months that we have been involved, there have been some real highlights that I wanted to share with you. 

Firstly, we spent a couple of months chatting to local people with lived experience. We wanted to gather an understanding of what matters to them in their lives, who they turn to for support and their wishes for the future. The engagement with people in this area is taken seriously and we had the pleasure to meet over twenty people who were happy to chat. Their insight has been used to create the service outcomes. This included their wish to have ‘a nice and normal life’, that ‘the opposite of addiction isn’t abstinence, it’s connection’ and my personal favourite: ‘why have you created a system for people who are reliable, when we are some of the most unreliable people around!’

Some of them joined us during the co-design process and this is where the fun really started. Our mission was to co-design a service specification which could then be procured against. A mixed group of people were brought together over a series of five workshops. The group included people with lived experience, commissioners, voluntary sector providers and clinicians. 

We used an appreciative design approach which includes a dreaming stage; you’re allowing people to imagine a different world where there are no budget or policy restrictions, where anything is possible. From this abundance, the group can design realistically but with many more options and ideas.

We employed a range of creative methods including Lego serious play, award ceremonies, building towers of cards and story-telling. The collaboration between the group built over time and enabled participants to develop relationships based on trust and shared purpose, something that is vital for successful alliancing.

The greatest compliment has been the feedback from the people with lived experience who worked in the group as full participants and colleagues. This includes:

“To see things so positive and how we all came together this is HUGE!”

“I learnt so much about myself yesterday it was so powerful.”

“I’ve finally found something that’s not rubbish and is going to make a difference… This is huge and something I’m so excited to be part of.”

Commenting on the process, Transformation Programme Manager Angharad Metcalfe from Neath Port Talbot County Borough Council said:

“It has been a great learning experience working alongside Ideas Alliance who have facilitated a truly collaborative approach, bringing us all together and keeping us on track in ensuring co-production is embedded in all we do. Listening to people who have experience of accessing and working in services and who have lived and living experience is key for us to be able to understand how our services need to operate. We would like to thank Ideas Alliance and all of the people who have come together over the last eight months to develop a shared vision for the future. Diolch Yn Fawr.” 

The co-design process has now come to an end and commissioners have drafted an inspirational specification which fully aligns with what matters to the people drawing support from services and service providers. This will be procured over the next few months using a procurement process which maintains the spirit of collaboration. 

Providers will be expected to bid as alliance groups, ready to work together with trust, shared purpose and shared risk and opportunity. We have no doubt that providers are ready for this challenge as they displayed such potential in the room with us.

We would like to thank the commissioners of Swansea and Neath Port Talbot for their boldness and bravery and for working alongside us with such a can do attitude. Well done to everyone involved!

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