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Early on during the COVID-19 pandemic and subsequent lockdown in the United Kingdom, community intelligence highlighted a growing need among people who had already been struggling. Some of these people, who come from all ethnicities, races, and religions, were familiar faces in Gurdwara langar halls (the communal dining areas in every Sikh place of worship). As soon as Gurdwara attendees noticed these community needs, phone calls and text messages started to spread, and plans were made to find solutions to help.

The events that this chapter covers, the systematic processes that spur people into action during situations of need, is not new. The acts of providing hot food, things that people need, and standing alongside people who are oppressed, is a normal practice in Sikh communities. It describes ‘Sikh activism around social justice and humanitarian relief [that centres on] Sikh concepts of sewa (selfless service) and langar (community kitchen) in a contemporary context’ (Singh, 2018).

This chapter therefore describes individual and collective actions by minoritised and often racialised Sikh communities to address needs and provide services that were necessary during the pandemic and related lockdowns. These services have included health and care services, like support for mental wellbeing, and provisions to nurture physical and emotional wellbeing. The co-production described in this chapter, therefore, relates less to research and more to the actual design and delivery of services by Sikh individuals and organisations. This chapter brings together the experiences of individuals and organisations, and describes the impact of existing structures on activism in racialised communities.

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Volume 2: Co-production Methods and Working Together at a Distance

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Groups most severely affected by COVID-19 have tended to be those marginalised before the pandemic and are now being largely ignored in developing responses to it.

This two-volume set of Rapid Responses explores the urgent need to put co-production and participatory approaches at the heart of responses to the pandemic and demonstrates how policymakers, health and social care practitioners, patients, service users, carers and public contributors can make this happen.

The second volume focuses on methods and means of co-producing during a pandemic. It explores a variety of case studies from across the global North and South and addresses the practical considerations of co-producing knowledge both now - at a distance - and in the future when the pandemic is over.

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Volume 1: The Challenges and Necessity of Co-production

EPDF and EPUB available Open Access under CC-BY-NC-ND licence. Groups most severely affected by COVID-19 have tended to be those marginalised before the pandemic and are now largely being ignored in developing responses to it.

This two-volume set of Rapid Responses explores the urgent need to put co-production and participatory approaches at the heart of responses to the pandemic and demonstrates how policymakers, health and social care practitioners, patients, service users, carers and public contributors can make this happen.

The first volume investigates how, at the outset of the pandemic, the limits of existing structures severely undermined the potential of co-production. It also gives voice to a diversity of marginalised communities to illustrate how they have been affected and to demonstrate why co-produced responses are so important both now during this pandemic and in the future.

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In this edited collection, our aim was to illustrate the value and means of co-production or, more specifically, why it is valuable and how it can be done. It is worth noting that our starting point for achieving this aim was reflecting on who has been disproportionately disadvantaged by the pandemic and how discrimination, marginalisation, and exclusion increased their vulnerability to both the COVID-19 virus (in terms of mortality and morbidity) and the implications of responses to its spread (in terms of relative access to resources, support, and involvement in key decision-making processes in research, policy, and practice). Our attention then turned to how we could ensure this book became a platform for these people, groups, and communities to share their experiences, insights, and expertise. As was outlined in the introduction to this volume, co-production has over time been defined and conceptualised in different ways. What our ambition for this book reveals is that central to our conceptualisation and practice of co-production in health and social care research, policy, and practice is an egalitarian imperative. That is, our primary interest in and advocation for co-production is as a means to ensuring that collaborative endeavours that explicitly address inequities in power can support marginalised communities, citizens, patients, and services users to create, shape, and improve health and social care research, policy, and practice.

Collectively, co-production endeavours must actively seek to promote health equity, by addressing inequity, diversity, and exclusion, and recognise the significant role that the social determinants of health have in creating and perpetuating inequalities in health and access to care.

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In the introduction to this volume, we outlined how the COVID-19 pandemic has highlighted the need to better understand and utilize co-produced responses to improve public policy, political responses, and health and social care research and practice. However, there are extensive constraining social structures that inhibit working in this way. The experiences of the most exposed, marginalised, and discriminated – in short, those who are systematically excluded in our societies – rarely directly influence the policies and practice that are ostensibly created for their protection. Crucially, given the disparities in the risk and outcomes of COVID-19, why are these people and communities not considered best placed to create and implement sought-after solutions for effective management, improvement, and research of pandemic responses?

Through this book, we wanted to:

  • explore how so many people are ignored, disempowered, and discriminated against in health and social care research, policy, and practice;

  • address how and why more collaborative, diverse, and inclusive responses could lessen the toll of this pandemic and future health emergencies, as well as more generally improve health and social care research, policy, and practice;

  • illustrate how and why collaborative ways of working can help to address the social wrongs and power imbalances that we need to right.

In particular, this volume set out to explore: (1) the impact of existing structures on ambitions and efforts to work in more participatory and collaborative ways in health and social care research, policy, and practice, and (2) how the pandemic has highlighted and exacerbated existing inequities and marginalisation both in practice and research. The collection has demonstrated through a diverse range of examples the impact of the pandemic on people’s lives and ways of working.

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Since the first lockdown I have spent my days as a welfare rights worker on the phone supporting people to claim the benefits they are entitled to, or if their claim has been rejected, helping them to appeal against this.

Although understandably the COVID-19 pandemic has resulted in a focus on health and public health policy, income maintenance policy is no less important. In the UK for example, numerous policies have been introduced since lockdown to deal with the two big interrelated problems any such pandemic poses – making people ill and damaging the economy. Fear of spreading infection has resulted in more and more people being temporarily unable to work, furloughed, losing their jobs, or being made redundant as well, as self-employed people losing their income and often their businesses. In such cases in the UK, people may claim universal credit. If they become sick, they may claim employer or statutory sick pay, although as we shall see, the small print gets more complicated.

This means that there has predictably been a massive increase in the numbers of people reliant on UK state benefits. Historically when that happens, for example, during the last World War, with the blitz injuring and making people homeless, or in times of depression and massive unemployment, it often leads to improvements in benefits policies as many more people discover for themselves that living on welfare is far from the easy option that the right-wing media often portray it as.

COVID-19 has happened following just such a moral panic with the harshest of ‘welfare reform’ policies in operation now in the UK for more than a decade.

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The COVID-19 pandemic has drastically altered people’s lives. While pandemics have of course occurred before, for modern times COVID-19 has been unusually destructive and inhibitory in scale. However, what this pandemic shares with previous ones is having a disproportionately detrimental impact on people who were already disadvantaged by structural inequalities before the pandemic began (Bambra et al, 2020; Marmot et al, 2020). The virus has been particularly pervasive and destructive in its impact on Black, Asian, and minoritised ethnic groups; people of lower socioeconomic status; people in undervalued employment; people living in deprived areas, poor housing, and/or overcrowded accommodation; older people; disabled people; people with learning difficulties; people with psycho-social disabilities; and people with long term conditions – especially those who rely on social care. This has caused us to reflect on the relative strengths and weaknesses of approaches typically taken in modern politics and public policy in general, and health and social care specifically, as well as to consider alternatives that could better serve us in the future. For us, key among these alternative approaches is co-production.

Predictably, those most severely affected by COVID-19 are the people and groups who are now largely being ignored in developing responses to the pandemic and consequently are further detrimentally impacted by it – in many cases fatally. Co-production offers an alternative. It is consistent with efforts to challenge the exclusionary nature of much ideology underpinning health and social care policy and practice and to move to more inclusive and participatory approaches (Beresford, 2021).

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