Experiences during the pandemic have highlighted the importance of maintaining/ utilising existing relationships and networks -particularly those developed by the voluntary sector in relation to individuals and communities that experience disadvantage. These groups and those grass roots organisations that are working with them, have a huge amount of insight to share. It is important for formal organisations (such as those researching and delivering healthcare) recognise that people from communities are best placed to identify the problems they face and innovate solutions and recognising that grassroots VCSE organisations and infrastructure organisations are vital to supporting and facilitating co-production, but we need to value and resource this work properly. A rapidly changing landscape is presenting challenges, but co-production is still possible and more important than ever. Working in partnership with Greater Manchester Poverty Action, Maddy Hubbard (Co-production Lead GMHSCP) maximised existing connections to deliver a Co-Production webinar. This explored how authorities and agencies may be able to co-produce more of their existing activity and their recovery plans. It also encouraged participants to share some the challenges and experiences of co-production in the context of Covid-19. Maddy is leading the the GMVCSE co-production network in her new role as Engagement and System Change Manager for Action Together.

The importance of endeavouring to still engage and involve marginalised and seldom heard groups. This should include a focus on those disproportionately affected by the pandemic such as BAME communities. Charles Kwaku-Odoi (Chief Officer) from the Caribbean and African Health Network reported on a number of online events to bring individuals and organisations together, so they can continue to engage and rapidly respond to the needs of different communities during the pandemic and beyond. CAHN conducted a recent survey on the impact of Covid-19 within the Caribbean and African community that highlighted the need for culturally sensitive services as well as concerns about social isolation and mental health (download report Nasrine Akhtar of ‘Awakening Minds’, Oldham, shared experiences of supporting local BAME communities during the crisis and activities to support mental The active involvement of local BAME communities is key to the work of Diversity Matters North West (DMNW). Chief Officers, Gemma Gaskill and Rehana Begum reported on their approach to ensure project activity is carried out ‘with’ and/or ‘by’ members of the community rather than carried out ‘to’, ‘about’ or ‘for’ them. This includes peer mentoring and joint research activity. Community involvement is embedded in the DMNW project evaluation framework. Discussions within the forum have led to a new engagement project (a partnership between CAHN, NIHR PSTRC, NIHR Applied Research Collaboration, and Health Innovation Manchester) to explore the experiences of pregnancy and maternity services for women of colour during the pandemic to co-produce future work to address inequalities and improve maternity care.

Covid-19 has emphasised existing inequalities where those in low paid jobs are placed at greater risks, or have lost all their income overnight and have been unable to access benefits. In the case of homelessness, people who are already massively disadvantaged and at risk of major and life threatening illness are now facing even greater risks. Policy response has led to creation of temporary housing influencing a complex picture of benefits and risks, especially as temporary accommodation closes down. There could also be groups that are facing challenges such as homelessness and poverty, that have not experienced this before. Throughout the pandemic Groundswell have tried to ensure the voice of lived experience of homelessness is heard from people across the country. Through the #HealthNow project, in which Groundswell is the lead partner, regular meetings have been held in the 3 pilot areas of Greater Manchester, Newcastle and Birmingham alliance meetings have been held regularly bringing together local stakeholders from housing, health and homelessness with people with lived experience to raise issues, discuss plans and develop actions to improve the experience of people who are homeless throughout the crisis. Groundswell also established a research project to monitor the impact of covid-19 on people experiencing homelessness and have conducted interviews with people across the country which a published in a fortnightly briefing. Organisations including Healthwatch and the #HealthNow network led by Groundswell and Shelter are responding to these challenges via their community research and initiatives. Groundswell are also working in partnership with the NIHR Patient Safety Translational Research Centre and Health Innovation Manchester to investigate access to health care for homeless people during the pandemic.

Many people have experienced major changes in day-to-day life – some positive and some negative. There are major concerns about mental health. We are very aware that the public is not a homogenous group and people will have very different experiences accessing services and the need for support according to their own personal circumstances. Discussions with public contributors within HInM and wider activities by forum members have highlighted such variations and the need for varied approaches to capture such experiences. Some approaches identified have included poetry, a photo diary, video stories and blogs. For example, the NIHR PSTRC have worked with their mental health public involvement and engagement group to produce a virtual exhibition on the subject of ‘Hope during the Covid-19 pandemic’, and a set of short films reporting on experiences of people with early stage dementia and carers within community settings; the VOCAL team have developed a webcomic to highlight experiences of young people during the Additional activities will be accessible via our website soon. Developing understanding of the impact and effects Covid has had on people’s experiences of NHS care – for Covid and for all other conditions – will be important for shaping policy and service development going forwards. Stephanie Snow leads the NHS at 70 project and is working with over 50 volunteer interviewers to capture people’s experiences in real time and build a ‘digital archive’ that will serve as permanent evidence-base. Feedback from volunteer interviewers and upwards of 250 interviewees highlights that creating these social connections during this period of physical isolation is positively impacting the well-being of everyone involved.

In a recent session focused on this topic, members shared experiences and work to tackle digital inequalities and social exclusion. A key theme has been the common problems of many people in getting appropriate access to technology and needs for support and improving digital literacy. Sharing our experiences, resources and learning will promote more effective involvement and engagement. In a blog, Paul Hine, Director at Made by Mortals (people powered musical theatre) has shared his experience of moving face to face activity, with under-served communities, on-line. Through their remote approach they have seen vulnerable people overcome their fear of technology, make connections in new ways, extend their social networks and find resilience to the challenging times we all face through participation in creativity with others. They have also found opportunities to adapt their methodologies for a digital setting and improve their reach. Covid-19 is creating new involvement and engagement opportunities. On-line activity may mean that some opportunities are more accessible to certain groups such as those with mobility issues whilst excluding others. Digital Buddies (Salford Foundation) shared their innovative approach to improving social connections for people who struggle using technology for communication. Participants are paired with digital volunteers to provide friendship and support and has been successfully tackling loneliness and social isolation in local Members of the forum have also worked in partnership to co-produce community engagement work to develop and test a new quality and outcomes framework that will support access to digital services within primary care across Greater Manchester (e.g. discussion groups co-produced with Awakening Minds and Made by Mortals).