Fugitive coproduction: Conceptualising informal community practices in Scotland's hospitals

Abstract

Within public administration, coproduction is a ubiquitous policy discourse, and increasingly an analytic lens through which public relationships with public services are viewed. This article reports an interpretive qualitative study of community practices around three changing hospitals in the Scottish NHS, comprising semi-structured qualitative interviews with citizens, NHS staff, politicians and journalists, as well as non-participant observation of community and NHS events. Initially focused on community opposition to top-down hospital change, the study identified a surprising range of supportive community actions for their local hospitals, including volunteering, fundraising and innovative co-delivered service models. Building on these examples, the paper presents a model of ‘fugitive coproduction,’ where individuals and groups within communities collaborate with local staff in ways which significantly shape the provision of local services, without permission or authorisation from relevant authorities, and in modes that are centrally concerned with immediate perceived need not strategic change. I argue that these forms of public action can make valuable contributions to public services, and that they hold lessons for the wider reform of public administration.