Co-producing the PROSPER recommendations

Discussion, conclusion and recommendations - Exploring voluntary sector specialist services for victim-survivors of sexual violence in England: the PROSPER co-production study - NCBI Bookshelf An official website of the United States government Here's how you know The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site. The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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(Health and Social Care Delivery Research, No. 13.10.) Exploring voluntary sector specialist services for victim-survivors of sexual violence in England: the PROSPER co-production study. Show details Health and Social Care Delivery Research, No. 13.10. Bradbury-Jones C, Damery S, Fruin K, et al. Southampton (UK): National Institute for Health and Care Research ; 2025 Apr. Contents Search term < Prev Next > Chapter 8 Discussion, conclusion and recommendations Introduction In this concluding chapter, we draw on the integrated findings from the combined WPs and discuss the primary implications and limitations of the PROSPER study. Drawing on ecological systems theory (Bronfenbrenner, 1979), 91 the delivery, funding and commissioning of VSS services are conceptualised as a series of interconnected ‘systems’. We anticipate that the model set out in this chapter might be useful as a resource for training and education or as an aid to communications in any interactions that are concerned with the delivery, funding and commissioning of VSS services, or it might be developed further or tested in future research. The model offers an orientation point to discuss the key recommendations from the PROPSER study and this is the second focus of this chapter. Our principles and practice of close partnership working with VSS services, commissioners and policy-makers throughout the study and, indeed, in the development of the recommendations mean that the chances of implementing the findings are augmented. In turn, it is hoped the PROSPER study findings can have a positive impact on service delivery and the support of victim-survivors of SV – the PROSPER study raison d’être. Development of a new model The data integration process discussed in the previous chapter led to the organisation of key findings around the following four areas: macro commissioning context; organisational structures; relationships and people; values and principles. Given that these four domains are broadly concerned with micro through to macro level, we saw the potential for them to be understood through a socioecological lens. Inspired by Urie Bronfenbrenner’s ecological systems theory, 91 we therefore captured the integrated findings conceptually and diagrammatically into a new model ( Figure 19 ). Bronfenbrenner’s ecological model holds that an individual is influenced by the reciprocal relationship between them as a person and their environment (and the different ‘systems’ in that environment). Presented as a pattern of concentric rings, the individual exerts influence on and is influenced by the different systems. In the context of PROSPER, the model shows the influence of micro- and macro-level factors associated with SV and how a victim-survivor might operate and interact with the five systems, from proximal to distal. Most models evolve over time and the model presented may be modified once it has been subject to peer scrutiny and feedback, but in the iteration presented in this report, it comprises the six prominent themes developed to capture the recurring, overarching issues at the heart of our integrated findings, detailed below: FIGURE 19 Site overview diagram – funding structures. The complex and precarious funding landscape. The challenge of competition for funding and contracts. The importance and success of partnership working with organisations. The pressured environments within which VSS services work. Different roles, scope and eligibility of voluntary and statutory services within an area. The ways services are organised and delivered, underpinned by services’ values and philosophies. Table 12 sets out a brief description of each theme and how the themes link to findings within each of the three WPs in the PROSPER study. The table does not provide an exhaustive account of the links between themes and the empirical data; however, it is intended to help trace which of the study’s key findings support the key, overarching themes. The table is followed by Figure 20 . Figure 20 adapts Bronfenbrenner’s ecological model to map how the organisation and funding of VSS services shapes the experience of victim-survivors. TABLE 12 Table of key findings and linkages to the empirical data FIGURE 20 The delivery, funding and commissioning of VSS services to support victim-survivors of SV. The intention of presenting this adapted model is to promote greater recognition of (1) the centrality of local geographic and political contexts shaping VSS delivery and organisation (2) the intricate, yet impermanent, ties that bind together the various layers of the VSS ‘commissioning ecosystem’. While these findings in many ways reiterate previous literature (much of it developed by the VSS sector), the degree of interconnection and complexity is likely to be unknown to those not immersed in the processes, politics and partnerships that have been so carefully and often laboriously navigated over recent years; that is, those people who are not VSS senior practitioners or commissioners. We argue that it is important to make visible the sophisticated work that takes place to forge connections and alliances across these social, political and relational spaces, which in turn challenges conceptualisations of commissioning as a primarily evidence-based and/or ‘rational’ process. The model in turn helps to explain the precarious and at times desperately long journey that some victim-survivors are forced to navigate when seeking specialist support. It also indicates that while there is little doubt that increased investment could change if not transform some aspects of service delivery, other factors – such as the way that decisions are made, partnerships forged and ‘on the ground’ practice developed – also shape the sustainability and quality of services for victim-survivors. Contextualising the findings in a broader context In many respects, the PROSPER study has confirmed what is already known about the complexity and precariousness within the VSS sector, with short-term funding from state and independent bodies generating considerable instability for VSS services. Concern over existing practice has changed the range and type of support available to victim-survivors of SV . As described by Robinson and Hudson, there has been the introduction and expansion of SARCs to provide a range of immediate, short- and longer-term support and assistance to victim-survivors of SV . Over the same period, however, there has not been a similar development and support of VSS services, prompting concern over the long-term sustainability in the sector. 36 As others have highlighted, such precariousness negatively affects staff morale and retention and can undermine sector leaders’ ability to work in a strategic and creative way. 92 The problem is exacerbated by the introduction of SARCs, 93 which increase the number of referrals received by VSS organisations, not always with supporting financial remuneration (Survivors Trust, 2010). 94 The PROSPER study findings have shown the considerable challenges of competition across the sector as regards competition for funding, balanced with insights into positive models of partnership working. Our findings regarding the problems of short-term funding have been acknowledged previously as an undermining factor for organisational stability, particularly in respect of staffing. 95 There is some evidence that size matters. Large organisations are likely to do relatively well as regards funding, 95 whereas smaller VSS organisations often have fewer resources to dedicate to the tendering process. 96 Robinson et al . (2008) report how one of their interviewees commented that ‘agencies subsume their mutual hatred in a desire to secure funding’. While they acknowledge that the situation is not quite so bad as to instil hate between agencies, they do acknowledge that services are frequently ‘scrabbling for small scraps of money’. 5 Resonating with the PROSPER findings, we found considerable challenges and competition in terms of funding, but far from ‘hatred’, a significant respect between organisations in the sector, who ultimately share the same goal of supporting victim-survivors of SV . In terms of partnership, as stated above, the PROSPER study has highlighted clear examples of best practice in services and agencies working together. The Women’s Resource Centre (2023) 101 argue that working in partnership is the primary response to competitive tendering, including working in alliance with specialist services run by and for minoritised women and girls (services that are often ignored in discussions of SV , yet being best placed to elucidate how processes of racialisation add to the trauma of SV). It is important, they contend, that services remain complementary because working within the system can force the change that is needed. 96 The Women’s Resource Centre argue that women’s services generally know what their communities need, but through commissioning, they go through processes that dilute their services, while also competing against other organisations. 96 Arutyunova (2018) also talks about complementarity, suggesting that the way ahead is to move away from thinking about funding in terms of compartments and siloed thinking and instead focus on interdependence, correlation, complementarity and value added. 100 Moreover, this can be achieved through a feminist funding ‘ecosystem’. This way of conceptualising funding shifts from a ‘funding landscape’ (where power is held/retained at the top, typically by funders and commissioners) to a ‘funding ecosystem’, whereby people and resources become more connected, coherent and complementary. 100 In line with the study objectives, the PROSPER study provided rich insights into VSS organisations’ responses to the commissioning landscape – or perhaps we might now call it the commissioning ecosystem . 97 This study evidences the pressured environment in which practitioners operate across the VSS sector, associated with complexity in the lives of those they support. Similarly, interviewees in the study by Hester and Lilley (2018) described the specialist ISVA role as one that is varied and complex. 38 More recently, Horvath and colleagues (2021) reported how ISVAs and ISVA managers who completed their survey were experiencing some psychological distress and moderate to high vicarious trauma. 103 The same study showed how ISVAs holding high caseloads experienced more psychological distress than ISVAs with lower caseloads. 98 In addition, the longer the ISVA spent working with clients who have experienced SV , the more likely they are to experience vicarious trauma. 98 Like those from the PROSPER study, these findings show the human cost of pressured VSS environments, discussed here in relation to VSS staff. Victim-survivors are also impacted by pressured environments. Echoing wider findings, the PROSPER study heard consistent testimony from victim-survivors about the challenges finding the right support and, moreover, accessing this support at the right time for them. Furthermore, victim-survivors’ trust in services can be threatened by uncertainties about the way services are/might be delivered and the time taken to be able to access them. As members of the PROSPER team have reported, trust is undermined by uncertainties about VSS services’ future and sudden changes in how services are delivered (or ended). This can have a particularly detrimental impact on victim-survivors who have ‘complex’ needs. 92 There is evidence though that some of this can be mitigated through harnessing the advantage of being a VSS organisation, where independence and flexibility are perceived as a strength for gaining access to victim-survivors and maintaining their confidence. 36 The PROSPER study has provided clear evidence of the value that victim-survivors place on VSS services. This is a finding that we had expected and it is one that has been highlighted by others. 99 It is a finding that needs to be reinforced however, given the challenges that the sector continues to face in providing sustainable, specialist provision to all victim-survivors. VSS services are seen to provide a space where victims can tell their story without fear of judgement. 36 They often provide the only ‘safe space’, where disclosure and support tend to be consistently positive and where victim-survivors are ‘held’ in that safe space. 38 It is of course important to recognise that disclosure is a choice. Coupled with empowerment and boundaries, choice is an important principle of a trauma-informed approach and all such principles require careful balancing. For example, a victim-survivor may make an informed choice to stay silent and this choice needs to be respected. However, if staying silent creates more risk/harm, then boundaries need to be put in place around what happens next. Next steps may not require an individual to speak up on their own, but next steps may need some action to be taken to prevent or disrupt the escalation of further harmful behaviours. According to the Women’s Resource Centre, commissioning needs to change to recognise grassroots organisations that have risen from the communities they serve, in order to get what they need, rather than what commissioners say they need. 96 This links us back to the commissioning landscape and its impacts on the direct support to victim-survivors. It also leads to reflection on the approaches that underpin such support. Like earlier research that has shown the value of survivor-centred, trauma-informed approaches, 100 the PROSPER study has highlighted the importance of SV support being needs-led, feminist and trauma-informed, encompassing survivor empowerment and gender awareness. The important role played by VSS organisations helping victim-survivors overcome the trauma of SV , and in getting SV recognised as a significant social problem, cannot be overstated. 93 Trauma-informed support involves identifying survivors’ strengths, prioritising their autonomy and considering how identity and context influence their experiences and needs. 100 Becoming a trauma-informed organisation requires organisations to move away from traditional models of support and to re-evaluate their practices and policies so that they operate through a trauma-focused lens. 101 Pemberton and Loeb (2020) argue that given that SV impacts women at disproportionate rates compared with men and that SV results from power inequities, the healing journey for survivors must take such issues into account. 92 Feminist therapy specifically acknowledges the mental health risks associated with living in a patriarchal and hegemonic environment. 103 There is no one feminist therapeutic way of practice and, therefore, practitioners are connected through shared values, 104 with feminist values premised on the idea of believing women and respecting their confidentiality and autonomy. 5 The PROSPER study has also shown the importance of survivor empowerment and gender awareness within VSS service delivery. Kulkarni (2019) talks of intersectional trauma-informed services, 93 which aligns well with our study findings. Intersectional approaches underscore the ways in which social categories, such as race, class, ability, gender and sexuality, interact to shape victim-survivor experiences and how individuals frequently contend with multiple oppressions. 105 It is this complexity in the lives of many victims-survivors of SV that mirrors the complexity of the commissioning landscape. Figure 20 is intended to capture this complexity in a representation that shows simplistically the relationship between micro and macro and how crucial the impacts of commissioning are on individual victim-survivors. Co-producing the PROSPER recommendations There is an increasing imperative in health research to focus on knowledge exchange through engaging with those who will be the users of the research. 94 The overarching goal of knowledge user engagement is to co-produce knowledge that is relevant and useful to those making real-world decisions. 94 With this in mind, we took deliberate action to engage with key knowledge users at the dissemination event held near the end of the study. It was an attempt to create what has been termed evidence informed policy-making. 95 On 28 November 2022, during the final full month of the PROSPER study, the study team hosted a dissemination/engagement event to which local and national stakeholders were invited. The intention was to use the integrated findings as the springboard for discussion regarding how they inform the recommendations. This activity arose from the team’s philosophy that maximum impact from research findings can only be achieved through meaningful engagement with those who are likely to be affected by or implement such findings. There were over 30 attendees, including representatives from the Home Office, NHSE , Rape Crisis England, OPCC , Survivor Alliance, The Survivors Trust and one victim-survivor participants who had taken part in the case study analysis. The event was utilised to present a first draft of the integrated findings and to provide opportunity for feedback and revision to any aspects of the findings at that stage. We received no requests for revisions and therefore used the opportunity to work with the findings to formulate the key recommendations. Using four round-table discussions that were chaired by a member of the PROSPER team, the attendees were asked to consider the final PROSPER objective: make recommendations for the commissioning and provision of VSS services at practice and policy levels, in order to strengthen overall service provision for victim-survivors of SV . Each table was allocated one of the four areas as per our theoretical framework: macro commissioning context; organisational structures; relationships and people; values and principles. A structured discussion took place and scribed by the chairperson in relation to the following questions: What recommendations do we need to make for the commissioning and provision of VSS services at practice and policy levels? Based on PROSPER findings, how can we strengthen VSS service provision for victim-survivors of SV? The event was instrumental in developing the recommendations presented in this report. In addition, post event, we have had the opportunity to elicit further feedback from colleagues from VSS organisations and we are confident that this co-production process has resulted in recommendations that are both usable and relevant. Recommendations Table 13 considers each of the six key themes identified in Figure 20 and the concomitant recommendations that we have developed. We aim to highlight the linkages between the data, our analysis and our co-produced recommendations. We acknowledge that in certain areas of England (some of) these recommendations are being implemented or are in operation. However, we know that such adoption tends to be the exception rather than a standard approach. TABLE 13 PROSPER recommendations mapped against the six core themes The recommendations do not appear in a priority order. Instead, we draw attention to their interconnection and hope, long term, that if not all, a minimum of one to two recommendations per key theme be adopted. As already described, the recommendations are firmly grounded in the empirical and co-produced elements of PROSPER and we regard them as important, if not crucial guidance. As our data imply, failures to invest in the ways recommended here runs the very real risk of losing the specialism, difference and life-saving work that VSS services contribute. Failure to invest will also sustain the current status quo (which will become further entrenched) in terms of unequal access to services for victim-survivors, a lack of choice in provision, failure to build upon examples of effective practice, a failure to foster improved relationships, partnerships and expedient ways of working and a failure to ease the debilitating pressures of high-intensity work environments. In addition to the recommendations relating to the empirical WPs on the PROSPER study, we also have some recommendations arising from the experiential, co-research work, as follows: Working with co-researchers: Begin the process as early in the research cycle as possible. Avoid piecemeal co-production payments. Do not underestimate the power of in-person connection and support. Robust protocols, clear lines of communication and defined areas of responsibility need to be in place to manage and minimise destabilising incidents. Principal investigators need to be alert to how power dynamics can affect the team, particularly in relation to the need to disrupt the presence or escalation of unacceptable or unhealthy behaviours. Principal investigators are pivotal in fostering a culture of co-researchers being seen in ‘3D’, that is, seeing a co-researcher’s skill set beyond their lived experience. Research leaders and funders need to remain open to novel and unexpected benefits and respond to these in creative ways so that insights are harnessed for future use. Research leaders and funders need to embrace the transformative and healing power of creativity – to recognise it as a credible area for financial investment. Critical reflection is crucial on how to embody intersectional approaches into co-research and the limitations associated with such attempts. PROSPER limitations Methodological limitations The study was limited by its reliance on one theoretical framework, rather than drawing on multiple perspectives. While Billis and Glennerster’s 50 theory provided a useful structure, particularly in synthesising the findings, we may have derived different insights from using another approach. Similarly, we may have been constrained by imposing the structure of a theoretical framework and mapping the findings to its four domains. A more open, inductive approach might have led to insights that fall outside the rigid structures of a theoretical framework. In addition to these broad methodological limitations, the specific areas of recruitment for the survey and case study phases are worthy of discussion. As already discussed, it was anticipated initially that the survey responses (WP2) would identify variations in the national picture which could be explored further in four in-depth case study sites, and as such, the survey data would be instrumental in helping to identify and select case study locations. However, changes to project timelines (and the influence of the COVID-19 pandemic) meant that case study locations had to be selected and work initiated at those sites prior to the survey data being analysed. Nevertheless, the survey data provided a useful post hoc justification for the case study sites that were selected. In relation to the case study work, the figures for participant recruitment were lower than projected figures for a number of reasons. First, from a study design perspective, much of the recruitment and interviewing took place at a time where the country was going into/coming out of various COVID-19 lockdowns and restrictions. This impacted on the timeline for the project and inevitably had an impact on individuals’ ability and willingness to engage in the study. Second, in terms of service demand, a large proportion of the recruitment took place over the year-end period which is a particularly busy time for organisations especially within the voluntary sector, again likely impacting engagement. Finally, projected figures, determined towards the beginning of the project – around 4 years before the case study phase – became less representative of the true number of services as time went on, and services nationally were closed. While the final number of participants was lower than anticipated, we believe there was more insight gained from the WP1 interviews than originally intended, thus bolstering understanding and latter stages of the PROSPER study data. Limitations of our definition of a ‘specialist’ service During the PROSPER project, we grappled with how best to define and operationalise the concept of specialist services for victim-survivors of SV , cognisant of the different ways that services can provide valuable care and support to victim-survivors. We sought to differentiate between services who can and do support victim-survivors but who do not ‘specialise’ in SV , that is, staff do not receive bespoke training or are required to have specific knowledge, and/or services are not designed primarily or exclusively with the needs of SV victim-survivors in mind. Given that a primary aim of the PROSPER study was to identify, map and explore the implications of the limited, often precarious, nature of support for victim-survivors of sexual violence specifically , we judged that this distinction was important to uphold for reasons of conceptual clarity. An unintended result of this definition was, however, that it may have led to a narrow definition that excluded the contribution of services with multiple specialisms and/or services for whom victim-survivors are likely to turn to but who may not offer a ‘traditional’ model of a specialist SV service. This exclusion seems most apparent in terms of not including black and minoritised VAWG women’s services who did not state that they provided specialist support around SV (e.g. ‘women’s services’ may not have specifically identified strands of specialist SV-orientated support or therapy), but also extends to victim-survivors who are minoritised by virtue of their disability and/or sexuality. The predominately white British ethnicity of our practitioner and victim-survivor participants likely reflects these limitations of recruitment strategy. However, as noted, the disability status of victim-survivors may have been relatively unimpacted (see Table 8 earlier in the report). Deviations from original application and impacts of the COVID-19 pandemic The pandemic negatively impacted on obtaining ethical approval for the case study work due to the disruption to services and their ability to take part in the study. This in turn delayed the start of the case study phase of the project. Throughout the ‘active’ period of the pandemic, we had to reflexively review the specific mode of data collection and engagement in response to social distancing (e.g. conducted online instead of face-to-face), but this did not impact the quality of the study, nor did it significantly impact the timeline for data collection and analysis. The deadline for completion of the surveys was extended by 3 months to the end of June 2021 due to challenges and pressures on time commitment faced by the sector during the pandemic. Initially, a variety of avenues were available to disseminate the survey to commissioners; however, a number of the options became unavailable due to prioritisation of the COVID-19 vaccine roll-out, especially amongst CCG and public health commissioners. The survey response rate was approximately 25%, which is in line with expected totals using this method. The uptake of the VSS sector survey was higher than this average, while the uptake of the commissioner survey was lower. All participants who undertook the surveys completed the questions and many provided in-depth free-text answers, thus adding an unanticipated layer of depth to the data. The planned start to the case study phase was October 2021, which was later than originally anticipated. This delay was in part a knock-on effect of delays completing the survey phase. However, the study team began concurrent planning for the case study phase in late 2020 and thus have minimised the impact of these delays. As regards the planned case study sites for WP3, making contact with and creating networks in a couple of the initial candidates for potential case study sites were difficult and time-consuming. After reviewing the initial work carried out in these areas, we elected to identity and develop two new case study sites, again, impacting time frames. Finally, the recruitment of co-researchers was initially expected to be in January 2020; however, the co-researchers were not recruited until just before the case study work began in 2021. The justification was that the co-researchers’ primary contribution would be to the case study work by undertaking victim-survivor interviews jointly with the academic researchers. We also planned that they would contribute to the interpretation of results, report/article writing and dissemination. At the time, we believed that involvement of co-researchers prior to these activities ran the risk of holding limited relevance to them. On reflection, however, this was a misjudgement and we should have involved them earlier (as discussed in Chapter 6 and indicated in the study recommendations). PPIE activities: The PPIE activities associated with the PROSPER study are multiple and pervasive. Victim-survivors’ views fed into early iterations of the proposal prior to application through: the NIHR CLAHRC-West Midlands PPI group, which includes a victim-survivor who has used VSS services; engagement with The Survivors’ Trust; and staff working directly with victim-survivors, some of whom were victim-survivors themselves. There were two PPIE co-applicants, one of whom is a survivor of SV . The second was a PPIE representative with an interest in services to support victim-survivors. Both these individuals are experienced PPIE representatives who played an active role in steering group and study team meetings. Moreover, the PPIE survivor was part of the interview panel for the appointment of the co-researchers and has played an important role in their support. A reflective account of her role and experience working on the PROSPER study as a PPIE representative with lived experience of SV is included in Appendix 5 . This should be read in conjunction with insights from Chapter 6 , to gain a comprehensive understanding of the combined, rich, multifaceted experiential insights brought to bear on the PROSPER study. Equality, diversity and inclusion and the PROSPER study There are several issues that need to be acknowledged in relation to equality, diversity and inclusion (EDI). We consider these in terms of strengths and limitations, focusing broadly on EDI in relation to (1) research participants and (2) the study team. Equality, diversity and inclusion and research participants We sought diversity and maximum variation sampling in the qualitative work. The case study sites in WP3 were selected on the basis not only of the different models of VSS service delivery, but also on geographical and demographic differences. Women are disproportionately represented among victim-survivors of SV , and this is reflected in our samples (as presented in earlier chapters, see Table 8 ). However, one of our case study sites offered VSS services specifically for men. This led to insights from the perspectives of male victim-survivors and the services that support them, that would likely have been missing otherwise. In addition, in WP3, the proportion of victim-survivor participants who identified as people with disabilities was far greater than the proportion of practitioner/commissioner participants. These demographic findings point to a relationship between experiences of violence and abuse and physical and mental health issues that may be casual or associative (i.e. that disabilities are associated with greater ‘vulnerability’ to violence and abuse) of which there is evidence in the wider literature. Equality, diversity and inclusion and the study team The co-researcher component of PROSPER has been at its core. In Chapter 7 , we highlighted some of the strengths and limitations of the recruitment processes – and, crucially, practices of working with the co-researchers in Chapter 6 – and how these practices are likely to have shaped who took part in PROSPER, and how. For example, as shown in the co-researcher profiles, there were no male co-researchers. This is in spite of our efforts, which involved advertising the role through a number of VSS services for men. The co-researchers’ profiles also demonstrate lack of diversity in terms of ethnicity, with only one identifying as Black Caribbean. A significant benefit of working with the co-researchers has been their connections with and for most, their employment within, VSS organisations in England. While this has been an overwhelming asset, it might mean that potential co-researchers from different socioeconomic backgrounds were excluded from the application and selection process because we were unable to reach them. Finally, as regards the authorship team, we are majority white women; highlighting lack of diversity as regards ethnicity and gender. This is offset in other areas however, with (as far as we know) four people in the team identifying as gay and others being people with disabilities, neurodivergent and/or living with a range of mental health conditions. Conclusions The PROSPER study has provided hitherto missing evidence regarding the funding and commissioning of SV services in England. It has also presented some unexpected opportunities for learning that had not been conceived in the planning or early stages of the study. Theoretically, PROSPER was informed by Billis and Glennerster’s 50 theory in relation to the voluntary sector. As discussed in the previous chapter, it proved to be a useful framework, but we adapted it to meets the specific needs on the PROSPER study. As described, we added a broader dimension that allowed us to capture the PROSPER findings about the commissioning context, which are at its core. Theory is not static; it is constantly evolving. With this in mind, we can claim an advancement of theory in the field of research in the voluntary sector. Even if the focus of future research is on voluntary sector service delivery (as is the case with a great deal of research in this field), it is likely that the wider lens of commissioning of such services will have relevance. We had not intended to adapt the work of Billis and Glennerster, 50 but it was necessary to meet the unique needs of the study. We will capitalise on having done so, by sharing the unexpected new insights in forthcoming academic publications. Further, the co-research component took on a life of its own. We had anticipated that the co-research would be a vehicle to obtain the best insights possible from the victim-survivor interviews. We are confident that this was the case. However, we had not expected the significant learning that would arise from the co-research itself as a practice; the ‘doing’ of co-research that we described in Chapter 6 . This has unexpectedly led to new knowledge about the undertaking of co-research in the field of SV . We are now in a position to make an important contribution to the field of co-production and co-research literature and practice. Much of the learning can be extrapolated to co-research studies quite broadly. However, we have learnt that there are very specific and crucial lessons in relation to research about violence and abuse that are specific and critical, primarily regarding personal safety and risks of retraumatisation. We have already begun to disseminate these important insights so that the unexpected new knowledge we have generated can benefit other researchers and (potential) co-researchers. Copyright © 2025 Bradbury-Jones et al . This work was produced by Bradbury-Jones et al . under the terms of a commissioning contract issued by the Secretary of State for Health and Social Care. This is an Open Access publication distributed under the terms of the Creative Commons Attribution CC BY 4.0 licence, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. See: https://creativecommons.org/licenses/by/4.0/ . For attribution the title, original author(s), the publication source – NIHR Journals Library, and the DOI of the publication must be cited. Bookshelf ID: NBK613637 Contents < Prev Next > Share Views PubReader Print View Cite this Page Bradbury-Jones C, Damery S, Fruin K, et al. Exploring voluntary sector specialist services for victim-survivors of sexual violence in England: the PROSPER co-production study. Southampton (UK): National Institute for Health and Care Research; 2025 Apr. (Health and Social Care Delivery Research, No. 13.10.) Chapter 8, Discussion, conclusion and recommendations. 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