Currently, many policymakers try to encourage client involvement during the public service delivery process and make it a co-production. Clients are encouraged to act as active agents and embrace an integrated approach to address their problems to empower them. However, different studies have raised questions regarding to what extent these ambitions are appropriate for clients with vulnerabilities, such as clients with multiple problems. Aiming to further explore this issue, we studied the expectations of clients with multiple problems concerning the co-production of public services. We interviewed 46 clients with multiple problems at the start of their support trajectory. All 46 participants lived in five districts in Rotterdam, the Netherlands, and were recruited via community-based primary care teams. Our study indicates that co-production ambitions might not resonate with clients with multiple problems. The study shows that these clients’ expectations are driven by their feelings of being overwhelmed and stressed out by their situation, feelings of being a victim of circumstances, bad experiences with public services in the past, their evaluation of what counts as a problem and the envisioned solutions. These clients expect public service providers to take over, fix their main problem(s) and not interfere with other aspects of their lives (not an integrated approach). Although participants seek a ‘normal’ life with, e.g., a house, work, partner, children, holidays, a pet, and no stress (a white picket fence life) as ideal, they do not feel that this is attainable for them. More insight into the rationale behind these expectations could help to bridge the gap between policymakers’ ambitions and clients’ expectations.

中文翻译：

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做着不可能的梦？关于公共服务共同生产存在多重问题的荷兰客户期望的探索性研究

目前，许多政策制定者试图在公共服务提供过程中鼓励客户参与并使其成为联合制作。鼓励客户充当积极的代理人，并采用综合方法来解决他们的问题，以增强他们的能力。然而，不同的研究提出了这些雄心壮志在多大程度上适合有漏洞的客户的问题，例如有多个问题的客户。为了进一步探讨这个问题，我们研究了在公共服务联合生产中存在多种问题的客户的期望。我们采访了 46 位客户，他们在他们的支持轨迹开始时遇到了多种问题。所有 46 名参与者都住在荷兰鹿特丹的五个地区，并通过社区初级保健团队招募。我们的研究表明，联合制作的雄心可能不会引起有多种问题的客户的共鸣。研究表明，这些客户的期望是由他们对自己的处境感到不知所措和压力的感觉、成为环境受害者的感觉、过去公共服务的糟糕经历、他们对问题的评估以及设想的解决方案。这些客户期望公共服务提供者接管、解决他们的主要问题，并且不干扰他们生活的其他方面（不是综合方法）。尽管参与者寻求“正常”的生活，例如，有房子、工作、伴侣、孩子、假期、宠物和没有压力（白色尖桩篱笆生活）是理想的，但他们并不觉得这对他们来说是可以实现的。