Co-design involves bringing health practitioners, consumers and carers together with equal respect, combining their knowledge with the shared aim of improving health services where consumers are no longer seen as passive recipients.
Co-design utilises the experience and input of all stakeholders in re-designing or co-producing service delivery. Through the co-design process, which can involve a cycle of information gathering, consultation, planning, implementation and review, the process participants become equally contributing agents of change.
There are many definitions of co-design, also known as experience-based co-design or co-production.
Paul Bate and Glenn Robert describe experience-based design as ‘a joint venture that involves users and professionals working together over a period and throughout the change process as the co‐designers of a service’ (Bate & Robert, 2006). They note that in keeping with the burgeoning view of health service users as integral to the improvement and innovation process ‘knowledge of the experience, held only by the patient, is unique and precious’.
The King’s Fund describes experience-based co-design as ‘an approach that enables staff and patients (or other service users) to co-design services and/or care pathways, together in partnership’.
Co-design has been steadily introduced into more and more health service structures all around the world over the last ten years, including in the United Kingdom, United States, Canada, Australia and New Zealand. It has become a central concept for the delivery of effective contemporary health services.
“[Co-production] is about involving people not only in the rowing and the steering of the boat, but also in actually building it.” — Mr. Sandy Watson OBE DL, Chairman NHS Tayside.
While there are many variations in how the terms ‘consumer engagement’ or ‘consumer participation’ are used, they are generally understood to mean patients, consumers, clients, service users and carers having a voice and taking an active role in shaping decisions around the management and delivery of health services.
Community involvement and consumer involvement, extensions of the same concept, are key elements used in New South Wales Health’s Policy and Implementation Plan for Healthy Culturally Diverse Communities 2012 – 2016. Definitions in this plan are:
- Community involvement describes the full range of research, consultation and participation in a decision-making process of a group of people sharing a common interest (e.g. cultural, social, political, health, economic, geographic).
- Consumer involvement describes the engagement of individuals in a decision-making process as partners, advisers and informants.
- Paul Bate and Glenn Robert, ‘Experience‐based design: from redesigning the system around the patient to co‐designing services with the patient’, Quality & Safety in Health Care. Oct 2006; 15(5): 307–310.
- For more from the King’s Fund about experience-based design and their co-design project model visit their Experience-Based Co-Design Toolkit.
- Read about the Scottish experience of introducing co-design into the national health system at the Scottish Co-production Network website.
- The Australian Institute of Health Innovation and the Agency for Clinical Innovation commissioned a literature review around definitions of consumer and community engagement. The report, published in 2012, can be downloaded from the ACI website.
- Download New South Wales Health’s Policy and Implementation Plan for Healthy Culturally Diverse Communities 2012 – 2016 from the NSW Health website.