Co-design is a relationship where professionals and citizens share power to plan and deliver support together, recognising that both partners have vital contributions to make in order to improve quality of life for people and communities.

1. Principles and Praxis
Co-Design in Healthcare
Marie Ennis-O’Connor

2. WHAT, WHO, WHY, WHEN, HOW

3. WHAT IS CO-DESIGN?

4. 3 WAYS TO DO
HEALTH CARE IMPROVEMENT
• Don’t listen very much to users and do
the designing for them
• Listen to users then go off and do the
designing for them
• Listen to users and then go off with
them to do the designing together
Paul Bate, 2007

5. TO For With

6. Co-design challenges power paradigm

7. Lived experience is equal to other forms of
knowledge, evidence and expertise

8. “Co-production is a relationship where
professionals and citizens share power to
plan and deliver support together,
recognising that both partners have vital
contributions to make in order to improve
quality of life for people and communities.”
Source: nef/NESTA (National Endowment for Science, Technology and the Arts UK)
Co-production Critical Friends

9. Co Design

10. Edgar Cahn in his book No
More Throw-Away People
relates the parable of the
Blobs and Squares to explain
co-production.
THE PARABLE OF THE BLOBS AND SQUARES

11. WHAT, WHO, WHY, WHEN, HOW

12. WHO SHOULD BE INVOLVED?

13. STAKEHOLDERS
patients
service users
carers
front line staff
communities
health professionals
researchers
industry
policy makers

14. WHAT, WHO, WHY, WHEN, HOW

15. WHY CO-DESIGN CARE?

16. #1 Democratic
people have the right to
participate in the design of things that impact them

17. #2 PRAGMATIC
we can achieve more
by working together than we can apart

18. #3 USER EXPERTISE
drawing on user experience and expertise
will accomplish a better outcome

19. #4 INNOVATION
seeing things from different points of view leads
to new perspectives and greater innovation

20. #5 DIVERSITY
more diverse and accessible care for all

21. #6 TRUST AND
TRANSPARENCY
improves interactions and understanding

22. #7 COLLECTIVE OWNERSHIP
develops a sense of joint ownership

23. WHAT, WHO, WHY, WHEN, HOW

24. WHEN TO CO-DESIGN

25. use co-design when…
• Starting a new service improvement
project.
• Developing a new process, product or
service.
• Exploring a specific service issue, e.g.
reducing waiting times.
• Wanting to understand services from
the patient perspective.
• Implementing changes.

26. WHAT, WHO, WHY, WHEN, HOW

27. THE CO-DESIGN PROCESS

28. FOUR CO-DESIGN PRINCIPLES
1. Prioritise the patient experience
2. Trust the process
3. The ‘means’ is as important as
the ‘ends’
4. Acknowledge the patients’
contributions throughout the
process

29. #1 Prioritise the patient experience
What would this look like?

30. #2 Trust the process
What would this look like?

31. #3 The ‘means’ is as important as the ‘ends’
What would this look like?
The social outcomes
of co-design work
are just as important
as the co-design outputs
OUTPUTS

32. #4 Acknowledge contributions
What would this look like?

33. some ideas…
• Assistance to attend meetings (travel
expenses, accommodation, etc)
• Personal thank you cards after
workshops or other events
• Celebratory events when improvements
have been made
• Written recognition in publications,
reports and website

34. CO-DESIGN PROCESS
Engage
Plan
Explore
Develop
Decide
Change

35. STEP 1 ENGAGE
who needs to be involved?
engage them early in the process
ensure engagement is meaningful

36. what are
the ethical
considerations?

37. PRINCIPLES OF GOOD PRACTICE
1. The improvement initiative should be designed and undertaken in a way
that ensures its integrity and quality
2.
All people who are involved, must be informed fully about the purpose,
methods and intended possible uses of any information they provide
3.
All participants must formally consent to the use of any information they
provide, including attribution of quotations, film extracts, etc
4.
All people involved participate on a strictly voluntary basis, free from any
coercion and able to withdraw at any time without need for explanation
5.
All people involved must not be knowingly exposed to harm or distress
6. Privacy and confidentially must be respected as requested
(Ethical Considerations for Experience Based Design: 2007)
www.institute.nhs.uk

38. what are
the barriers
to
meaningful
engagement?

39. some thoughts
• Lack of time
• Accessibility
• Entrenched thinking
• Reluctance to cede power
• Tokenism
• Balance of power
• Trust

40. STEP 2 PLAN
establish the goals of your
improvement work and how you might
go about achieving them
ensure you have adequate funding and
organisational commitment in place to see the
process through
map assets

41. ASSET MAPPING
• The resources, including
the skills, knowledge
and networks which
people and communities
have to offer
• Transforming the
perception of people
from passive recipients
to equal partners

42. STEP 3 EXPLORE
learn about patient experiences
how are they treated?
how would they like to be treated?
what outcomes do they want?

43. how will you
do this?

44. some ideas
experience based survey
co-design workshop
patient journey mapping

45. Focus on designing
experiences rather than
systems or processes!

46. drill down into the emotions

47. how will you turn it around?

48. STEP 4 DEVELOP
turn your ideas into specific improvements
what are the desired outcomes of this work
for patients and their communities?

49. STEP 5 DECIDE
brainstorm as many specific goals and ideas as
you wish, then narrow these down to two or
three key goals and ideas

50. DECISION MATRIX
idea
strengths
uniqueness
weakness
fixes
transform

51. STEP 6 CHANGE
turn your IDEAS
into ACTION

52. National Voices UK
www.nationalvoices.org.uk

53. @JBBC
socialease@live.ie