Co-design is a way of improving healthcare
services with patients.

Many service improvement projects have patient involvement but co-design focuses on understanding and improving patients’ experiences of services as well as the services themselves.


Co-design elements
There are six elements of co-design that form the structure of this guide.

01 Engage
Establishing and maintaining meaningful relationships with patients to understand and improve healthcare services. This critical element underpins all improvement work and is continuous throughout.

02 Plan
Working with patients and staff to establish the goals of your improvement work and how you might go about achieving them.

03 Explore
Learning about and understanding patient experiences of services and identifying improvement ideas.

04 Develop
Working with patients to turn ideas into improvements that will lead to better patient experiences.

05 Decide
Choosing what improvements to make and how to make them. Its success depends on an understanding of the patient journey and the insights about service improvement this offers.

06 Change
Turning your improvement ideas into action. Remember that you do not need to make all the changes by yourself, make as many improvements in partnership with other stakeholders as you can.

Co-design principles
There are four key principles for success in doing co-design work within health services.

Note: the tools in this guide were developed and refined through healthcare improvement projects in cancer services at Waitemata District Health Board (DHB).

While the case studies are drawn from our Waitemata work, these methods are widely used, for example in England, Australia and Canada. They have been adapted for use in hospital care, community care and primary care.

01 Prioritise the patient experience
When you’re doing co-design work, it is easy to let patient perspectives and priorities get subsumed by staff and organisational needs. To counter this, always keep the patient perspective at the forefront of what you are doing.

02 Trust the process
At times the tools used in this guide may involve processes that are unfamiliar or foreign to you. There may be times when you, or the people you are working with, get frustrated and want to rush to the end of a tool without following the steps. Be prepared to step outside your comfort zone and work collaboratively through the process. The results will be worth it.

03 The ‘means’ is as important as the ‘ends’
The social outcomes of co-design work, such as establishing formal networks among patients and encouraging patients who are interested in becoming consumer advocates, are just as important as the co-design outputs, such as producing a new leaflet or opening a new clinic.

04 Acknowledge the patients’ contributions throughout the process
This may include:
• Assistance to attend meetings, e.g., petrol vouchers.
• Thank you cards after workshops or other events.
• Celebratory events when improvements have been made,
• Written recognition in publications and reports.
• Offer training for patients who want to become advocates.