Many organisations focus simply on implementing improvement initiatives.

The ones that are successful however are those that both implement and sustain improvements over time.

Given the increasing demands on the health budget, ensuring that improvements survive is essential as a principle of good project governance.

Co-design’s emphasis on working with all stakeholders, and service users in particular, means it is implicitly more sustainable than conventional approaches.

Ideas for sustainability

Make sure your co-design work has adequate funding. Raising expectations is a significant risk with any project and when engaging patients and families it is even more important to ensure appropriate funding to see the process through.

Gain support from the top. Organisational or departmental commitment to the process, and the outcomes that are generated, should be secured at the outset.

Gain support from affected staff. As with any change management process, securing the buy-in of potentially affected staff early is vital.

Share the lessons you learn. Continuous improvement relies on PDCA (Plan, Do, Check, Act) cycles to constantly refine the process and it’s important these lessons are shared widely, both within and outside your organisation.

Make sure innovations and changes have both clinical and management ‘owners’. Linked to the notion of organisational commitment, the presence of clinical and management champions who are prepared to defend the changes is essential to ensuring sustainability after the formal project has ended.