Health Service Co-Design


Co-design visions

A co-design vision is a written statement about what your health service aspires to achieve including what your service will deliver to patients and what patients can expect as a result.

Why use it

Improvement work can sometimes resolve system issues without improving patient experiences. Even when considered, patient experiences may still be overshadowed by other elements. Having a vision helps keep the patient in focus.

When to use it

Use this tool in the early stages of your co-design work. It is particularly useful when developing a new service but can be used in other contexts too.

1. Use the four-box template 

Use the four-box template below to help you develop your vision.

2. Develop a draft service promise and paitent outcome statement

A service promise commits the service to providing a specific experience for patients. It begins with the words 'we will...' and says what the service will do. A patient outcomes statement commits you to providing specific outcomes for patients.

Develop a draft service promise and patient outcome statement to communicate your project vision. This will help people understand why the improvement work is being done.

3. Finalise your service promise and patient outcome statement

Use these as a reference point for all your improvement ideas and developments. Does the improvement contribute to the promise and its outcomes?

Four-box template

Template Instructions

1. Brainstorm patient experiences

With your group, brainstorm adjectives, e.g. confident, and adverbs, e.g., quickly, to describe patient experiences. Insert these into Box 1. 

When you have finished Box 1, move on to Box 2. Use Box 2 to clarify and sharpen the experiences.

2. Brainstorm patient outcomes 

With your group brainstorm any outcomes you believe are important for patients, their families and friends, and their communities and insert these into Box 3.

When you have finished Box 3, move on to Box 4. Use Box 4 to clarify and sharpen the outcomes.

3. Review the content 

When you have finished all four boxes, review the content. Develop promise and outcome statements in ordinary, simple, clear language.


  • Make the vision as tangible, practical and patient-oriented as possible.
  • Don't use medical or system jargon in your promise or outcome statements. Instead use simple words and phrases a patient can understand.
  • Try not to debate words and semantics. Remember, this is a draft and as you learn through the project, these statements should evolve.
  • Always use patients as your reference-point. If patients are not involved in developing the vision, make sure you run it past them afterwards and reword if necessary.
  • You can include your completed four-box template as a reference diagram in your planning documentation.

Example: Co-design vision for melanoma care

Services involved in melanoma care at Waitemata DHB came up with the following service promise and patient outcome statements as part of its work.

Service promise

"We will tell you what you need to know in a timely and responsible way, and will also tell you what want to know when you ask. We will tailor information to your personal needs, and will also advocate on your behalf to get the information you need."

Patient outcome statement

"We will help you gain a good quality of life by being more knowledgeable and skilled about Melanoma. We want your growing knowledge to give you better control of your health and your future. We want you and your family to be more secure, assured and certain about the best ways to gain this."