Also known as: Co-production, Co-creation, Experiential co-design

What is healthcare co-design?

Co-design is an approach attempting to actively involve all stakeholders (e.g. planners, employees, partner agencies, consumers, service users) in the design of processes to help ensure services meet needs and are effective at meeting needs. 
Why use co-design?

Often service reviews or planning for new services is designed and based on the experiences and expertise of planners, managers and clinicians. Service users and other sector agencies are often brought in for consultation once the majority of the decisions are made.

Co-design is a method for turning this around and partnering with service users and agencies from the beginning. This assists to ensure closer alignment of service delivery with what will work best for everyone overall.

Many service users have significant knowledge to share about how it feels to experience a healthcare process and staff have extensive knowledge to share on the clinical or technical aspects of care. Together they are able to contribute ideas from their own perspectives and share and learn from each other. This leads to a better understanding of current processes and increases the ability to create more effective improvements for the future.

When to use co-design

  • When working on service improvement
  • Developing new processes
  • Troubleshooting issues
  • Looking at better understanding the patient perspective
  • When ready to implement change

The features/principles of co-design

  • Person centred: Co-design asks service providers and service users to walk in the shoes of each other to be able to use these experiences as a means for creating change. 
  • Starts with a desired end: Builds backwards from the outcomes you are trying to achieve. This helps prevent getting caught up with what is currently wrong with the system 
  • Practical, real world solutions: Testing whether ideas work in practice, and then refining ideas until solutions are developed that work for service users and providers.  
  • Makes ideas, experiences and possibilities visible and tangible: Makes complex systems accessible across a range of people who may have different perspectives and knowledge about the system.
  • Inclusive, drawing upon many perspectives, people, experts, disciplines and sectors: All participants are seen as experts and input has equal standing. Assists to find real, workable solutions to complex issues. Challenges beliefs and questions assumptions.

Co-design phases

  1. Engage
  2. Plan 
  3. Explore
  4. Develop
  5. Decide 
  6. Change 


The benefits of co-design explained

How to use co-design

This step-by-step toolkit was funded by the NZ Ministry of Health. The tools were developed and refined through healthcare improvement projects and have been adapted for use in hospital care, community care and primary care.

We recommend teams visit this website to inform their co-design journey. 


Improving healthcare through the use of co-design - Hilary Boyd, Stephen McKernon, Bernie Mullin, Andrew Old (Journal of the New Zealand Medical Association
NZMJ 29 June 2012, Vol 125 No 1357; ISSN 1175 8716 Page 76)