Health Service Co-Design


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.


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


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


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


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


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.


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.


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

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.

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.

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.

Acknowledge 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.