Co-design to deliver service improvement - what does this mean and how can we do it? A qualitative study with cancer patients and professionals.

Anna Haste, Linda Sharp, Richard Thomson, Sarah Sowden

Research output: Contribution to journalArticlepeer-review


Objectives: To explore the concept and feasibility of service co-design with patients and professionals (commissioners and providers) with regards to the upper gastrointestinal (UGI) cancer care pathway.

Design: Qualitative telephone interviews and face-to-face focus groups.
Setting: North East and North Cumbria region of England.
Participants: Twenty patients completed interviews. Nine patients and ten professionals formed two focus groups. Eligibility criteria required patients to be within six months of receiving their first treatment for an UGI cancer and be referred initially through the urgent (two week) GP referral route. Professionals working with the UGI cancer care pathway were recruited via the NHS Cancer Alliance communications network. Thematic analysis was undertaken to identify barriers and facilitators to co-design for service improvement.

Results: Six themes emerged from the professional and the patient focus group analysis and patient interviews: Responsibilities and expectations of involvement in co-design, Understanding – knowledge, Perspectives, Building relationships, Environment, Impact and effectiveness. Participants suggested that neither the professional nor the patient view was more important, but rather that each was important in different ways and for different areas of potential improvement. Based on the themes a checklist has been created to provide practical suggestions for both professionals and patients on how to approach co-design for service improvement.

Conclusions: By providing a checklist of elements to consider when attempting to embark on co-design activity, this study offers policy and practice partners a clearer understanding of how to implement co-design in real life settings. This may assist them in fulfilling the strategic objective to incorporate the principles and practice of co-design into routine service development and improvement. It could also be used to identify possible considerations or decisions when approaching the co-design process, rather than starting afresh every time a co-design approach is used.
Original languageEnglish
JournalBMJ Open
Publication statusSubmitted - 10 Dec 2020


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