‘Co-designing with consumers, whānau and communities so there is collective development of organisational priorities, processes and evaluation, and consumers, whānau and communities are involved at all levels.’
– The code of expectations for health entities’ engagement with consumers and whānau
Video resources
Find out more about co-design
Co-design is an intentional process that involves collaboration and includes the unique perspectives of users, stakeholders and staff when making key decisions and designing solutions.
During co-design, it is important to gather, analyse and test feedback before making decisions and implementing solutions.
The role of consumers and whānau in co-design is to share their experiences of the health system. This can also become part of a broader representation of a whānau or community’s views, strengths and health needs.
The co-design process is inclusive and participatory, and aligns with Te Tiriti o Waitangi principles of partnership, active participation, equity and options (Waitangi Tribunal 2019).
Collaboration with stakeholders allows consumers and whānau to participate in, and their voices to be incorporated into, policies, practice and initiatives. Health providers and organisations can expect a wide range of benefits when integrating co-design in their business-as-usual practice. These can include an improved creative process, better service definitions, a more efficiently organised project and improved patient, whānau and staff experiences.
A recent systematic review, Co-design in Aotearoa New Zealand: a snapshot of the literature (Mark and Hagen 2020) suggests that co-design can provide a means of genuinely connecting with service users. This allows for consumers and whānau to use their lived experiences to develop solutions, and more importantly, ‘define the problem itself’. The review also found that co-design in an Aotearoa New Zealand context is valued for building capacity, capability and confidence – especially when designing with youth – and that its benefits extend further to working with whānau and organisations.
In line with Te Tiriti principles, co-design offers an opportunity for whānau Māori and Māori communities and organisations to lead and partner with the health system from the start of a project through implementation and evaluation and towards sustainability.
Governance level
This can include but is not limited to consumers and whānau providing their unique lived experiences on boards, steering groups and committees. Specifically, co-design at the governance level is characterised by two-way flow of information and shared power and responsibility. Consumers play an active part in defining agendas and making decisions. For example, consumer advisory groups and consumer councils provide a strong voice for consumers, whānau and the community so they can engage with and advise on service planning, design, delivery and evaluation to make the services better for users.
Project team level
Consumers and whānau contribute their unique skills and experience of the focus area as active members of project teams. For example, they may identify community networks and advise on and help develop methods so other consumers can share their experiences.
For consumers and whānau to be part of a project team requires preparation, support and resourcing by the organisation involved.
The consumer and whānau experience level
Consumer and whānau members are invited to share their lived experiences of the health system, which provides valuable insights and ideas that lead to improvements. Topics might include how to improve patient information or access to primary care.
- Inform consumers and whānau about how they can be involved and supported to guide the planning, design, delivery and evaluation of health services.
- Develop consumer-friendly questions (surveys, interviews, hui) with an evaluation team and, where possible, an ethics advisory group.
- Consider testing questions on consumers from another consumer advisory group project team (with similar demographics).
- Think about data sovereignty and be able to explain your policy on how you collect data.
- Start any project with a plan to close the communication loop.
Why use co-design?
Co-design is an intentional process that involves collaboration and includes the unique perspectives of users, stakeholders and staff when making key decisions and designing solutions.
During co-design, it is important to gather, analyse and test feedback before making decisions and implementing solutions.
The role of consumers and whānau in co-design is to share their experiences of the health system. This can also become part of a broader representation of a whānau or community’s views, strengths and health needs.
The co-design process is inclusive and participatory, and aligns with Te Tiriti o Waitangi principles of partnership, active participation, equity and options (Waitangi Tribunal 2019).
Benefits of co-design
Collaboration with stakeholders allows consumers and whānau to participate in, and their voices to be incorporated into, policies, practice and initiatives. Health providers and organisations can expect a wide range of benefits when integrating co-design in their business-as-usual practice. These can include an improved creative process, better service definitions, a more efficiently organised project and improved patient, whānau and staff experiences.
A recent systematic review, Co-design in Aotearoa New Zealand: a snapshot of the literature (Mark and Hagen 2020) suggests that co-design can provide a means of genuinely connecting with service users. This allows for consumers and whānau to use their lived experiences to develop solutions, and more importantly, ‘define the problem itself’. The review also found that co-design in an Aotearoa New Zealand context is valued for building capacity, capability and confidence – especially when designing with youth – and that its benefits extend further to working with whānau and organisations.
In line with Te Tiriti principles, co-design offers an opportunity for whānau Māori and Māori communities and organisations to lead and partner with the health system from the start of a project through implementation and evaluation and towards sustainability.
Engaging with consumers and whānau at different levels
Governance level
This can include but is not limited to consumers and whānau providing their unique lived experiences on boards, steering groups and committees. Specifically, co-design at the governance level is characterised by two-way flow of information and shared power and responsibility. Consumers play an active part in defining agendas and making decisions. For example, consumer advisory groups and consumer councils provide a strong voice for consumers, whānau and the community so they can engage with and advise on service planning, design, delivery and evaluation to make the services better for users.
Project team level
Consumers and whānau contribute their unique skills and experience of the focus area as active members of project teams. For example, they may identify community networks and advise on and help develop methods so other consumers can share their experiences.
For consumers and whānau to be part of a project team requires preparation, support and resourcing by the organisation involved.
The consumer and whānau experience level
Consumer and whānau members are invited to share their lived experiences of the health system, which provides valuable insights and ideas that lead to improvements. Topics might include how to improve patient information or access to primary care.
Fundamentals of co-design
- Inform consumers and whānau about how they can be involved and supported to guide the planning, design, delivery and evaluation of health services.
- Develop consumer-friendly questions (surveys, interviews, hui) with an evaluation team and, where possible, an ethics advisory group.
- Consider testing questions on consumers from another consumer advisory group project team (with similar demographics).
- Think about data sovereignty and be able to explain your policy on how you collect data.
- Start any project with a plan to close the communication loop.
Resources
Short open-access e-learning courses on co-design are available | Link
Project case studies and co-design resources are available | Link
The aim of the Te Ao Māori Framework is to help health services improve the quality of care given to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. The framework was developed by Te Tāhū Hauora Health Quality & Safety Commission in partnership with Māori health providers, Whānau Ora providers and participating Te Whatu Ora districts across Aotearoa New Zealand.
Use this tip sheet to create a short narrative or ‘elevator pitch’ about your project. It can encourage participation in an improvement project or be a tool for socialising and promoting work through face-to-face interactions, leaflets or posters.
Understanding co-design through review of project case studies. Link
Co-design case study: Susanne Cummings
Co-design in Aotearoa New Zealand: a snapshot of the literature. This review gathers readily available local scholarship and literature about co-design in Aotearoa New Zealand up to September 2019. It is aimed at practitioners as much as academics and is more of a snapshot than a formal academic literature review. It outlines:
- how to create a resource to support groups and individuals working in, or commissioning, co-design
- the current landscape of formal scholarship on and research into co-design for those practising or commissioning co-design in Aotearoa New Zealand
- a benchmark of current research applying to, or about, co-design, highlighting areas for future scholarship and collaboration.
This tool has been developed for use within health care system organisations to measure consumer engagement at the governance level (eg, boards, steering groups, committees and project teams). It is free to be adapted. | Link
Co-design e-learning courses
Short open-access e-learning courses on co-design are available | Link
Project case studies and co-design resources are available | Link
Te Ao Māori Framework
The aim of the Te Ao Māori Framework is to help health services improve the quality of care given to whānau Māori across Aotearoa New Zealand and advance the uptake and implementation of te ao Māori and mātauranga Māori concepts into general health system design and health practice for all. The framework was developed by Te Tāhū Hauora Health Quality & Safety Commission in partnership with Māori health providers, Whānau Ora providers and participating Te Whatu Ora districts across Aotearoa New Zealand.
Prepare a project ‘elevator pitch’
Use this tip sheet to create a short narrative or ‘elevator pitch’ about your project. It can encourage participation in an improvement project or be a tool for socialising and promoting work through face-to-face interactions, leaflets or posters.
Examples of co-design projects
Understanding co-design through review of project case studies. Link
A consumer’s perspective on involvement in a co-design project
Co-design case study: Susanne Cummings
Literature summary
Co-design in Aotearoa New Zealand: a snapshot of the literature. This review gathers readily available local scholarship and literature about co-design in Aotearoa New Zealand up to September 2019. It is aimed at practitioners as much as academics and is more of a snapshot than a formal academic literature review. It outlines:
- how to create a resource to support groups and individuals working in, or commissioning, co-design
- the current landscape of formal scholarship on and research into co-design for those practising or commissioning co-design in Aotearoa New Zealand
- a benchmark of current research applying to, or about, co-design, highlighting areas for future scholarship and collaboration.
The MCE-Q Middlemore Consumer Engagement Questionnaire
This tool has been developed for use within health care system organisations to measure consumer engagement at the governance level (eg, boards, steering groups, committees and project teams). It is free to be adapted. | Link
Further reading
Czuba KJ, Coomarasamy C, Siegert RJ, et al. 2022. Measuring health consumers’ engagement at the governance level: development and validation of the Middlemore Consumer Engagement Questionnaire. New Zealand Medical Journal 135: 81–94. URL: https://journal.nzma.org.nz/journal-articles/measuring-health-consumers-engagement-at-the-governance-level-development-and-validation-of-the-middlemore-consumer-engagement-questionnaire.
Toko King P, Cormack D, Edwards R, et al. 2022. Co-design for indigenous and other children and young people from priority social groups: a systematic review. SSM – Population Health 18: 101077. DOI: 10.1016/j.ssmph.2022.101077.
Waitangi Tribunal. 2019. Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry (Wai 2575). URL: https://waitangitribunal.govt.nz/inquiries/kaupapa-inquiries/health-services-and-outcomes-inquiry.
Measuring health consumers’ engagement at the governance level
Czuba KJ, Coomarasamy C, Siegert RJ, et al. 2022. Measuring health consumers’ engagement at the governance level: development and validation of the Middlemore Consumer Engagement Questionnaire. New Zealand Medical Journal 135: 81–94. URL: https://journal.nzma.org.nz/journal-articles/measuring-health-consumers-engagement-at-the-governance-level-development-and-validation-of-the-middlemore-consumer-engagement-questionnaire.
Systematic review: Co-design for children and young people from priority groups
Toko King P, Cormack D, Edwards R, et al. 2022. Co-design for indigenous and other children and young people from priority social groups: a systematic review. SSM – Population Health 18: 101077. DOI: 10.1016/j.ssmph.2022.101077.
Wai 2575
Waitangi Tribunal. 2019. Hauora: Report on Stage One of the Health Services and Outcomes Kaupapa Inquiry (Wai 2575). URL: https://waitangitribunal.govt.nz/inquiries/kaupapa-inquiries/health-services-and-outcomes-inquiry.
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Page last updated: June 2023