Chapter 3 - What was our approach to co-design?

The co-design process for integrated care in North West London is built on a ten-step methodology. These ten steps are shown in Exhibit 3.1 below and outline the set of steps that need to be taken to design a system of integrated care.

Exhibit 3.1 

In order to implement these ten steps, we have undertaken a co-design process that has been split into five modules that addressed key questions of design for integrated care. These five modules were: population and outcomes, GP networks, provider networks, commissioning governance and finance, and informatics. The co-design process has been central to the design of integrated care for North West London.

Integrated care in North West London will only work if it keeps the person who uses services at the centre of all decisions and design processes. Care must be reorganised to focus on the holistic needs of people, and to appear as a single, seamless system to the service user, regardless of the underlying organisation of the system. To this end, the programme has engaged in a co-design process that has brought together lay partners, clinicians, commissioners, health and care professionals and voluntary services from across the system to contribute to the future of integrated care.

I have absolutely no doubt that the input of the lay partners in every aspect of the ‘design phase’ has had a material impact and will continue to do so in carrying the design into practical effect where I think the Lay Partners will have an even more important role."

Lay Partner

Co-design has been central to the process of testing ideas and generating a set of concrete options for North West London. In our context, co-design means an inclusive and collaborative process with a breadth of stakeholders who can represent the varied interests of service users, their families, their carers and their communities. We believe strongly that this process has not only facilitated reaching a solution that everyone supports, but has also inspired more creative and effective ideas for the future of the system.

The cornerstone of the co-design process was the set of working groups that we held across five modules to address the central questions of integrated care design for North West London. We established a working group for each module which consisted of an equal partnership between lay partners, clinicians, commissioners and care professionals to co-design the future of integrated care. Throughout this programme, we have focused on the importance of incorporating both the professional expertise of the clinicians and care professionals and the holistic lived experiences of the lay partners. There was lay partner representation on each one of the module working groups, and we have worked as equal partners throughout the programme. This work builds on past co-design work that was done for the Shaping a Healthier Future programme and part of our integrated pioneer status.

The co-design process described above has shown that we have undertaken across North West London has been one of the most ambitious co-design processes ever implemented in the NHS. In addition to their involvement in the module working groups, we have included lay partners at every level of the programme governance structure, and their lived experiences have been incorporated into every output that we have created together. In this way, we have ensured that what we are designing makes sense for people, rather than for organisations or systems. We have ensured that we are taking into account what people want from their care, their goals and aspirations, their local contexts and their current complaints, in order to better serve the whole population of North West London through integrated care.

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