Co-production is a term that can mean different things to different people, so it is essential for us as an Integrated Care Board to have a shared understanding of what it means. Our definition reflects national good practice:
“Co-production is a partnership where people with lived and learnt experience work together to have meaningful influence over the things that matter to them.”
Co-production Framework
This two‑page co‑production framework sets out what co‑production means at NHS Nottingham and Nottinghamshire ICB, and what people can expect when we say we are working in co‑production.
It brings together our values, principles and expectations into a clear, practical summary.
The framework is designed to be easy to read, print and share. It acts as a common reference point so that everyone involved has a shared understanding of what good co‑production looks like in practice.
How to use this framework
This framework can be used to:
- explain our approach to co‑production at the start of a piece of work
- support conversations about how people will work together
- check whether involvement is meaningful and inclusive
- challenge ways of working that do not reflect our values
It is not intended to be a tick‑box or a one‑off exercise. Instead, it supports ongoing relationships built on trust, respect and shared decision‑making, with lived experience recognised as equal to professional expertise.
By using this framework, we are setting clear expectations for ourselves and our partners — and holding the system to account for doing co‑production properly, not just talking about it.
To make this information accessible to everyone, the content of the co‑production framework is also available below in text format.
When co-production is done well, people and carers with lived experience of health and care:
- Work as equal partners alongside staff with learnt (professional) experience.
- Are involved in making decisions together, ensuring everyone has a meaningful and equal voice.
- Collaborate throughout the entire process – from start to finish – from design to delivery and evaluation.
- Are recognised for their valuable skills, knowledge, and lived experience in improving services.
- Feel genuinely listened to and can share power in decision-making.
- Feel valued, empowered, and better connected – while staff also report that co-production results in services and processes that work more effectively and efficiently.
Our Co-production Principles and HEARD Values
- Value people’s skills, knowledge and interests to improve services
- Share what we learn and achieve through co-production
- Include anyone who wants to be involved
- Use clear, accessible communication for all
- Be honest and open to build trust
- Reflect on and improve how we work
- Support and develop confidence, knowledge and skills
- Build genuine partnerships and address power imbalances
- Value peoples time and contributions
- Encourage creativity and innovation
Diagram showing the principles and values of co‑production:
Equality: staff share power with poeple by involving them from the start. This allows everyone to learn together about what works and what doesn’t.
Accessibility: Staff use different, more accessible ways to communicate and think about what needs to change to involve people better.
Respect: Each person’s input is respected and valued. There are clear policies on expenses and remuneration and people understand how their contribution is being used.
Diversity: People are brought together from a range of different experiences, skills and perspectives to work together to find solutions to problems.
The Flower of Participation
The Flower of Participation diagram shows the different ways people and communities can be involved in shaping health and care, with people at the centre to reflect our belief that health and care should always start with what matters to them. It illustrates a range of approaches, from “doing to” people, where decisions are made for them, to “doing with” people. We are focusing on the co‑production petal of the flower, which is the most collaborative and empowering approach, based on equal partnership and shared decision‑making.
The approaches shown in the Flower of Participation diagram are outlined below:
Co-production: An equal partnership where people with lived and learnt experience work together from start to finish.
“What are the biggest priorities and how can we work together to achieve them?“
Co-design: Co-design involves working with people who use services to design the support they want and need, based on their own experiences and ideas. They have genuine influence in shaping services that are then delivered for them.
“This is what we want to achieve. How should we go about it?”
Engage: Engagement means working with people to understand their views and experiences by asking open questions. While people may influence some decisions, their level of involvement can depend on the timeframes and budget available.
“This is what might happen. What do you think about it?”
Consult: Consultation involves inviting people to share their opinions on proposed changes, often through surveys or meetings. While this allows some input, the focus is typically on what we need to know, and people may feel their involvement is limited or tokenistic if they are not fully empowered to drive change.
“This is what is happening and why. Do you agree or disagree?”
Inform: Informing involves sharing information about changes so that people can understand them. This could include producing leaflets, running sessions, or providing online information. It’s a one-way communication where people are updated but not involved in decision-making.
“This is what is happening.”
Find out more about Co-production:
