{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T02:18:59Z","timestamp":1787797139798,"version":"build-2784847793"},"reference-count":45,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Co\u2010design in health services is increasingly recognised as essential for creating services and policies that address patient and community needs. However, genuine co\u2010design can be challenging, with existing toolkits often catering to professionals, reinforcing power imbalances and limiting community leadership. This paper aims to present a novel co\u2010design framework for health services and describe the co\u2010design process taken in its development.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The co\u2010design process involved a series of engagement activities (online forums, focus groups, discussions and workshops) with health consumers, health professionals and researchers within a metropolitan health service in Queensland, Australia. This process, co\u2010led by a clinician researcher and health consumer, explored the implicit meaning of co\u2010design and the barriers and enablers to co\u2010design within the local setting, and the strategies required to support operationalisation of co\u2010design. These data were combined with research literature, existing frameworks and lived experience to iteratively co\u2010design the online framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight focus groups, forums and workshops across five hospitals and multiple community health services involved 128 individuals who contributed their professional and lived experience with co\u2010design to inform the development of the co\u2010design framework. The resultant \u2018Better Healthcare Together\u2019 framework includes three main components: (1) before you start co\u2010design, (2) the co\u2010design team and (3) the co\u2010design process. A key feature of the framework is its deliberate focus on power, inclusion, equity, and bringing together diverse lived and professional experience to solve healthcare problems.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This co\u2010design framework provides a flexible approach to consumer partnerships, with reflections on the process highlighting the relational nature, the need to avoid expert mindset and the evolving landscape of consumer engagement. While widely used, the framework alone may not build true health system co\u2010design capability due to the need to address systemic and organisational barriers to co\u2010design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>Members of the public contributed to this work across all stages of this project, including as project co\u2010leads and co\u2010researchers, members of the steering committee, workshop co\u2010facilitators, and co\u2010design participants. They are also co\u2010authors on this paper.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hex.70784","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T16:45:10Z","timestamp":1785257110000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Better Healthcare Together: Co\u2010Designing a Framework for Health Service Co\u2010Design"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4498-4342","authenticated-orcid":false,"given":"Adrienne M.","family":"Young","sequence":"first","affiliation":[{"name":"Dietetics and Food Services Royal Brisbane and Women's Hospital Brisbane Queensland Australia"},{"name":"Australian Frailty Network, Frazer Institute The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-2457-0342","authenticated-orcid":false,"given":"Anja","family":"Christoffersen","sequence":"additional","affiliation":[{"name":"Australian Frailty Network, Frazer Institute The University of Queensland Brisbane Queensland Australia"},{"name":"Consumer Representative Metro North Health and Queensland Health Brisbane Queensland Australia"},{"name":"Champion Health Agency Mt Coolum Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4406-9248","authenticated-orcid":false,"given":"Dale","family":"Trevor","sequence":"additional","affiliation":[{"name":"Consumer Representative Metro North Health and Queensland Health Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Stringer","sequence":"additional","affiliation":[{"name":"Consumer Representative Metro North Health and Queensland Health Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Cudmore","sequence":"additional","affiliation":[{"name":"Cudmore Consulting Upper Cooomera Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9605-1277","authenticated-orcid":false,"given":"Leonie","family":"Sanderson","sequence":"additional","affiliation":[{"name":"People Tech Revolution and The Ageing Revolution Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Nasato","sequence":"additional","affiliation":[{"name":"Queensland University of Technology and Metro North Health Nursing &amp; Midwifery Academy Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7410-4652","authenticated-orcid":false,"given":"Lisa","family":"Anemaat","sequence":"additional","affiliation":[{"name":"Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance Metro North Health and The University of Queensland Brisbane Queensland Australia"},{"name":"Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4479-1284","authenticated-orcid":false,"given":"Katrina L.","family":"Campbell","sequence":"additional","affiliation":[{"name":"Healthcare Excellence and Innovation Metro North Health Brisbane Queensland Australia"},{"name":"Centre for the Business and Economics of Health The University of Queensland Brisbane Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdaf084"},{"key":"e_1_2_13_3_1","unstructured":"Australian Commission on Safety and Quality in Health Care. 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