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Co-production to inform clinical commissioning in COPD: an evaluation of Working Together for Change

Frances Early, Sarah-Jane Winders, Snigdha Reddy, Jonathan Ralphs, Jonathan Fuld


Rationale, aims and objectives: Patient involvement in healthcare decision-making is often limited to consultation. Co-production is an approach that empowers patients to work collaboratively with providers as agents of change.  The objective of this study was to explore participants’ experiences and satisfaction with a co-production process, Working Together for Change (WTfC), used to inform the commissioning of services for people living with Chronic Obstructive Pulmonary Disease (COPD).

Method: Mixed methods developmental service evaluation drawing primarily on qualitative data from semi-structured interviews. Setting and participants: Community-based intervention with COPD patients, carers, commissioners and providers of COPD services. Intervention: One-to-one reviews with 45 patients identified what was working, not working and what was important for the future regarding COPD management. In 2 one-day workshops attended by 14 patients and carers and 17 professionals this information was analysed to inform commissioning priorities.

Results: Participant satisfaction was high. Thematic analysis identified 3 themes: (1) an engaging experience, (2) a constructive process enabled by strong patient presence, real patient experiences, collaboration, sense of freedom, a range of contributions and commitment & (3) personal gains from the patient and carer voice being counted, mutual understanding, seeing the value of patient involvement and learning and sharing. Some concerns were raised about the process and suggestions made for improvement.

Conclusions: WTfC was an acceptable process to inform COPD commissioning activity and resulted in an agreed and priorities action plan for COPD service commissioning. It supported collaborative working, egalitarian relationships and mutual learning between patients, carers and professionals. As a standalone activity it was not possible to evaluate the value of the outputs to commissioners or the objective impact but it provided a powerful introduction to co-production methods. WTfC can be an impactful starting point for embedding co-production into the commissioning process. 


Chronic Obstructive Pulmonary Disease (COPD), commissioning, co-production, developmental service evaluation, patient and public engagement, patient-centred care, patient empowerment, patient involvement, person-centered healthcare, self-management

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