NHS England has celebrated Co‑production Week since 2016. In 2025, the week runs from 30 June to 4 July, with the theme “Innovation through Co‑production” (NHS England, 2025). Throughout the week, NHS England hosts webinars and events that showcase how working in partnership with people who use services can improve the design and delivery of care. The week also invites health and care systems to move beyond statements of intent and demonstrate how co‑production is embedded in everyday practice.
This focus is not symbolic. NHS England makes it clear that co‑production is not an optional extra. It is a central part of delivering care that is personalised, inclusive and responsive. It means people with lived experience are not only consulted but involved in shaping the very systems and services that affect them (NHS England, 2025).
Co‑production and Co‑creation
Co‑production is defined as a relationship where professionals and citizens share power to plan and deliver support together, recognising that both have vital contributions to make (Social Care Institute for Excellence, 2015). It involves working together to shape services, deliver them, and reflect on them as equal partners.
Co‑creation tends to take place earlier in the process. It involves the joint development of ideas, strategies or visions. In co‑creation, people with lived experience work with professionals from the beginning. This might include shaping the priorities or designing what a service could look like (Voorberg et al., 2015).
Both ideas are about sharing power. Both ask important questions. Who shapes our services? Whose voice is central? Are we making enough space for people most affected to take the lead?
Why Co‑production Week Matters
Co‑production Week is an invitation for organisations to take a closer look at how they work with people. It asks whether involvement is meaningful, whether it leads to change, and whether power is being shared.
Some trusts use the term co‑creation to reflect a commitment to shared purpose. One example comes from Tees, Esk and Wear Valleys NHS Foundation Trust, which explains co‑creation as:
“Working together towards shared goals. It applies to any situation where our Trust works in equal partnership with people who use our services, carers, staff and partner organisations” (Tees, Esk and Wear Valleys NHS Foundation Trust, no date).
A contributor to the Trust’s co‑creation framework said: “As the ethos of co‑creation becomes embedded… the support to involvement members grows and develops”
(TEWV, 2025).
These are not just words. They speak to a change in culture. Co‑production and co‑creation are not one-off meetings. There are ways of working that require trust and respect.
A Brief History of the NHS
The ideas behind co‑production have been developing in health and social care since the 1990s. They are linked to the social model of disability, to the rise of service user movements, and to efforts to challenge medical models of care (Boyle and Harris, 2009).
In mental health services, co‑production has often been more visible. Recovery approaches and the growth of peer support were early examples. Policies such as Valuing People (2001) helped embed the idea in learning disability services.
Yet it has not always been implemented consistently. Sometimes the word is used without the reality. Power remains with professionals. Time and resources are often limited. And giving up control can be uncomfortable for services.
What It Looks Like in Occupational Therapy
Occupational therapy describes itself as person-centred and enabling. We aim to work alongside people to promote independence and engagement in meaningful activity. In theory, this fits closely with co‑production.
Some examples show what this can look like in practice. In mental health, occupational therapists have worked with people to co‑design group timetables, support peer-led sessions, and agree on goals together (Royal College of Psychiatrists, 2020). In stroke rehabilitation, experience-based co‑design has supported individuals to shape their definitions of recovery (National Institute for Health Research, 2020). In education and workforce planning, service users have co‑created parts of the curriculum and influenced national occupational therapy strategies (Health Education England, 2023).
These examples are encouraging. But they are not consistent across the profession. We need to ask how far co‑production is embedded in daily practice.
What RCOT Says
The Royal College of Occupational Therapists (RCOT) is clear that co‑production should be part of how the profession operates. Their public contributors framework states:
“We commit to sharing, planning and decision-making with people and their communities… from start to finish”
(Royal College of Occupational Therapists, 2023a).
RCOT’s guiding principles set out expectations for fair involvement, support, recognition and shared leadership (Royal College of Occupational Therapists, 2023b). These principles reflect values of equity and inclusion. But it remains unclear how consistently these are applied across different settings.
What the HCPC Requires
The Health and Care Professions Council (HCPC) does not use the terms co‑production or co‑creation directly. However, its standards expect registered professionals to work in partnership with people.
Occupational therapists must:
“Respect and uphold the rights, dignity, values and autonomy of service users, including their role in the assessment, diagnostic, treatment and/or therapeutic process”
(Health and Care Professions Council, 2023, Standard 1.1).
They must also listen and involve people in decisions about their care (HCPC, 2023, Standard 4.1). These are not optional practices. They form part of safe and ethical care.
Are We Truly Co‑producing?
These standards are clear. But we need to ask whether we are living up to them.
Do we co‑produce our assessments?
Are care plans built together?
Are people with lived experience involved in shaping services, not just using them?
Being person-centred is not the same as being collaborative. Good intentions are not enough. Co‑production involves shared decisions, and that means shifting power and sharing control.
If we want to meet the standards set by our professional bodies, we must do more than name co‑production. We must practise it.
A Personal Reflection
I sit on the Co‑creation Board in the NHS trust where I work. It brings together people with lived experience and staff to work on shared projects. It is a space where co‑creation is recognised and supported.
Sometimes I feel frustrated. It can feel like there are a lot of conversations and not much action. I do not always see the outcomes reflected in services. Some of this is shaped by my own experience. I often want to get on with the work. But I also know that building strong foundations matters. If we do not do that, nothing will change.
In a large organisation like the NHS, there will always be different views, targets and priorities. That can make the process slow. Still, I see progress in the fact that co‑creation is no longer hidden. It is being talked about. It is being planned for. That is a start.
We are not there yet, but we are moving. And for me, that is something worth holding on to.
Rachel xxxxx
References
Boyle, D. and Harris, M., 2009. The Challenge of Co‑production: How equal partnerships between professionals and the public are crucial to improving public services. London: NESTA. Available at: https://www.nesta.org.uk/report/the-challenge-of-co-production/ [Accessed 30 June 2025].
Health and Care Professions Council (HCPC), 2023. Standards of proficiency: Occupational therapists. London: HCPC. Available at: https://www.hcpc-uk.org/standards/standards-of-proficiency/occupational-therapists/ [Accessed 30 June 2025].
Health Education England (HEE), 2023. Allied Health Professionals Leading Integration 2022–2023. Available at: https://www.hee.nhs.uk/sites/default/files/AHPs%20Leading%20Integration%202022-2023.pdf [Accessed 30 June 2025].
National Institute for Health Research (NIHR), 2020. Experience-based co-design in stroke services. NIHR Journals Library. Available at: https://www.ncbi.nlm.nih.gov/books/NBK561469/ [Accessed 30 June 2025].
NHS England, 2023. Co‑production: Working in equal and reciprocal relationships. Available at: https://www.england.nhs.uk/always-events/co-production/ [Accessed 30 June 2025].
NHS England, 2024. Co‑production Week 2024: What’s Missing? Available at: https://www.events.england.nhs.uk/co-production-week-2024 [Accessed 30 June 2025].
Royal College of Occupational Therapists (RCOT), 2023a. Public contributors: Co‑production. Available at: https://www.rcot.co.uk/support-the-profession/equity-diversity-belonging/public-contributors [Accessed 30 June 2025].
Royal College of Occupational Therapists (RCOT), 2023b. Guiding principles for public contributors. Available at: https://www.rcot.co.uk/media/1287/download?attachment [Accessed 30 June 2025].
Royal College of Psychiatrists (RCPsych), 2020. Co‑production: A guide for mental health services. London: RCPsych and NCCMH. Available at: https://www.rcpsych.ac.uk/docs/default-source/improving-care/nccmh/culture-of-care/resources/co-production-guidance.pdf [Accessed 30 June 2025].
Social Care Institute for Excellence (SCIE), 2015. Co‑production in social care: What it is and how to do it. London: SCIE. Available at: https://www.scie.org.uk/co-production/what-how/ [Accessed 30 June 2025].
Tees, Esk and Wear Valleys NHS Foundation Trust, no date. Co‑creation framework. Available at: https://www.tewv.nhs.uk/get-involved/co-creation/ [Accessed 30 June 2025].
Voorberg, W.H., Bekkers, V.J.J.M. and Tummers, L.G., 2015. A systematic review of co‑creation and co‑production: Embarking on the social innovation journey. Public Management Review, 17(9), pp.1333–1357. https://doi.org/10.1080/14719037.2014.930505