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Secure mental health services in one UK region have acted within a network to develop a range of involvement practices. A new quality benchmarking tool has been created to appraise the implementation of these involvement practices. The purpose of this paper is to report upon a qualitative evaluation of this development.

Staff and service users involved in the co-production of the benchmarking tool were engaged in a series of focus groups and participatory inquiry approaches enacted in the course of scheduled network meetings. Data thus collected was subject to thematic analysis.

Four distinct themes were identified which were titled: Taking time, taking care; The value not the label; An instrument of the network; and All people working together. These are discussed in relation to recent theorising of co-production.

Effectively, this study represents a case study of developments within one region. As such, the findings may have limited transferability to other contexts.

Staff and service users can work together effectively to the benefit of each other and overall forensic services. The benchmarking tool provides a readymade mechanism to appraise quality improvements.

Despite a prevailing culture of competition in wider health-care policy, cooperation leads to enhanced quality.

The benchmarking tool is a unique development of a longstanding involvement network, demonstrating the positive implications for enacting co-production within secure services.

Short breaks enable unpaid carers to have a life alongside caring, supporting their physical and emotional well-being. In the UK, short breaks are usually explored during a Carers Assessment. The conversations underpinning these assessments require considerable skill and presently there are few tools to support the exploration of short break needs, desired outcomes and options. Images are used in other conversations to enhance communication, help people consider options and broaden thinking. This study aims to explore whether and how stakeholders thought images might support short break conversations.

To improve access to meaningful short breaks, we need to be guided by the insights of unpaid carers, those they support, practitioners, commissioners and policymakers. We hosted two online involvement events, designed to facilitate the exchange of perspectives and ideas amongst diverse stakeholders. The events explored the acceptability, facilitators and challenges of using images to enhance unpaid carer short break conversations.

The online events were attended by 47 short break stakeholders. These stakeholders saw merit in using images to support short break conversations. They identified several facilitators and challenges to introducing images into practice. The paper highlights how this learning can inform future research and practice development.

Supporting the well-being of older unpaid carers is a pertinent concern as the number of older unpaid carers continues to grow. This paper reports on how stakeholders have informed the earliest stages of practice and research development in a relevant area and provides a model of involvement that others can emulate.

Recognising current, significant rates of youth sexual violence and abuse (YSVA) and the need for more comprehensive prevention approaches to combat this social issue, new approaches are required to ensure that agency is given to the people who are most affected and who know their lives the best. This paper aims to report a youth-led (Young Voices United [YVU] Committee) participatory design approach aimed at delivering the highest level of engagement to understand what people agree is needed to reduce YSVA in their own communities.

The seven-step co-design (Trischler et al., 2019) process was implemented following ethical clearance. Over five months, 13 group co-design sessions involving 102 young people aged 12–25 years, 17 parents/caregivers (including young mums) and 9 teacher/guidance officers were conducted. Purposive sampling was undertaken to ensure that young people who had previously experienced YSVA or were most at risk of experiencing YSVA were overrepresented. Convenience sampling was used to gain wider community involvement in co-design. Four sessions were facilitated by YVU members, who were aged between 12 and 25 years, and more than 66 people helped the design team. Inductive thematic analysis identified emergent themes across completed co-design sessions.

New ideas and solutions to prevent YSVA can be identified by young people who have previously experienced violence, carers, other young people and community members. A core finding in this study is the need for positive relationship role models and an enhanced understanding of consent. Education and training, a community promotional campaign, sector involvement, capacity-building and consideration of the unique needs of different target audiences were key ideas emerging from youth-led co-design. The YVU Committee provided recommendations for resource prioritisation.

This youth-led co-design process empowered the community. Project stakeholders have since formed partnerships won funding and used that funding to co-design and trial a new programme aiming to provide a safe haven for young people at risk of YSVA. The pilot programme delivers a safe and supportive environment for young people delivered at a time when it is needed most. Other geographical areas are now seeking to replicate the programme. The co-design processes and tools detailed in this study can be adapted to the design of programmes for those already engaged with the youth justice system and should be considered as part of a public health approach to effectively prevent and respond to YSVA and other youth crimes.

This paper advances understanding, providing a practical approach that ensures youth views are given weight [audience and influence described in Lundy’s (2007) participatory framework]. This paper explains how the YVU Committee, established at the commencement of the project, oversaw the community co-design effort, which followed Trischler et al.’s (2019) seven-step co-design process. Ideas were generated, and consensus views were consolidated, delivering the highest level of engagement according to Willmott et al.’s (2022) methodology, agent of change, training and engagement taxonomy. The participatory design method led to high levels of community engagement, and the success of the project is attributed to the establishment of the YVU Committee and stakeholder support.

The increasing financial burden and complexity of health-care services, exacerbated by factors such as an ageing population and the rise of chronic conditions, necessitate comprehensive and integrated care approaches. While co-created service design has proven valuable in transforming some service industries, its application to the health-care industry is not well understood. This study aims to examine how health consumers are involved in health-care service co-creation.

The study searched 11 electronic databases for peer-reviewed articles published between 2010 and 2019. Additionally, hand searches of reference lists from included studies, Google^© citation searches and searches for grey literature were conducted. The Whittemore and Knafl integrative framework guided the systematic review, and Callahan’s 6 Ws framework was used to extract data from the included articles, facilitating comparisons.

The authors identified 21 articles, mainly from the UK, North America and Australia. Despite the need for more research, findings reveal limited and geographically narrow empirical studies with restricted theory and method applications. From these findings, the authors constructed a conceptual model to enhance nuanced understanding.

This study offers four contributions. First, it introduces the Health Service Design Transformation Model for Comprehensive Consumer Co-Creation, illustrating health consumers’ multifaceted roles in shaping services. Second, consumer vulnerabilities in co-creating services are identified, linked to diverse consumer groups, power dynamics and decision complexity. Third, this study suggests broadening participant inclusion may enhance consumer-centricity, inclusivity and innovation in service design. Finally, the research agenda explores consumer experiences, organizational dynamics, value outcomes and co-creation theory for health-care service advancement.

Those who care for people with schizophrenia and substance use disorders (PLS-SUD) are faced with the complex demands of a long journey to recovery. For the carers, this translates into specific needs related to various areas of their lives. However, few studies have contributed to the understanding of these carers’ needs. The purpose of this qualitative evaluative study is to identify, understand and prioritize the needs of PLS-SUD carers in the context of intervention design from the viewpoint of carers themselves (n = 9), those they were accompanying (n = 5) and other key actors involved (n = 10).

A design of action research was employed. Data analysis was done in three phases: concept map analysis, thematic analysis and transversal analysis of the results from two focus groups, 28 interview transcriptions and a logbook.

Over 60 needs were identified. After review, 39 of those were selected for prioritization. For needs related to the carers’ role as clients of the health-care system, the committee prioritized the needs for support, sharing with other carers and improving their own well-being. For the role of supporter, knowledge about substance use disorders and their interactions with psychotic disorders as well as skills such as communication and problem resolution were considered priorities. Needs to be prioritized relating to the role of partner were fewer.

The results of this study highlight the diversity and complexity of the needs experienced by carers.

This is among the first needs surveys carried out by stakeholders to describe the needs of PLS-SUD carers.

This paper aims to share how the Centre for Ageing and Dementia Research co-designs research within a national programme of work to improve the lives of older adults and those affected by dementia. Through examples of this work, the authors identify the barriers and enablers to participatory approaches and lessons to inform future involvement activities.

This study reflects on implementing the UK National Standards for Public Involvement into practice. Of international relevance, the observations span the research process from research prioritisation and design to research implementation and knowledge exchange.

This study demonstrates the importance of using a relational approach, working toward a common purpose and engaging in meaningful dialogue. Only through offering choice and flexibility and actively learning from one another can co-design lead to synergistic relationships that benefit everyone.

Key implications for researchers engaged in patient and public involvement are be receptive to other people’s views and acknowledge expertise of those with lived experience alongside those with academic expertise. Training, resources and time are required to effectively support involvement and meaningful relationships. A nominated contact person enables trust and mutual understanding to develop. This is an ongoing collective learning experience that should be embedded throughout the entire research process.

This paper demonstrates how the standards are implemented with people who are often excluded from research to influence a national programme of work.

Research ethics and integrity stipulates that research must be conducted with responsibility towards the research community and should benefit the intended population. This chapter will share insights from an ongoing research programme to reduce family conflict in the context of dementia care while discussing the accompanying ethical considerations. Research into dementia care has primarily focused on improving outcomes for the care dyad, leaving the influence and input of the wider family unit under investigated. Family conflict can detrimentally impact the quality of care provided and leave caregivers vulnerable to psychosocial difficulties. Family conflict occurs in the context of dementia care but there is little research on how to reduce, or prevent, such conflict occurring. In this research programme, a systematic review investigated the effectiveness of interventions that include the wider family unit to reduce family conflict; only one study was included which evidenced the lack of interventions in this area. A qualitative scoping review was then conducted to explore the lived experiences of caregiving families with experience of family conflict and reported solutions. It was found that conflict occurred due to factors including care decisions and role transitions which impacted relationships and affected care provision. Solutions to conflict were less often reported, indicating an important gap in the literature. Interviews with Alzheimer's Society staff and volunteers revealed that stigma and denial surrounding dementia were prevalent, and families were often reluctant to seek external help. This research programme is currently establishing public patient involvement (PPI) to develop the research methodology and interview questions for people with dementia (PWD) and their family caregivers to explore their lived experiences and potential solutions to family conflict. To conclude, this research programme will propose a family-focused intervention aimed at systemic family conflict for those caring for someone with dementia.