How do we embed a co-production strategy with health citizens to improve health and social care?

10th April 2024

Authors: Dr Md Shafiqur Rahman Jabin, Assistant Professor, University of Bradford, UK, and Dr Jae Hargan, Experts by Experience Coordinator, University of Bradford, UK

Jabin Rahman Jabin photo Jae Hargan photo

The concept of 'health citizenship' refers to health knowledge, skills, and insights from personal experiences that integrate the lay knowledge of patients and the public. The knowledge is then translated into health actions such as planning health and social care education, research, and policy.

Health citizens play a vital role in improving the quality of life for people who use health and social care services. The concept has gained momentum over the last decade as the acceptance of health and social care research and education has increased. Multiple funding and regulatory bodies worldwide have recognised the benefits of their positive contributions. Health citizens can contribute to addressing ongoing challenges (e.g., access, inequalities), enabling academics, researchers, and health and care professionals to better understand the concerns, needs and expectations of end users.

Various terms are used interchangeably for health citizenship, such as patient and public involvement (PPI), service user and carer involvement, or the health citizens may also be referred to as expert by experience – a term preferred by our health citizens at the University of Bradford, UK.

However, one approach to incorporate health citizens to address health challenges is the co-production strategy involving a collaborative process of sharing authority and responsibility between researchers/academics and health citizens, empowering decision-making to identify solutions together. Thus, the lived experience and unique perspectives of health citizens help enhance the quality of health and care education, research, policies, and future practices that meet the needs of both patients and care providers. The question then arises – how do we effectively embed a co-production strategy with both groups, i.e., researchers/academics and health citizens?

In terms of education, health citizens need to be involved in co-designing and delivering activities, starting from student recruitment to teaching and assessment. Similarly, the research journey requires setting priorities, creating ideas and research questions, and engaging in grant applications until dissemination.

To ensure authentic engagement, a consistent approach to partnership working is essential. For instance, at the University of Bradford, experts by experience developed a co-production checklist for managing expectations, identifying roles and sharing examples of good practice with each other. Involvement was enhanced by introducing a training programme towards a co-productive culture to be delivered to all – health citizens, academics and researchers. The approach was supplemented by creating an advisory group of health citizens to improve the delivery of activities, such as student recruitment, curriculum development, research, and governance. Finally, an annual involvement audit of health citizens was used to identify good practices and keep track of potential improvements.

To achieve embedding a co-production strategy with health citizens, meaningful and positive environment – a sense of belonging for health citizens needs to be established. This means health citizens are in control of their engagement and play a key role in the decision-making process that may impact future health and care practices.

A sense of belonging can be ensured by creating and maintaining both physical and digital spaces for a diverse group of health citizens so that the activities, feedback responses, and other relevant information are accessible to each member.

Continuous reviewing and improving training opportunities will help develop people’s skills and confidence so as to interact with a broad range of people within their line of work. In addition, setting up a quality standard working group and developing a peer leadership/buddying programme can enable experienced members to support other health citizens in the team.


University of Bradford (2022) Experts by Experience Co-production Strategy (2023-2028) Vision and guiding principles

our goals

Healthier lives

We understand the importance of a world that recognises and protects the most vulnerable and acknowledges the importance of a healthy mind as well as a healthy body.