ArticleHealth expectations : an international journal of public participation in health care and health policy2025
Enablers and Barriers to an Experience-Based Co-Design Process to Develop Service Improvements in Enhanced Community Care in Ireland: A Qualitative Study.
Article in Health expectations : an international journal of public participation in health care and health policy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Better Healthcare Together: Co-Designing a Framework for Health Service Co-Design.Health expectations : an international journal of public participation in health care and health policy · 2026Article
- Co-designing suicide prevention research with mothers of suicidal adolescents - applying McKercher's Model of Care.Research involvement and engagement · 2026Article
- Facilitators' experiences of co-designing an intrapartum care intervention in four sub-Saharan African countries: a qualitative study.BMJ open · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundExperience-Based Co-Design (EBCD) is a popular collaborative process where service users and healthcare providers share their experiences of using and delivering services to identify ways to adapt services to enhance those experiences.
objectiveThis study aimed to identify enablers and barriers to the successful implementation of EBCD as part of Ireland's recently adopted Enhanced Community Care (ECC) programme.
designService users and staff at two sites (N = 17) participated in an accelerated EBCD process designed to enhance service provision for older people and those living with chronic conditions. This included four co-design working group sessions per site.
methodsTranscripts from the co-design working groups and from brief follow-up interviews with individual participants were analysed. Thematic analysis was used to identify enablers and barriers to the EBCD process.
resultsWe generated six key themes reflecting barriers and enablers; enablers were the fundamental role of the facilitator (Theme 1), a flexible approach that met group members' needs (Theme 2) and active and interactive activities to support participant engagement (Theme 3). The fundamental role of the facilitator was also identified as a barrier (Theme 4); additional barriers included balancing experience-sharing and decompressing (Theme 5) and the scope of the group as an invisible barrier (Theme 6), which reflected challenges in facilitating dialogue about change when participants were aware of system-level constraints on the potential for change.
conclusionsThe facilitator is critical in ensuring the successful implementation of the EBCD process. Considering how best to draw on the facilitator strengths while also ensuring that the service user perspectives are equally weighted with staff perspectives is important for effective communication within EBCD projects. PATIENT OR PUBLIC CONTRIBUTION: Service users (also including carers) at two sites participated in EBCD projects alongside health and social care professionals, ultimately generating two service improvements for the ECC programme. The participation of these service users was celebrated at an academic conference, which was attended by a number of service users, and where the outcomes of the EBCD project were presented.
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