I believe referring to people as ‘complex’ e.g., in mental health care feels a bit like it says more about the practitioner’s willingness to listen and apply evidenced-based principles to helping the person than it does about the person in distress. All humans are complex. If we develop systems which continually try to improve health care through co-production this might provide a safer and more effective means of management. Health care systems should be better aligned to people’s needs. Better to complete pre-flight checks and to continuously learn than to try to correct forced landings.

With respect Tom, design professionals will need to work with clinicians, patients and carers to balance the health care economy. I expect quality and patient safety will require a person-centred approach to be effective. Co-production is imperative, as is asset-based community development, to support unpaid carers having to manage risk at home. Holistic care and risk management in my view depends upon building relationships and getting to know what doesn’t fit neatly in a system.

I don’t disagree but my point is that most Service design activity is about ‘system’ design. Things like IT interface, record keeping, scheduling, data collection, Process Management, Juran’s trilogy, etc. All areas requiring Professional skills. Co-production with Service users comes later in the process, never-the-less it is still very important.

Morning Tom. I appreciate your expertise. A coordinated approach to redesigning service delivery will need to consider local context, the views of service users and founding principles of the NHS.