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16. What next for your EBCD project?

This section offers some tips on how to sustain the progress and spread the improvements to patient experiences made through experience-based co-design (EBCD).


Sustaining and spreading improvements to patient experiences will help maximise the effectiveness, and value for money, of EBCD. Once your EBCD project has identified and implemented improvements, it is good practice to map and examine them in terms of their sustainability at a later period. Positive findings will provide useful evidence for you to use in proposals for future EBCD work.

Even at the design stage, it is helpful to consider sustainability as an issue. But in a constantly changing health service, it is not always possible to guarantee that a positive intervention will remain the ‘right’ way to do something if other circumstances change. However, because the changes that arise from EBCD are often very simple and practical, many services have found that their changes have been sustained. And EBCD has an impact on people’s ethos and mindset, reconnecting them with the values of patient-centred care and encouraging organisations to involve patients in service design as a matter of course. This shift accompanies people throughout their working lives.

A key ingredient in sustaining change is continuing to keep staff engaged, using the language and values that motivate them most (see Sections 3, Making the case for the project and 6, Recruiting and interviewing staff). Another is to align the focus of an EBCD project with other drivers within the organisation, to increase the chance of support and staff buy-in, and to share resources.

Key points

  • Make sure that all staff involved have a shared understanding of the nature of collaborative decision-making and what is necessary – or ‘appropriate’ – for patients.
  • Put in place quality-improvement staff who can sustain ongoing and trusted working relationships with clinical staff.
  • Make sure ward managers and ward-based staff are engaged in discussion about co-design priorities and work. Service matrons, in particular are crucial in driving the work forward.
  • Make sure the interventions are tailored to the changing needs and priorities of  clinical staff and patients alike.
  • Ensure that the improvements take into account the particular dynamics and challenges of inter-professional team working.
  • Improvements must have the active support of senior managers, including clinical leaders, and the organisation as a whole.
  • Make sure the improvement initiatives are aligned with local quality-improvement work in other services.

We hope that this toolkit has given you the inspiration to work with patients to improve your health service, as well as the necessary practical guidance to run a successful project.

There is a range of other resources available that could help you set up and run a successful project using experience-based co-design. See our evidence and further reading around experience-based co-design for more details.

We have set up an EBCD LinkedIn group for people to share experiences of EBCD – either as a member of staff or a patient. If you have specific questions about the approach, or would like an informal conversation about putting it in to practice, or are just interested to find out more, please join the group.

EBCD Workshops and training

We run co-design training workshops throughout the year, based on this toolkit. We also offer tailored training and support, which can be delivered at your organisation.

For more information, or to register your interest in future workshops, please enter your details here.

During the Covid-19 crisis we have adapted our EBCD workshop into an online course which we will be running in September 2020. For more information please visit the event page here.

View the EBCD case studies.