Improving co-design methods implies that we need to understand those methods, paying attention to not only the effect of method choices on design outcomes, but also how methods affect the people involved in co-design. In this article, we explore participants' experiences from a year-long participatory health service design project to develop 'Better Outpatient Services for Older People'. The project followed a defined method called experience-based design (EBD), which represented the state of the art in participatory service design within the UK National Health Service. A sample of participants in the project took part in semi-structured interviews reflecting on their involvement in and their feelings about the project. Our findings suggest that the EBD method that we employed was successful in establishing positive working relationships among the different groups of stakeholders (staff, patients, carers, advocates and design researchers), although conflicts remained throughout the project. Participants' experiences highlighted issues of wider relevance in such participatory design: cost versus benefit, sense of project momentum, locus of control, and assumptions about how change takes place in a complex environment. We propose tactics for dealing with these issues that inform the future development of techniques in user-centred healthcare design.

Engaging young people in participatory design can be challenging, particularly in health-related projects. In a study co-designing diabetes support and information services with teenagers, we found framing activities using popular culture was a useful strategy. Various cultural references helped us stage activities that were productive for the design process, and were engaging for our young participants (e.g. exploring practical implications through discussions in a ‘Dragons’ Den’). Some activities were more effective than others and the idea of language-games, which has been widely explored in participatory design, explains why our strategy was successful when there was a clear ‘family resemblance’ between the popular cultural references and certain essential stages of designing. However, attention is required in selecting appropriate cultural references if this strategy is adopted elsewhere, and design facilitators should focus first on devising accessible language-games, rather than expecting popular cultural references to provide complete solutions to the challenge of staging participatory design.

Aims and objectivesTo explore, using the example of a project working with older people in an outpatient setting in a large UK NHS Teaching hospital, how the constructs of Person Centred Nursing are reflected in interviews from participants in a Co‐design led service improvement project.BackgroundPerson Centred Care and Person Centred Nursing are recognised terms in healthcare. Co‐design (sometimes called participatory design) is an approach that seeks to involve all stakeholders in a creative process to deliver the best result, be this a product, technology or in this case a service. Co‐design practice shares some of the underpinning philosophy of Person Centred Nursing and potentially has methods to aid in Person Centred Nursing implementation.Research designThe research design was a qualitative secondary Directed analysis.MethodsSeven interview transcripts from nurses and older people who had participated in a Co‐design led improvement project in a large teaching hospital were transcribed and analysed. Two researchers analysed the transcripts for codes derived from McCormack & McCance's Person Centred Nursing Framework.ResultsThe four most expressed codes were as follows: from the pre‐requisites: knowing self; from care processes, engagement, working with patient's beliefs and values and shared Decision‐making; and from Expected outcomes, involvement in care. This study describes the Co‐design theory and practice that the participants responded to in the interviews and look at how the co‐design activity facilitated elements of the Person Centred Nursing framework.ConclusionsThis study adds to the rich literature about using emancipatory and transformational approaches to Person Centred Nursing development, and is the first study exploring explicitly the potential contribution of Co‐design to this area.Implications for practiceMethods from Co‐design allow older people to contribute as equals in a practice development project, co‐design methods can facilitate nursing staff to engage meaningfully with older participants and develop a shared understanding and goals. The co‐produced outputs of Co‐design projects embody and value the expressed beliefs and values of staff and older people.

This paper describes the use of Experience Based Design (EBD), a participatory methodology for healthcare service design, to improve the outpatient service for older people at Sheffield Teaching Hospitals. The challenges in moving from stories to designing improvements, codesigning for wicked problems, and the effects of participants" limited scopes of action are discussed. It concludes by proposing that such problems are common to participatory service design in large institutions and recommends that future versions of EBD incorporate more tools to promote divergent thinking. Author KeywordsExperience based design, Older People, Service Design.

We present a method for the situated discovery and articulation of issues at the intersection between the politics of place making and city planning. We describe the construction and use of designed tools, such as historical political archives; counterfactual maps; and cards to invite situated dialogue between the social and institutional practices and mechanisms that produce our cities. Grounded in an account of the political as vernacular and embodied, our analysis advance understandings on the politics of design, and on the complex interrelationship between places and political spaces. We outline how HCI can adopt methods and develop sensitivities to support democratic practices and publics envisioning their urban futures.