What is Co-creation? Examples, definitions, meanings and insights from the #CoCreatingWelfare project

On the 10th of May 2019, I was invited to an event to celebrate the successes and challenges of Co-Creation, and the wonder of working together, fully, actively and with a shared philosophy. This was definitely an area I was keen to learn more about and a methodology I was keen to use in my research…I was intrigued.

The event was funded by and centered around the 3-year European project ‘Co-Creating Welfare’, designed to improve the implementation of Co-Creation in the welfare sector. This event happened toward the end of the project. It was conducted in partnership with colleagues in Denmark, France, Portugal and the UK, and led by Dr Gemma Pearce and Paul Magee from Coventry University.


Access full details to the  project here. 

project partners

Here is Dr Gemma Pearce in action (@GemmaSPearce )

Here is Paul Magee in action (@Paul_IDTU )

Paul Magee


Six principles for co-creation

1. Co-creation is innovative and aims to create new prosperity in a local context
2. Co-creation creates new qualities through combinations of different resources
and skills
3. Co-creation is a dialogue-based process, where the different actors define the
challenge and the solution together
4. Co-creation propagates initiative and the rights for all to participate
5. Co-creation creates an understanding of interdependence
6. Co-creation requires openness and willingness to take risks

“The Danish NGO “The Voluntary Council”

brown dried leaves on sand

Presentations from co-creators showcased their collaborative activities, barriers, opportunities and provided tangible case-studies of practice with practical, bite-sized tools to compliment delegates’ own work.

Obviously, as a midwife I was keen to hear

Always Events® are defined as “those aspects of the patient and family experience that
should always occur when patients interact with healthcare professionals and the
delivery system.”

Always Events is a trade marked product owned by the Institute of Healthcare Improvement. It was originally developed by the Picker Institute in the USA – http://www.ihi.org

 for more…

NHS Mandate states that by 2020 we must: ‘improve the percentage
of NHS staff who report that patient and service user feedback is
used to make informed improvement decisions’

⁦The amazing ⁦⁩ shared insights about participatory appraisal as a tool for engaging with communities. Mapping creatively leads to different outcomes 👏🙌🎉😀

   created a lovely space for learning, sharing & thinking time. Follow  for more.

One participant said…

“thanks all, I’m energized & inspired.”

A great presentation from Trupti of all about the project and what they have learned so far about co-creation!

A fun, innovative approach to engaging staff and students in curriculum and course design 😃 was explained by

inspires us all as she shares her research in in health technologies.

So then we got to immerse ourselves in co-creation… What did this look like?

white and black Together We Create graffiti wall decor

Being introduced to the ‘CUBE’

A Co-Creating Welfare Activity

You can learn more about the CUBE via the video below…

Using the CUBE, we were asked ‘What gets in the way of a truly co-creative culture?’...then we were engaged in co-creation activities facilitated by &  outputs were co-created by  …The following videos summarize what followed…


Participants were also asked to use the CUbe in co-creation facilitated by &  …here is a a summary presentation of this activity by  ..


And again..the CUbe was used in co-creation, facilitated by &  see the outputs here presented by


…and yet more insights presented here by


Some were inspired to break down barriers with Playdoh…


Some used Lego to co-create. The following was co-created by  &  

So what makes co-creation different?


Through Co-Creation, all stakeholders are involved in shaping the decisions that impact them….

What did I learn?

love to learn pencil signage on wall near walking man

What is co-creation not…

-Not financial
– Not top down decision-making
– Not telling and selling
– Staff dictating terms of reference
– Cannot be forced
– Staff persuading/influencing people about the change area
– Not managerial
– Not about exclusion
– Not about paying lip service
– Not driven by organisational priorities
– Not having a shared goal or purpose
– Not being asked for service user input and then the project not happening
– Not one person’s idea
– Not about reaching an outcome in a defined time
– Not institutional or increasing red tape
– Clients not receiving feedback about the changes
– Not ticking an inspectorate box

What is Co-Creation?

Some people may call it cocreation, co-creation, coproduction, co-production, codesign, co-design, coproduce, co-produce and/or co-construction. People who co-create are ‘Co-creators’, and this is how they define Co-creation….

-Meeting people – Connecting, talking, sharing
– Developing shared understanding and vision
– Active engagement
– Making people feel heard
– Having shared processes and shared outputs
– No assumptions
– Patients are humans, not processes or policies
– Importance of listening
– Ensuring you get input from a range of groups, not just those most easily
accessible or articulate
– Developing a shared list of objectives
– Opportunities for clients to make a change
– The importance to allow time to build relationships
– Accessible and flexible
– Creative
– Celebrating success together
– The process that facilitates stakeholders to have equal status and value in
the creation of a process, product or service
– Helping staff to also feel heard and on board
– Adaptable approaches to client engagement
– Ensuring we meander everywhere
– Importance of equality of voices in shaping services
– Making clients feel valued in their care and giving them purpose
– Importance of not over-defining scope which can limit creativity
– Seeing things from peoples’ perspective

please stay on the path signage

Example rules for co-creation

-Contribute to the co-creation community through their experiences, skills and time;
-Distribute leadership responsibilities and collectively share co-creation community-Engage in insightful and non-threatening discussions of ideas and experiences;
-Be respectful and use appropriate language in team discussions;
-Listen and respond to each other with open and constructive minds;
-Be willing to share challenges, lessons learned, constraints / barriers faced and
-Not be afraid to respectfully challenge each other by asking questions;
-Will refrain from personal attacks;
-Be committed to build on each member’s strengths;
-Be committed to help others to improve areas that need further development;
-Use short, clear sentences and avoid using obscure expressions without an
-Be committed to search for opportunities for consensus or compromise, and for
creative solutions;
-Be willing to contribute to an atmosphere of problem solving;
-Promote their personal and professional goals through participation in the cocreation community.

(Centres for Disease Control and Prevention, 2016)


What does a co-creation event look like in practice?

English Co-production Network Exploration Event from At The Moment Productions on Vimeo.


My Takeaways…


Breaking down the co-creation process into three manageable chunks certainly makes it easier for me to think about how to structure my own co-creation activities in future…

  • Stage One: Co-Define

  • Stage Two: Co-Design

  • Stage Three: Co-refine

postcard toolkit

Free information loaded postcards to takeaway means that I can now refer to what I have learnt on the go to support me in co-creating ‘on the move’…

Seven co-creation activities to use in practice…

  1. The Q Sort Activity, which is an activity to experience collaborative work and collective problem formulation.
  2. Role Play Activity, which is an activity to experience how to collect ideas and knowledge to solve a concrete challenge.
  3. Story Cubes Activity, which is an activity to experience the creation of common narratives related to a challenge or solution.
  4. Fish Bowl Activity, which is an activity to experience collaborative problem solving.
  5. Meta Plan Activity, which is an activity to experience how to draw on the existing knowledge within a group.
  6. Pecha Kucha Activity, which is a dynamic presentation method.
  7. The Cube Activity, which is a method to support a creative brain storm activity.

I am also fascinated by the amazing ‘SPRINT’ methodology (from Google Venture) introduced to us by the inspiring @dietercise . I will certainly be implementing this methodology into my future work. Learn more via the media below…

Image result for sprint methodology

How does SPRINT work in practice?

Get access to the full co-creation toolkit associated with this project here. Currently, this site shows the project process, but in Sept 2019 it will be revised and updated to it’s final version.

Lastly, it is important to remember that…

Thank you to everyone involved in the #CoCreatingWelfare project for supporting the development of personal and inter personal skills in co-creation for all!

If you would like to follow the progress of work going forward..

Follow me via @SallyPezaroThe Academic MidwifeThis blog

Until next time…Look after yourselves and each other 💚💙💜❤