At a glance…

• Co-production is when professionals and people with lived experience (often service users) work together to find solutions to challenges in public services and communities
• In Wales, there is no legal requirement to work with citizens in the design and delivery of health services
• FTWW is working to ensure patient involvement – or co-production – happens in Wales, especially in ‘women’s health services’, like maternity and gynaecology

Why co-production is important to FTWW

FTWW was set up to bring patients in Wales together to share our views and challenges in accessing the health services we need. This remains core to what we do.

We believe very strongly in channelling these experiences in ways that make a real and positive difference to our health and lives, so that the health inequities experienced by women and people registered female at birth can be properly understood, addressed, and prevented in the future.

We know that this can only happen when we work in partnership with service providers and professionals, whether they be governments, health boards, clinicians, academics, educators, employers and beyond. It is really important to us that those with lived experience, with the wealth of knowledge and expertise that comes from that, play an equitable role in decision-making. This includes the design and evaluation of the services we receive. We call this co-production.

In a nutshell, co-production is when professionals work in partnership with people who have lived experience, to develop solutions to challenges in public services and communities. You can read more about co-production and what it means on the Co-production Network of Wales website here.

Co-production in healthcare in Wales

The principles of co-production are embedded in some of Welsh legislation, including the Wellbeing of Future Generations Act and the Social Services and Wellbeing Act. However, at present, when it comes to the design and delivery of health services, there isn’t necessarily the same legal requirement to work with citizens.

In the absence of legislation, FTWW is working to ensure patient involvement – or co-production – happens on the ground, in the Welsh NHS and in our 7 health boards. This is particularly important in services often described as ‘women’s health services’, like maternity and gynaecology, because there has been evidence in the recent past to show that not hearing women’s voices can result in harm, for example in the 2020 Independent Medicines and Medical Devices Safety Review, chaired by Baroness Julia Cumberlege, entitled “First Do No Harm”.

Of course, we know that women’s health doesn’t only sit with maternity and gynaecology services, so we continue to raise awareness and support our members’ involvement in the design of other health services too, most notably as the NHS Wales creates a 10-year Women’s Health Plan. You can read more about the Plan here. One of the key recommendations made was for the Plan to be co-produced with public and patients. This recommendation is echoed in the NHS Wales ‘Women’s Health in Wales’ Discovery Report, based on almost 4000 survey responses. The report described how, regardless of the health issues with which women are living, their top priority is ‘having their voices heard’ in the healthcare they receive.

Co-production in action

In the meantime, a good example of where FTWW is working with service-providers to ensure patient involvement in the design, delivery, and evaluation of healthcare is in North Wales, in Betsi Cadwaladr University Health Board’s Women’s Directorate, where we have helped set up the Gynae Voices Forum. North Wales Gynae Voices is a very powerful way for patients to share their experiences and views, and work with clinicians and management to develop information and approaches to care which meet our needs. Gynae Voices has been cited as a model of good practice in the Royal College of Obstetricians’ 2022 Workforce Report (page 64) and, more recently, in Public Health Wales’s July 2024 e-bulletin here. Our mission is to help set up a Gynae Voices forum in every health board in Wales.

FTWW is a member of the Coproduction Network for Wales