Co-design is built on a straightforward idea: the people affected by a service or decision should have a meaningful role in shaping it.
Putting that principle into practice, however, requires more than inviting people to a workshop or asking for feedback on something that has already been designed.
The NSW Agency for Clinical Innovation’s Co-design Toolkit offers a practical resource for health services looking to work differently with consumers. Its central premise is that consumers and health staff should work together as equals in leadership, design and decision-making — moving beyond involvement after an agenda has been set to shared problem definition and solution design from the outset.
Explore the ACI Co-design Toolkit
A process practitioners can actually use
One of the toolkit’s strengths is that it treats co-design as both a process and a way of working.
The process is organised around four stages: start up and engage; gather; understand; and improve. Teams begin by framing the problem and establishing the co-design team, then build their understanding through lived experience, make sense of what they have learnt, and work together to develop, prototype, test and refine solutions.
That distinction matters. Good co-design is not defined by a particular workshop technique. The methods sit within a broader approach that requires people to work differently together.
The toolkit puts considerable emphasis on behaviours such as balancing power, challenging assumptions, creating a shared vision, being transparent, valuing different forms of expertise and setting clear expectations about how decisions will be made.
For engagement professionals, these are useful reminders that the quality of a co-design process depends as much on the conditions surrounding participation as the activities used during it.
Knowing when not to co-design
Perhaps one of the most valuable parts of the toolkit is its acknowledgement that co-design is not automatically the right approach.
ACI identifies several warning signs: the solution has already been decided, there is no genuine scope for change, the organisation is not ready to share power, or the exercise risks becoming a box-ticking activity. Tight timeframes, limited capability and insufficient resources can also constrain what is realistically possible.
This is an important distinction for practitioners.
Calling something co-design creates expectations about influence, shared decision-making and power. If those conditions cannot be provided, another form of engagement may be more appropriate — and more transparent.
ACI also takes a pragmatic approach to imperfect conditions. Its guidance recognises that a complete co-design process will not always be possible, particularly in complex public-sector environments. Instead of applying the label regardless, teams can identify which co-design practices can genuinely strengthen their work.
Power needs to be designed too
The toolkit also makes power visible rather than treating it as an abstract principle.
Its guidance asks teams to consider whose knowledge is valued, who has access to information, who makes decisions, what barriers affect participation and whether people with lived experience are genuinely able to contribute as equals.
There is also dedicated guidance for working with Aboriginal communities, drawing on the 8 Aboriginal Ways of Learning and emphasising relationships with community, place, story, different ways of knowing and appropriate local involvement from the beginning.
This reinforces a broader lesson: co-design cannot be separated from context. A process may be technically well designed and still fall short if it does not recognise relationships, culture, history and existing power dynamics.
Building stronger co-design practice
For practitioners wanting to explore these questions further, Engagement Institute has also developed two Co-Design Practice Notes.
What is Co-Design? provides a practical overview of what co-design is — and is not — and when it may be appropriate. Considerations for a Co-Design Approach explores some of the issues practitioners need to work through when planning and delivering co-design, including purpose, roles, power, resourcing and decision-making.
Taken together with the ACI toolkit, they provide a useful sequence for practice: first determine whether co-design is the right approach and whether the conditions exist to do it meaningfully; then select a process and methods that support genuine, shared design.
Because the question is not simply “How do we run co-design?”
It is also: “Are we genuinely prepared to design this with people?”
