People are living longer, but with more long-term health conditions. The number of people living with major illness is also projected to increase by 2.5 million by 2040 (Health Foundation, 2023). Health and care teams are stretched, and we know we need to work differently.

We believe that:

• We need to support people holistically, not treat individual conditions.
• We need to build people’s confidence to manage their health, not feel the responsibility to manage and fix every issue.
• We need to involve people in service design, not deliver the services we think people want.
• We need to work together with people using our services, and learn from the expertise we all bring.

Co-production and co-design are central to Bridges, the way we came to exist, the way we operate and the way we innovate and evolve. They are threaded through everything that we do. We have a long history of recognising and addressing the power imbalance in healthcare interactions within our work and this really helps us to deliver effective and authentic co-design projects.

Many of the people with lived experience who work and partner with Bridges have been involved in co-design elsewhere. They have plenty of examples of tokenistic patient involvement where they are asked about something that has already been created and there is limited scope to be truly creative. Genuine co-design requires equal collaboration; where everyone has the confidence to contribute, listen and debate whatever comes up.