Moving Beyond the 'PPG': Co-production and Inclusion Health

Background: We frequently fail to meaningfully incorporate patient voice in the development of health services, in particular the voices of those who are most disadvantaged.

Aim: To share learning from a co-production project to improve primary care experience for those with multiple disadvantage and lived experience of trauma.

Method: We formed a collective of women (Bridging Gaps). Group members had lived experience of poverty, mental health challenges, addictions, homelessness, and sexual exploitation. Other members were researchers, GPs, and members of a third-sector organisation. We worked alongside local GPs to change how services were delivered. We collected interviews ( = 9), ethnographic data from group meetings ( = 3), and reflective notes from group members ( = 19). Data on our process were analysed using a framework approach drawn from the principles of trauma-informed care.

Results: We highlight the challenges for those with multiple disadvantages and trauma experience to meaningfully and safely engage in traditional Patient Participation Group (PPG) models. True co-production of services requires adequate resources and close collaborative working with local community organisations. Groups must be facilitated by those with relevant experience and the ability to both notice and manage power dynamics within the room. With sufficient support, co-production models have potential to empower group participants and improve health services.

Conclusion: Partnership working between GPs, the third sector, and other organisations is vital. This can allow GPs to benefit from the expertise of those with relevant lived experience in tackling health inequalities.