Coproduction and health: Public and clinicians' perceptions of the barriers and facilitators

Background Coproduction is an approach increasingly recognized across public services internationally. However, awareness of the term and the barriers and facilitators to its implementation in the NHS are not widely understood. This study examines clinician and public perceptions of coproduction within the context of the Prudent Healthcare initiative. Objectives To provide insights into how coproduction is viewed by clinicians and the public and identify perceived barriers and facilitators to its implementation. Design Using qualitative research methods, interviews were conducted with the public (n = 40) and clinicians (n = 40). Five focus groups were also conducted with the public (n = 45) and six focus groups with clinicians (n = 26). The COM-B model was used to analyse the data; key domains include Capability, Opportunity and Motivation. Setting This is an all-Wales study, involving six Health Boards, an NHS trust and community and patient groups. Results Key barriers relating to Capability include lack of awareness of the term coproduction and inadequate communication between clinicians and citizens. Opportunity-centred barriers include service and time constraints. Conversely, facilitators included utilizing partnerships with community organizations. Motivation-related barriers included preconceptions about patients' limitations to coproduce. Conclusions There were broadly positive perceptions among participants regarding coproduction, despite initial unfamiliarity with the term. Despite study limitations including underrepresentation of employed public participants and junior doctors, our analysis may assist researchers and policymakers who are designing, implementing and evaluating interventions to promote coproduction.