Co-Producing Person-Centred Plans with Families and Advocates in ABI Services
Co-production is a key component of person-centred planning in acquired brain injury (ABI) services, particularly where cognition, insight or communication are affected. Families and advocates often hold valuable knowledge about an individual’s history, preferences and effective support approaches. However, providers must balance this input carefully to ensure that the person’s own voice remains central. For broader context, this article should be read alongside Person-Centred Planning & Strengths-Based Support and ABI Service Models & Pathways.
Commissioners and inspectors increasingly scrutinise how co-production is achieved in practice. Providers must demonstrate not only that families and advocates are involved, but how their input is balanced, documented and reviewed alongside the individual’s preferences.
Why co-production matters in ABI services
ABI often affects relationships, communication and roles. Families may take on increased involvement, while individuals may experience changes in identity or decision-making ability. Co-production helps providers build a fuller understanding of what matters to the person.
However, without structure, co-production can become unbalanced, with the person’s voice overshadowed by others.
Commissioner and inspector expectations
Commissioner expectation: Inclusive and balanced planning. Commissioners expect providers to demonstrate how different perspectives are considered and integrated into planning.
Regulator expectation (CQC): The person’s voice remains central. Inspectors expect clear evidence that co-production does not replace individual involvement, and that supported decision-making is prioritised.
Structuring co-production effectively
Effective co-production requires structured processes that ensure all voices are heard and balanced appropriately.
Operational example 1: Facilitated co-production meetings
An ABI provider introduced structured planning meetings with clear agendas and facilitation. Meetings began with the individual’s views, supported where necessary, before incorporating family and advocate input.
Decisions were documented clearly, including how different perspectives were considered. This improved transparency and strengthened relationships between all parties.
Managing disagreement and conflict
Disagreement is common in ABI services, particularly around risk, independence and pace of change. Providers must manage this constructively and transparently.
Operational example 2: Documented decision rationale
A service implemented decision rationale records capturing areas of disagreement, how discussions were managed and how final decisions were reached. These records were reviewed regularly to ensure ongoing relevance.
This approach reduced conflict and provided clear evidence for commissioners and inspectors.
Maintaining the person’s voice
Co-production must not override individual involvement. Providers must demonstrate how they prioritise the person’s voice, even where communication is complex.
Operational example 3: Voice-first planning approaches
An ABI provider introduced “voice-first” planning tools, capturing the individual’s preferences using visual, audio or simplified methods before involving others. Family input was then added to complement, not replace, these views.
This ensured that plans remained genuinely person-centred and improved engagement outcomes.
Balancing risk, choice and family perspectives
Families may have different views on risk and independence. Providers must balance these perspectives while maintaining a person-centred approach.
This includes:
- Clear documentation of discussions and decisions
- Structured risk assessment processes
- Regular review of decisions and outcomes
Balance is critical for both safety and quality of life.
Governance and oversight
Providers must monitor how effectively co-production is being achieved. Governance processes should assess both documentation and practice.
This can include:
- Audits of co-production records
- Feedback from families and advocates
- Review of decision-making processes
Strong governance ensures consistency and accountability.
Evidencing co-produced planning
To meet expectations, providers must clearly evidence co-production. This includes:
- Who was involved in planning and why
- How views were gathered and considered
- How decisions were reached and reviewed
Clear evidence strengthens both inspection outcomes and commissioning confidence.
Co-production as quality practice
In ABI services, co-production strengthens understanding, improves outcomes and supports trust when delivered effectively. Providers that embed structured, balanced approaches demonstrate mature, person-centred practice that meets both regulatory and commissioning expectations.