Embedding Service User Co-Production Into Quality Governance and Assurance
Service user co-production is often described as a value, but too rarely embedded as a governance mechanism. When feedback is disconnected from audits, quality meetings, and leadership oversight, it loses influence and credibility. This article explains how to embed service user feedback and co-production into formal governance using quality standards and assurance frameworks that commissioners and CQC expect.
Why governance matters for co-production
Without governance, co-production depends on individual managers and can disappear during staff turnover or operational pressure. Governance ensures that service user voice consistently influences decisions about quality, safety, staffing, and outcomes.
Effective governance does not mean bureaucracy; it means clarity: who listens, who decides, who acts, and who checks that change worked.
Building co-production into quality structures
A robust model integrates feedback into:
- Monthly quality and safety meetings.
- Audit programmes and thematic reviews.
- Service improvement plans.
- Senior leadership and board reporting.
Feedback themes should be treated as evidence alongside incidents, complaints, audits, and performance data.
Operational example 1: Feedback-driven audit focus
Context: Multiple people reported inconsistent staff approaches to personal care, leading to discomfort and confusion.
Support approach: The manager commissioned a focused audit co-designed with service users, asking: “Does care feel the same regardless of who supports you?”
Day-to-day delivery detail: Audit questions were rewritten in plain language and trialled with people. Observations were conducted with consent, and findings were discussed in a co-production forum. Training and competency checks were targeted at specific gaps rather than generic refreshers.
How effectiveness was evidenced: Re-audit results showed improved consistency, and feedback scores increased. Governance minutes showed how feedback shaped audit priorities.
Operational example 2: Leadership oversight informed by service user voice
Context: Senior leaders received high-level quality data but limited direct insight into lived experience.
Support approach: A quarterly co-production summary was introduced for leadership meetings.
Day-to-day delivery detail: The summary included top feedback themes, actions taken, unresolved risks, and direct anonymised quotes. Leaders were required to challenge delays and request evidence of impact. Actions were tracked through the quality action log.
How effectiveness was evidenced: Leadership decisions increasingly referenced service user experience, and repeat themes reduced over time.
Operational example 3: Co-producing quality improvement priorities
Context: Annual quality priorities were historically set by managers alone.
Support approach: The service ran a co-production planning session where people identified what would most improve their lives.
Day-to-day delivery detail: Priorities were translated into measurable objectives with named leads and timescales. Progress was reviewed quarterly with service users, and adjustments were made based on feedback.
How effectiveness was evidenced: The quality plan clearly showed co-produced priorities and progress, supporting inspection and commissioner review.
Commissioner expectation: transparent governance
Commissioner expectation: Commissioners expect governance systems that demonstrate accountability and learning. They will look for:
- Clear reporting of feedback themes.
- Evidence of leadership oversight and challenge.
- Demonstrable impact on quality and outcomes.
Regulator expectation: well-led services
Regulator / inspector expectation (CQC): Inspectors assess whether services are well-led by examining how leaders listen, learn, and improve. Embedded co-production within governance strongly supports a positive judgement.