Measuring the Impact of Co-Production in Mental Health Services: Outcomes, Evidence and Quality Assurance
Co-production becomes credible when a provider can evidence what changed and how it improved safety, experience or outcomes. In this set on co-production, lived experience and personalisation, impact measurement is essential: it demonstrates operational maturity and prevents involvement becoming tokenistic. Measurement must also reflect mental health service models and pathways, because what “good” looks like differs across crisis pathways, step-down services, community recovery and longer-term support. This article explains how to measure co-production impact using practical indicators, governance routines and audit-ready evidence.
Start with a simple impact logic
The most effective approach uses a clear chain: Issue → Co-produced change → Expected operational effect → Evidence source. This keeps measurement grounded. For example: “People don’t understand triage outcomes → rewrite triage letters with lived experience contributors → fewer repeat contacts and complaints → call data + complaint themes + experience survey items.”
Impact does not have to be complex, but it must be observable. Where direct outcomes are hard to attribute, use proxy indicators and triangulate across sources: audits, complaints, contact data, incident themes, staff supervision records and qualitative feedback.
What to measure (and what not to)
Avoid measuring “activity” alone (number of meetings, number of contributors). Those metrics show effort, not effect. Instead, measure change in areas co-production is designed to improve:
- Clarity and access: fewer repeat calls for clarification, improved experience ratings for “I knew what would happen next”.
- Engagement: reduced “loss of contact” episodes, improved attendance or contact stability for higher-risk cohorts.
- Safety and escalation: earlier recognition of deterioration, reduced crisis presentations linked to communication failures.
- Quality of records: stronger evidence of shared planning and rationale for decisions.
- Equity: improved access or satisfaction for groups previously reporting barriers.
Operational Example 1: Measuring the impact of co-produced crisis planning
Context: A provider co-produced crisis and relapse planning tools with people using services and carers, aiming to reduce preventable crisis escalation and improve clarity about what to do when risk rises.
Support approach: The service updated templates and introduced a structured review cadence: plans refreshed after any crisis episode, and at least every six months for higher-risk individuals. Managers ensured staff were trained and supervision prompts reinforced consistent use.
Day-to-day delivery detail: Measurement was built into routine practice:
- Monthly audit of a sample of plans for presence of early warning signs, agreed escalation steps, and consent notes for involvement.
- Tracking crisis episodes where a plan existed and whether it was followed (documented actions, contacts made, escalation steps used).
- Short experience questions after plan reviews: “Did this plan feel usable in a real crisis?”
Evidence of effectiveness: Audit scores improved over two quarters, and crisis contacts showed earlier escalation with documented steps being followed. The provider could evidence fewer crises linked to “no plan / unclear plan” themes, using incident reviews and contact data.
Operational Example 2: Measuring the impact of co-produced communications
Context: People reported high anxiety after receiving letters following triage or discharge, leading to repeat contact and complaints. Co-production focused on improving clarity and tone while keeping risk and threshold information accurate.
Support approach: The provider revised templates and introduced staff prompts for consistent verbal explanations alongside written communication. Governance controls ensured versioning and sign-off.
Day-to-day delivery detail: Measurement used three sources:
- Contact centre data: calls within 7 days of triage/discharge tagged as “clarification requests”.
- Complaints and concerns: theme coding for “unclear decision” and “no next steps”.
- Audit sampling: random check of letters plus a short call-back question asking whether the person understood next steps.
Evidence of effectiveness: Clarification calls reduced, and complaint themes shifted away from “unclear decision”. Audit feedback showed improved understanding of next steps, and staff reported fewer repetitive conversations during follow-up.
Operational Example 3: Measuring workforce impact from co-produced training
Context: The service introduced co-produced training on relational practice, validation and explaining thresholds, aiming to reduce escalation driven by poor communication and improve engagement for people with prior negative experiences.
Support approach: Training was embedded into induction and refreshed annually. Supervisors were asked to observe practice and discuss communication choices in supervision, using a structured reflective prompt.
Day-to-day delivery detail: Measurement used a mixed-method approach:
- Supervision audits: sampling notes for evidence of reflective discussion on communication and engagement, not just task management.
- Observation/spot checks: structured observation of phone calls or appointments (with consent and governance) focusing on clarity and shared planning.
- Experience measures: targeted questions for people who previously complained or disengaged (“I felt listened to”, “I understood the plan”).
Evidence of effectiveness: Supervision documentation improved, observation ratings increased, and targeted experience measures showed higher perceived respect and clarity. The service could link training to improvements through triangulated evidence rather than attendance records alone.
Commissioner Expectation: Clear outcomes and value from involvement
Commissioner expectation: Commissioners expect providers to demonstrate the value of co-production with evidence: what changed, how it improved outcomes or experience, and how improvements will be sustained across contract delivery and mobilisation phases.
Regulator / Inspector Expectation: Quality assurance and learning loops
Regulator / Inspector expectation: Inspectors will expect learning loops: involvement themes are logged, actions are taken, and results are reviewed. They will look for audit trails, governance minutes, and evidence that changes improve safety and person-centred practice.
Building co-production into your quality system
To keep impact measurement proportionate and sustainable, integrate it into existing routines: quality meetings, audit schedules, supervision sampling and incident thematic reviews. Use a simple dashboard with a handful of indicators linked to co-produced priorities, and review it quarterly. This keeps co-production measurable, accountable and aligned to service pathways.