Improving access to co-design through remote, adapted, and asynchronous approaches: a case study of the neuroscience optimised virtual environments living lab (NOVELL)

Healthcare research is increasingly focused on involving patients and the public in service design. This involvement is referred to in many ways, including Patient and Public Involvement (PPI), co-design, co-creation, or co-production. Engaging stakeholders including end-users in research is recognised as best practice, yet there is often little evaluation of the effectiveness of the approaches used to facilitate this engagement. In this paper, we present the engagement approaches developed to facilitate the involvement of people with stroke in a healthcare innovation project. Engaging people with stroke alongside other stakeholders presents a range of complexities, including the need to accommodate and support various levels of physical, communication, and cognitive challenges. This paper documents the flexible ways of working developed to remove barriers to involvement for people with stroke and other stakeholders, and evaluates their success using a Value Network Analysis to explore the outcomes from engagement from each stakeholder group’s perspective. The findings highlight how a wider range of people can be engaged in co-design practices, and explore the types of value that can be generated through participant-centred engagement practices.