Background The Health and Wellbeing Centre at North London Hospice has undergone significant change in its service provision. A priority for improvement project for the organisation was to develop a co-production model for new service developments.

Aims Establish within our needs stratified model one-to-one complex interventions, shared professional care and community/social engagement using a co- production model; develop a means of designing and delivering new interventions; empower users and staff to develop self-management skills; ‘doing with, not doing to’; provide a resource for the organisation.

Methods A steering group provided support, guidance and oversight during the project. A co-production framework was adapted. The needs stratified model provided the framework for the level of intervention. User engagement as an equal partner in planning, delivering and assessing their care.

Example Photography ‘Catching the Light. Users expressed an interest in using photography as a medium for expression and enjoyment. An exhibition of a patient’s photography launched the initial co-production meeting, facilitated by a staff member. All stakeholders including camera societies were invited. (lived experience). Examples of using photography in palliative care was researched (research literature). Formulation of a plan at the exhibition, including recruiting volunteers with photographic technical ability to support the group (knowledge and expertise).The relationship between users and staff was equal, open and honest and led to a creative, supportive and powerful group who were empowered (candour, accountability, respect, communication skills).

Conclusion A collaborative co-produced model enabled our service users, local community and staff to be empowered to design, plan and deliver services of relevance to their needs. The culture of the service shifted; ownership, openness and honesty, sharing decision making, respect and valuing our users as equals grew and led the organisation to examine the relationship with users.