Community-led healthcare design is an approach that involves engaging and empowering communities to actively partner in the design and delivery of healthcare services. We know that community members have valuable insights into their own healthcare needs, preferences, and experience of care all of which are critical to the development of healthcare services that are more responsive to their needs. An improved consumer experience underpins achieving the Quintuple Aim of primary health care, which expands on the Quadruple aim by prioritising health equity alongside patient experience, population health, provider wellbeing, and cost-effectiveness.

It is more crucial than ever that we look for opportunities to embed community leadership in the development for a future focused healthcare system, as we move towards a period of change and reform. We face numerous significant challenges in healthcare across Australia, including those related to rural health, workforce availability, and digital transformation, to name a few.

At Larter, we think about community-led healthcare design in a number of ways.

Engaging with communities

Community and consumer engagement is a key first step to understanding healthcare needs, preferences and challenges. This needs to occur at a local level to ensure local issues are understood, and fit-for-purpose solutions are developed. For example, communities might have specific geographic needs such as rural communities or specific sociocultural needs (e.g., multicultural or First Nations communities).

At Larter, much of our work involves thinking through service access barriers, which can be very specific for different population groups. Our community engagement strategies often focus on specific groups who may be at higher risk of missing out on care or experiencing poorer health outcomes. This may include people with mental illness, people living with a disability, people living in rural and remote areas, families and carers, older people, LGBTQIA+ communities, First Nations peoples, and other groups living with vulnerabilities.

We work in partnership with community members to design engagement strategies appropriate to the community being engaged, to understand their healthcare experiences, challenges, and priorities.

Designing a Community Health Model

A community health model should reflect the needs, priorities and circumstances of the people it is intended to serve. Rather than applying the same approach everywhere, local health organisations can use community engagement, service mapping and co-design to understand barriers to care and identify practical solutions. At Larter, this can include working with communities across metropolitan, regional and rural Australia to develop healthcare approaches that are locally relevant, sustainable and responsive to consumer experience.

Co-designing healthcare services

Co-designing healthcare services involves bringing together healthcare provider, community members, and other stakeholders to collaboratively develop healthcare services that meet the needs and preferences of the community. This participatory approach empowers community members to contribute to the design and delivery of healthcare services, ultimately resulting in more responsive care.

For example, we have recently worked with community members to codesign social prescribing models, mental health services, and after-hours care models from scratch, to ensure that they reflect local needs and local sustainability options. Part of this approach also often involves co-designing outcomes frameworks through the collaborative development of ‘I statements’ which articulate the meaningful change that community and consumers want to see. These can be used to measure program impacts in a more robust and measurable way.

What Is Healthcare Design?

Healthcare design brings together community experience, service requirements and evidence to shape services around the people who use them. In practice, this means understanding how people access care, identifying barriers and working with consumers and providers to develop solutions that can operate effectively within the local health system. Larter applies this approach through community engagement and co-design, helping organisations develop services that are practical, responsive and aligned with local needs.

Empowering communities and building partnerships

Effective community-led healthcare design requires partnerships between healthcare providers and community members. This can be a new way of working for many health services, and it involves establishing trust, collaboration, and shared decision-making processes. One way to facilitate this is through the establishment and meaningful participation of consumer advisory groups.

It may be necessary to empower community members to be able participate safely and meaningfully in design processes. Providing training or mentoring, for instance, can ensure community members are equipped with the knowledge, skills and resources to confidently participate in decision-making processes.

At Larter, we prioritise this approach with community members who may face challenges to participation, such as people with poorer health / language literacy, or people with mental illness who may struggle with power dynamics in a process that might also include clinicians. This empowerment was a key component of community leadership in Victoria’s place based suicide prevention trials.

Health service partnerships can be challenging to establish and challenging to maintain momentum. Lack of clarity in governance or scope, implementation delays and / or participant turnover can affect group motivation and effectiveness. We were recently invited to support an innovative health, social services, and early education partnership in NSW, which required facilitation to reorient and revitalise itself after the pandemic’s disruption, so that the early childhood intervention objectives would be met most effectively.

Community-Led Healthcare Design in Australia

How does community-led healthcare design support the Australian healthcare system? It gives communities a meaningful role in shaping services around local health needs, access barriers and lived experience. In Australia, approaches can be adapted for metropolitan, regional and rural communities and for population groups with different healthcare needs. Larter combines community engagement, co-design and evaluation to help healthcare organisations create more responsive services and strengthen local health outcomes.

Continuous improvement approaches

Incorporating feedback from community members is essential to ensure that healthcare services are meeting, and continue to meet, their needs and preferences. This can include collecting feedback through surveys, interviews, and focus groups. The data collected can be used to improve healthcare services. Larter uses a range of approaches to close this feedback loop, not limiting ourselves to standard reports, but utilising approaches such as dashboards, slide-decks, videos, as well as social media communications.

Closing the feedback loop by communicating how suggestions have been incorporated is also a key part of this process as it creates a culture of continuous improvement, building trust and accountability, and fostering engagement and loyalty among stakeholders. 

Conclusion

Community-led healthcare design is most effective when community input influences decisions throughout the service lifecycle, rather than being limited to an initial consultation. For Larter, this means considering lived experience alongside evidence, workforce realities, service capacity and local priorities. A strong approach can help organisations make better-informed design decisions, build trust with communities and create healthcare services that remain responsive as needs change. This is particularly important across Australia, where healthcare challenges and available services can vary significantly between communities.

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