Co-Creation for Health System Innovation: Developing a Model and an Action Plan for Future Primary Care in...

Primary care in Switzerland faces a set of interrelated systemic challenges that exemplify a wicked problem. Addressing such complexity requires participatory approaches that integrate diverse perspectives and generate context-sensitive solutions. The project Health2040 engaged stakeholders in a co-creation process to co-design a future model of ambulatory primary care for Switzerland and an accompanying action plan to support its implementation.

The project employed a structured co-creation process, beginning with context exploration, evidence synthesis, and stakeholder consultations. Following the preparation phase, two co-design workshops with more than 50 stakeholders, including patients, healthcare professionals, government authorities, social care representatives, insurers, and researchers. The workshops combined customised participatory methods such as patient personas, visioning, system mapping through building blocks, fishbowl discussions, and the X-Curve.

The process produced two main outputs: (1) the 'Health Network for All' model, a vision for patient-centred, network-based, and digitally supported primary care, and (2) the Action Plan, which identifies three central action areas, profession-specific activities, and implementation strategies. Thirty-one individuals endorsed the plan.

The project illustrates how co-creation can be used to address wicked problems in health systems by linking visionary model-building with actionable strategies. The outputs provide a framework that may inform ongoing efforts to shape the future of Swiss primary care. Beyond the Swiss context, the study illustrates how internationally established primary care principles can be operationalized through co-creation in a local context and highlights methodological design principles that may inform similar processes in other settings.

Patients and members of the public contributed at different stages of the project. Stakeholder feedback informed workshop design and materials, and representatives from all relevant groups participated in developing and refining the project outputs and supporting dissemination activities. Patient representatives shared lived experiences, contributed to patient-specific model development, and participated in group discussions during the workshops.