This paper will describe a unique cross-disciplinary collaboration between the Medical School at Imperial College London and the School of Architecture and Cities at the University of Westminster, which explored the relationship between design, mental health and wellbeing, using a co-design paradigm. The collaboration included 650 students from across six courses, four under-graduate and two post-graduate namely; BSc Medicine, BA Architecture, BA Interior Architecture, BSc Architectural Technology, Master of Architecture, RIBA Part III as well as 40+ members of staff. Three years in the planning, this innovative project comprised of two one-day co-design workshops, during which 64 cross-disciplinary groups of students reflected on four defined mental health conditions to identify problems and propose solutions for the design of four existing NHS mental healthcare sites. The terms co-design, co-creation, and co-production all describe an open design process that empowers a wide range of stakeholders to make a creative contribution to the formulation and solution of a problem. Co-design offers an immersive and experiential learning experience, and challenges the conventional pedagogy of designer-client / expert-user, introducing experts by experience. While acquisition of discipline-specific skills and competencies was an expected outcome, the structure of the workshops fostered consideration of broader qualities such as ethics, empathy and duty-of-care. This paper will describe both the workshop itself and an evaluation of feedback from students, staff and other stakeholders. http://www.openstudiowestminster.org/co-production-2020-2021/

The design of a new hospital is typically used as a catalyst for change, redesign and implementation of new work processes to improve health services. Perceived outcomes after relocation may be linked to the success of co-design and stakeholder engagement processes. Especially in striking the right balance between the building (Bricks), processes and supporting IT (Bytes) and work processes (Behavior). Even when stakeholders are engaged in the design that is not to say that their needs will be safeguarded during trade-offs in various phases of decision-making. Furthermore, the time window between engagement and project delivery may contribute to a mismatch in perceived outcomes after relocation. This study aims to gain insight into the possible causes for the perceived mismatches as expressed by ward managers some 12 months after relocation. This was altogether some 6 years after the design of the facility was completed. It will increase our understanding of the complexity of design, construction and transition processes that have to deal with a gap in time between design and use. We adopt an interpretive case study approach in which in-depth interviewing has been combined with an extensive analysis of documents collected over time. We found transformative change requiring an integrative approach to the Bricks and Bytes throughout the whole process of designing, constructing and taking into use, with stakeholder engagement as a key element. Additionally we found Health Care Worker Behavior not well enough considered in a predominantly rational design and implementation process focusing on patient centeredness.