15. Adapting the approach to your budget

EBCD is not an approach that you need to stick to rigidly, so do not feel constrained by the methodology. However, it is valuable to adhere to the central elements of the approach – the patient interviews and interaction between the patients and staff – as these are the elements that identify problems and develop the solutions. Even so, it is possible to work around these either to create a pared-down version of EBCD, or to run a separate process that does not claim to be EBCD but that draws on elements of the approach.

The most resource-intensive stages of the process are interviewing and filming the patients and then editing the interviews. However, these form the crux of the approach: without the edited film of patient interviews, the approach could not be considered true experience-based co-design. The film is a very powerful tool that establishes priorities, motivates staff, and gives patients a voice. It enables patients to be their own messengers rather than having others talk on their behalf. On film, patients often talk more honestly than they might otherwise.

Key points

• The costs of your project will depend on which of the elements you include. For example, a recent project that used in-house editors, borrowed videoing equipment and was resourced entirely by existing staff only had to pay for the editor’s time, refreshments and expenses for patients. Meanwhile, another project that used experienced researchers from another organisation cost substantially more. The value of the potential benefits should always be weighed against any costs.
• The observation stage adds value to the project, but is not essential. However, it is a cost-effective way of adding valuable insights, and can provide a useful opportunity for recruiting participants.
• You could save money by avoiding using external consultants in the interviewing and filming stages. Perhaps someone within your organisation has these skills, or is keen to learn.
• It is important that staff voices are heard, but this does not have to be through one-to-one interviews. For example, it could be done through a staff focus group event instead.
• The co-design groups form a crucial, and relatively cost-effective, part of the EBCD process. The cost is moderate, and avoids making changes that do not quite 'hit the mark'. However, if you wanted a pared-down approach and had already identified one issue, you could set up just one co-design group to focus on that particular topic.
• If it is difficult to run several parallel co-design groups, you might choose to have one patient reference group that meets regularly, with whom staff could regularly consult on progress. Make sure the patient voice is not lost in the process.
• The key to getting a return on your investment is to make sure you have buy-in from staff early on in the process, so the changes that participants identify will actually be driven forward. This means that however much money, time and emotional effort is invested, it will result in positive change.

Read the next section

16. What next for your EBCD project?