When patients become co-producers: co-authorship or apparent participation?

Drawing on a case study of collaborative research where patients and health-care personnel cooperated to reorient a co-produced clinical practice (Outpatient Parental Antibiotic Therapy), we explored how actors with different competencies and power interacted to reach co-produced outcomes and how service management changed in a co-production context. The results highlight that co-productive practice increases the complexity and uncertainty of the organisational environment, as well as the managerial effort demanded of the implementing organisation. Moreover, the group’s professional cultures and tacit social norms can transform co-production in a ceremony. This study offers suggestions about ways to manage co-produced clinical pathways.