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AbstractRural citizens protest about changes in their model of local health services provision, appealing to a concept of social justice for equivalence of accessibility to services. This article explores the areas where citizens perceive deficits in social justice regarding services and the extent to which their appeals might have support in law and government guidance. The article explores how asymmetric philosophies of resource allocation and interpretations of inclusion in decision‐making process may underlie protest and concludes that, while policy rhetoric ignores constraints on citizen roles and choices in service design, protest will continue, as it is a manifestation of rural citizens' frustration.

AbstractThe "woolliness" and "methodological hurdles" of co‐production make it challenging to compare and contrast different co‐production policy initiatives and their outcomes, and distil "what works", for whom and in what circumstances. Inspired by Nabatchi et al. (2017) 3Ws typology of the Who, When, and What of co‐production, we draw on co‐production theory deriving from a narrative literature review and empirical research of co‐production cases in Scotland and Australia. We propose a new "5Ws" co‐production framework of Who, When, What, Why, and Where, arguing that the context (where) should be an integral part of co‐production analyses as socio‐political, geographical conditions, and service settings influence the processes and outcomes of co‐production, and that the reasons (why) behind co‐production determine who is involved in co‐production. The paper suggests that the 5Ws of co‐production can offer a useful theoretical lens for analyzing a variety of international co‐production cases to inform future policies and practice.

PurposeThis paper aims to explore the well-being impacts of social enterprise, beyond a social enterpriseper se, in everyday community life.Design/methodology/approachAn exploratory case study was used. The study's underpinning theory is from relational geography, including Spaces of Wellbeing Theory and therapeutic assemblage. These theories underpin data collection methods. Nine social enterprise participants were engaged in mental mapping and walking interviews. Four other informants with "boundary-spanning" roles involving knowledge of the social enterprise and the community were interviewed. Data were managed using NVivo, and analysed thematically.FindingsWell-being realised from "being inside" a social enterprise organisation was further developed for participants, in the community, through positive interactions with people, material objects, stories and performances of well-being that occurred in everyday community life. Boundary spanning community members had roles in referring participants to social enterprise, mediating between participants and structures of community life and normalising social enterprise in the community. They also gained benefit from social enterprise involvement.Originality/valueThis paper uses relational geography and aligned methods to reveal the intricate connections between social enterprise and well-being realisation in community life. There is potential to pursue this research on a larger scale to provide needed evidence about how well-being is realised in social enterprises and then extends into communities.

Background: Citizen participation in health service co-production is increasingly enacted. A reason for engaging community members is to co-design services that are locally-appropriate and harness local assets. To date, much literature examines processes of involving participants, with little consideration of innovative services are designed, how innovations emerge, develop and whether they sustain or diffuse. This paper addresses this gap by examining co-designed initiatives through the lens of social innovation a conceptualisation more attuned to analysing grassroots innovation than common health services research approaches considering top-down, technical innovations. This paper considers whether social innovation is a useful frame for examining co-designed services. Methods: Eighty-eight volunteer community-based participants from six rural Australian communities were engaged using the same, tested co-design framework for a 12-month design and then 12-month implementation phase, in 24 workshops (2014-16). Mixed, qualitative data were collected and used to formulate five case studies of community co-designed innovations. A social innovation theory, derived from literature, was applied as an analytical frame to examine co-design cases at 3 stages: innovation growth, development and sustainability/diffusion. Results: Social innovation theory was found relevant in examining and understanding what occurred at each stage of innovation development. Innovations themselves were all adaptations of existing ideas. They emerged due to local participants combining knowledge from local context, own experiences and exemplars. External facilitation brought resources together. The project provided a protective niche in which pilot innovations developed, but they needed support from managers and/or policymakers to be implemented; and to be compatible with existing health system practices. For innovations to move to sustainability/diffusion required political relationships. Challenging existing practice without these was problematical. Conclusions: Social innovation provides a useful lens to understand the grassroots innovation process implied in community participation in service co-design. It helps to show problems in co-design processes and highlights the need for strong partnerships and advocacy beyond the immediate community for new ideas to thrive. Regional commissioning organisations are intended to diffuse useful, co-designed service innovations. Efforts are required to develop an innovation system to realise the potential of community involvement in co-design.

Background: Citizen participation in health service co-production is increasingly enacted. A reason for engaging community members is to co-design services that are locally-appropriate and harness local assets. To date, much literature examines processes of involving participants, with little consideration of innovative services are designed, how innovations emerge, develop and whether they sustain or diffuse. This paper addresses this gap by examining co-designed initiatives through the lens of social innovation - a conceptualisation more attuned to analysing grassroots innovation than common health services research approaches considering top-down, technical innovations. This paper considers whether social innovation is a useful frame for examining co-designed services. Methods: Eighty-eight volunteer community-based participants from six rural Australian communities were engaged using the same, tested co-design framework for a 12-month design and then 12-month implementation phase, in 24 workshops (2014-16). Mixed, qualitative data were collected and used to formulate five case studies of community co-designed innovations. A social innovation theory, derived from literature, was applied as an analytical frame to examine co-design cases at 3 stages: innovation growth, development and sustainability/diffusion. Results: Social innovation theory was found relevant in examining and understanding what occurred at each stage of innovation development. Innovations themselves were all adaptations of existing ideas. They emerged due to local participants combining knowledge from local context, own experiences and exemplars. External facilitation brought resources together. The project provided a protective niche in which pilot innovations developed, but they needed support from managers and/or policymakers to be implemented; and to be compatible with existing health system practices. For innovations to move to sustainability/diffusion required political relationships. Challenging existing practice without these was ...