Frequently Asked Questions
Who developed the Spectrum of Participation?
The Spectrum of Participation was developed through peoplehub’s national developmental work on co-production with organisations and people with lived experience of long term health conditions and disabilities. The Spectrum was first published in early 2021. The graphics were revised in 2025 to improve readability.
Peoplehub was a Community Interest Company, founded in 2012 by people with lived experience and knowledge of the earliest personal health budget initiatives in England. The aim of peoplehub was to connect, inform and empower people with long term health conditions and disabilities so that they could have greater choice and control in their lives.
Some of peoplehub’s achievements include driving national‑level change in personalised care and co‑production, designing and delivering tailored workshops and innovative resources on personal health budgets and NHS Continuing Healthcare. Peoplehub created and facilitated local co‑production groups; and built a national personal health budget peer network that evolved into the NHS England Personalised Care Strategic Co‑production Group.
Peoplehub also created the original Peer Leadership Academy, which was commissioned by NHS England, and co-created the content of NHS England’s later online Peer Leadership Development Programme. These were personal development programmes to strengthen the knowledge skills and confidence of people with lived experience to meaningfully engage in strategic co-production.
Peoplehub ran successfully for 14 years, before dissolving in 2026.
Why was the Spectrum of Participation developed?
The Spectrum of Participation was developed to try to stop the unhelpful yet common tendency to label every interaction as “co‑production” and to replace historical hierarchical models of co-production.
It provides a non‑hierarchical way to describe distinct types of participation so that organisations can identify, from the start, what level of influence is actually on offer and choose the most appropriate approach for each situation. It also helps people with lived experience to understand how much influence their input may have.
By clarifying functions, expectations and the degree of decision‑making influence, the Spectrum helps reduce crossed assumptions, build more honest relationships, and makes participation more effective and fit for purpose.
How has the Spectrum of Participation been used?
The Spectrum has been used across a range of statutory and voluntary health and care organisations. People who have used the Spectrum have described it as a simple yet powerful, highly practical tool that clearly communicates what’s needed and expected for effective partnership working and co‑production. Some organisations and individuals have adopted the Spectrum as their “go‑to” template for practice and for introducing others to this way of working.
People have said that the graphics and definitions are influential and more helpful than the traditional co‑production ladders. They have found it supports transparency in decision‑making, helps to manage expectations, and highlights the need to invest in skills, capacity, and confidence.
It’s also used in educational settings with health and care students, and has been published in in the latest edition of Understanding Health and Social Care by Jon Glasby, published by Policy Press in March 2026.
Who can use the Spectrum of Participation?
The Spectrum of Participation is intended for use by anyone interested in how organisations and systems interact with people who use their services. Application of the Spectrum is not limited to the health and care sector. It is a tool to enable clear and effective relationships and interactions, particularly where input from consumers and customers is sought.
The Spectrum can also be used by individuals and groups of people who are invited by organisations to get involved in their work, as a way of clarifying the scope of influence on offer.
