Enhancing Healthcare Systems: Redefining Strategies and Stakeholder Engagement for Community Care Service Evolution

The optimisation of healthcare systems has become necessary due to the impact of an ageing population and the prevalence of chronic diseases, prompting a fundamental shift in healthcare strategies. This transformation highlights a departure from traditional hospital-centric care towards territorial healthcare delivery models such as primary and community care services. These innovative models aim to broaden service provisions by incorporating preventive measures and diverse services, emphasising community centrality, adaptability, and resilience. The focus on tailoring services to user needs has encouraged local institutions to engage various stakeholders. This inclusive approach primarily aims to expand research efforts and conduct a thorough analysis of the specific conditions prevailing within a given region. Stakeholders include healthcare organisations, local entities, universities, and other relevant parties. The ultimate goal is to foster a more comprehensive and participatory approach in evaluating and identifying community needs, ensuring diverse and multidisciplinary engagement to address local challenges and demands effectively. However, while the concept of co-design remains integral during the initial phase of service development, its actual implementation often risks losing significance, potentially undermining shared participation and cooperation among stakeholders. This lapse might lead to a lack of ongoing dialogue essential for adapting services to evolving needs and redistributing responsibilities. This study, centred around an Italian case, examines this gap and raises pivotal questions: What role does design assume in facilitating autonomous updates of services post the design phase? How can service design actively support stakeholder autonomy in the continuous evolution of services?