At the 26th International Conference on Integrated Care, in Plenary 2: Co-production: How can lived experience challenge policy and shape strategy?, Senior Researcher at the Foundation, Alejandro Gil-Salmerón from the International Foundation for Integrated Care (IFIC) set out the IFIC perspective on people as partners in care. Drawing on IFIC’s work, he explored how lived experience should shape services, research, policy and strategy, and why partnership requires a meaningful shift in power across systems.
Good morning, and welcome to ICIC26. My name is Alejandro Gil-Salmerón, and I work with the International Foundation for Integrated Care, IFIC. At IFIC, we talk a lot about equity, about inclusion, about co-design. But today, I want to focus on something simple. People as partners in care. Not as a slogan. Not as a gesture, but as a way of working. Because this idea is not soft. It is transformative, and transformation is never neutral.
In IFIC, we have a long history developing our 9 pillars framework of integrated care, and across all of them there is one idea that holds everything together: care must be shaped with people, not just around them. And yet, too often what we call participation is actually consultation. We ask for feedback, but within boundaries we still control. We invite people into conversations that we have already designed. That is not partnership.
Partnership begins somewhere else. It begins when we recognise that people are not passive recipients. They are not “users.” They are not “beneficiaries.” They are experts, experts in their own lives, holders of knowledge, co-creators of care, of services, of research, of systems. And when we take that seriously, something shifts. Power shifts. And let’s be honest, that can feel uncomfortable, because it challenges something very deep: the idea that expertise belongs only to professionals, to organisations, to institutions.
But lived experience is not an anecdote. It is not a testimonial. It is not a box to tick. It is knowledge, and it should shape how we design care, how we do research, how we build policy, how we define strategy. Because integrated care is not just about coordination. It is about justice. It is about making care more equitable, more inclusive, more real. And that means bringing lived experience into every level: not just services, but governance; not just projects, but policy; not just implementation, but strategy.
We see this in our work. People with lived experience shaping priorities, challenging methods, reinterpreting findings. And in our wider ecosystem, including the International Journal of Integrated Care, they are asking fundamental questions: what counts as knowledge? Whose voice matters? Who decides? Because lived experience reveals what systems miss. It reveals stigma. It reveals exclusion. And it reveals the gap between what services are designed to do and what people actually live.
And that matters, because lived experience does not just improve care. It can change policy. It can reshape strategy. It can challenge organisations like ours to ask: who is still not in the room, and are we really sharing power? Now let me be clear. We do not do this perfectly. No one does. Partnership is not a checklist. It is a practice. It requires reflection, adaptation, humility. But it is part of our responsibility.
And there is something else, something we do not talk about enough. Partnership does not only change the role of people. It also changes the role of professionals. Because right now, many systems expect professionals to do everything, to know everything, to decide everything, to fix everything. And that is not sustainable. Care was never meant to be a one-way act. When people become real partners, responsibility is shared, more honest, more human. Professionals are not diminished. They are freed, freed to become facilitators, allies, co-creators. That is not a loss of identity. It is a better one.
So when we talk about people as partners in care, we are not softening the language. We are changing the model. A model where care is shaped with people, not delivered to them. A model where lived experience shapes practice, research and policy. A model where equity and inclusion mean real influence over real decisions. Because partnership is not about making systems look inclusive. It is about making them just.
So I will leave you with this: what does partnership mean in practice? What does it mean for policy, for strategy, for how we design systems together? That is what this plenary is about. Thank you.
