This paper details overarching methodological insights resulting from several Inclusive Design projects in healthcare spanning ten years. A number of lessons have emerged, both practical and methodological, and are applicable to future design work in healthcare and the implementation of innovation.

The Double Diamond methodology was used in all projects, increasingly run in parallel / mixed with an agile approach and PDSA cycles, where rapid iterations of the methodology are run in series.

The final phase of the Double Diamond concerns delivery. The exact form that ‘delivery’ takes is unique to each project and partnership, but merits careful examination. Implementation of innovation is notoriously difficult in healthcare (Morris et al, 2011). Typically this is seen as post-‘design’, and necessarily requires the commitment of any healthcare project partner. Whilst some of the best innovations win design awards, many award winning designs are not adopted into front line use. There may be more to be done in design terms. The practices of co-research, co-creation and co-design are well used. Co-implementation efforts should start well before the end of the ‘Discover’ phase. These efforts may involve the identification of implementation stakeholders (standard practice in much co-design), but also funding bodies, the development of business cases and the adoption of commercial constraints in the design.

Adoption of innovation in healthcare takes time, and is fraught with many complicating factors. Many lauded design outputs are not in use, pointing to poor implementation strategies. The above benefits of the Double Diamond must be applied to implementation in order to help adoption. This not only means involving the relevant stakeholders and identifying the relevant funds for implementation earlier in the process, but crucially designing the output with an implementation strategy in mind. This practice of ‘co-implementation’ will improve future adoption of innovations.