Design is a set of practices aimed at realizing a certain desirable future and, as such, is predicated on the idea that the status quo can be improved. This chapter problematizes and highlights challenges facing healthcare improvement and innovation and discusses the role and opportunities that Design can bring to this, in particular, Co-Design (CD). Readers will be introduced to CD’s practices and approaches which act as a form of ‘anti-structure’ to counteract hegemonic medicalised service culture. Given healthcare is a complex service ecosystem, CD’s stance is to engage all stakeholders, providers and deliverers as well as the service receivers - and their carers, to allow for a plurality of voices, opinions and positions in generating improved solutions. By eschewing tokenistic, top-down ‘consultation’, readers will appreciate the ways in which CD can help create the non-hierarchical situations, conditions and tools for meaningful participation in - and contribution to – an end result whether this is an improved experience of healthcare or a more appropriate intervention.