Scholz, BrettGrey, FlickGraham, JoyceMitchell, ImogenKirk, LucyWarner, Terri2025-06-112025-06-111369-6513PubMed:39072847WOS:001277817400001ORCID:/0000-0001-9345-8907/work/182185959ORCID:/0000-0001-6013-4922/work/182186498ORCID:/0000-0003-2819-994X/work/182189322http://www.scopus.com/inward/record.url?scp=85199856927&partnerID=8YFLogxKhttps://hdl.handle.net/1885/733759000Introduction: In 2020, surging cases of COVID-19 meant that health services had to plan for crisis-level triage. In the Australian Capital Territory, the Clinical Health Emergency Coordination Centre sought to develop a triage policy in collaboration with a range of consumer, carer and community groups. This study aims to map the collaborative development of the COVID-19 ICU triage policy onto the principles of co-production.  Methods: Interviews were conducted with facilitators, members of advocacy or consumer groups and clinicians who were involved in the development of the triage policy. Interviews were thematically analysed using both theory- and data-driven approaches to, respectively, draw on the theoretical framework of co-production, and to explore participants' perspectives relevant to but beyond the scope of this theoretical framework.  Results: The findings suggest that at each stage of the initiative, there were ways in which the principles of co-production were met, and ways in which they were not met. One of the fundamental concerns that arose was about whether trying to solve a problem based on resources was compatible with a solution based on human rights.  Conclusion: Literature about co-production has been critiqued for being limited to aspirational concerns, or implying co-production is easily achievable. The current study contributes to existing research through the application of the theoretical framework of co-production and exploring ways its aims were met and not met within a system-level collaboration developing a high-stakes health policy.  Patient or Public Contribution: This study has been conducted and written by researchers working from lived experience perspectives, and other researchers working from traditionally mainstream health disciplines, including psychology and medicine. Further, the study is about patient and public involvement in the development of a health policy. Thus it both embodies and is about non-tokenistic collaboration between people with lived experience and other health professionals.The authors would like to acknowledge the 26 consumer, carer and community organisations that contributed to the development of the ACT COVID-19 ICU triage policy, and thank Kate Gorman from the Health Care Consumers Association for support in the initial conceptualisation of the collaborative approach. Open access publishing facilitated by Australian National University, as part of the Wiley - Australian National University agreement via the Council of Australian University Librarians.11enPublisher Copyright: © 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.co-productionconsumer leadershipCOVID-19lived experience leadershiptriage2024-07-2710.1111/hex.1415985199856927