This chapter has two distinct foci. We begin by looking at the wide variety of meanings associated with the term “co-production”, which has led to confusion and uncertainty about when, why, who and what is involved in this form of healthcare delivery. We provide a graphic showing a range of interactions that infer a deepening relationship between providers and users of services, with suggestions about where consultation ends and co-production starts. Following this we draw attention to the issues and challenges involved in managing co-production from the perspective of providers and users.