To describe the underpinning principles of the new Department of Health approach to change, health secretary Alan Johnson and NHS chief executive David Nicholson use the terms co-production, subsidiarity, clinical ownership and leadership, and system alignment.

Together, these principles could create a whole whose benefits are greater than the sum of its parts.

The next stage review guidance describes "co-production", the first of these principles, as engaging people to work together to make change happen. But the New Economics Foundation cautions: "When a good idea becomes a buzzword as this one has, there is always a risk that its meaning and purpose will be distorted." It points out that co-production is about much more than better consultation or involving people in decisions. It is about building the core economy of family, neighbourhood and community by establishing mutually supportive relationships that avoid exploiting traditional sources of care such as women and people from ethnic minority groups.

Co-production is also about building into planning, funding and deliving the potential for real reciprocity from recipients of care. The New Economics Foundation cites the Lehigh Valley Hospital outside Philadelphia, where patients are told that someone will visit them at home after discharge to make sure they are OK and that all the basics are in place.

However, the person who visits is a former patient, not a professional, and those being visited are asked if they would be willing to do the same for someone else as soon as they are able. It describes dramatic cuts in readmission as a result - "all by using the human skills of patients and their own need to feel useful".

Personalisation must be rooted in mutual support and a recognition that not everything needed can be bought. For example, should people be expected to use budgets to buy friendship, or should we be considering other ways to unleash neighbourhoods' capacity to care?

Co-production offers a tremendously exciting new agenda but only if more positive approaches to risk management and the devolution of power and decision making allow it to transcend the volunteerism of the Thatcher-Reagan years.

"Subsidiarity" is about ensuring that decisions are made at the right level, and as close to the user as possible. The tendency of staff not to step into their full authority is endemic in the NHS. As the New Economics Foundation highlights: "Their morale is as important as client morale. Yet in practice, the participation that they are asked to extend to clients is often not extended to them."

These new principles for change have great potential to create win-win situations for all of us. If we work together to create contexts where all of us can give of our best, including users and their supports, the scale of the benefits is limitless.