This paper reflects upon the research process of co-designing equitable engagement within the healthcare sector. The research considers approaches to co-design as rooted within researchers sharing decision-making and shifting power not from themselves to participants, but amongst the research team itself. Co-design is mostly discussed as a process of academics and non-academics sharing the research design journey through participatory, inclusive and dialogical methods. This study considers how this process evolves within the research team itself, whereby known research project roles, responsibilities and remit are put to one side allowing difference, conflict and disagreement to be explored using design research methods. The findings suggest design exploration of this kind is likely to support a type of engagement in a context such as healthcare often difficult to research. The benefits of the research are both methodological and empirical – in advancing methods for co-design as well as enriching empirical studies in healthcare.