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Primary care groups (PCGs) and primary care trusts (PCTs) are required to ensure that patient and public involvement underpins all activity. In Part 1, the literature review revealed many challenges to implementing this important measure of performance that would test those with responsibility for achieving a meaningful outcome for all stakeholders. Part 2 reports on a local study that used qualitative data from key stakeholders to examine how one PCG was responding to the involvement agenda. The findings revealed cynicism and doubt among board members about the purpose and value of involvement, despite which some progress had been made in engaging with local voluntary groups. However, the experience of involvement among local patients had not always been a positive one. It is suggested that issues of power and organisational culture will need to be tackled through greater investment in clinical and managerial staff development.

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