Public involvement means involvement in the design, planning and delivery of health services. Patient engagement means engagement in the patient's own health, care and treatment. There is good evidence that structured education courses for people with long-term conditions lead to better-informed patients and better clinical outcomes. Most people agree that involving the users of a service in its redesign will probably produce an improved service. The National Health Service (NHS) is a public service spending taxpayers' money, so it is only right that the public and patients are involved in the governance of general practitioner consortia. The principles of effective public involvement are: be clear about what involvement means, focus on improvement, be clear about why we are involving people, identify and understand our stakeholders and involve people.