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Patient involvement in shaping the face of modern medicine is increasing. Patient representatives - local and from the Patient and Carer Network - are now an integral part of shaping the work of the Future Hospital Programme through their direct involvement in the development sites. The path to a successful partnership between clinicians, managers and representatives is not easy but is worthwhile as illustrated in two stories from the Royal College of Physicians' phase 1 development sites in north Wales and Wakefield. Each trust is different, as are the viewpoints of clinicians and representatives. However, shared learning and partnership working is a very powerful catalyst in promoting change for the benefit of both patients and staff.

Making ripples: patient involvement in service planning