BMJ 2002;325:1263 ( 30 November )

Papers

Systematic review of involving patients in the planning and development of health care

Mike J Crawford, senior lecturer in psychiatry, ^a Deborah Rutter, research associate, ^a Catherine Manley, research worker, ^a Timothy Weaver, research fellow, ^b Kamaldeep Bhui, senior lecturer in social and epidemiological psychiatry, ^c Naomi Fulop, senior lecturer in health services delivery and organisation research, ^d Peter Tyrer, professor of community psychiatry. ^a

^a Department of Psychological Medicine, Imperial College School of Medicine, St Mary's Campus, London W2 1PD, ^b Department of Social Science and Medicine, Division of Primary Care and Population Health Sciences, Imperial College, Charing Cross Campus, London W6 8RP, ^c Institute of Community Health Sciences, St Bartholomew's and the Royal London Medical School, London E1 2AD, ^d Health Services Research Unit, London School of Hygiene and Tropical Medicine, London WC1E 7HT

Correspondence to: M J Crawford m.crawford{at}ic.ac.uk

Objective: To examine the effects of involving patients in the planning and development of health care.
Data sources: Published and grey literature.
Study selection: Systematic search for worldwide reports written in English between January 1966 and October 2000.
Data extraction: Qualitative review of papers describing the effects of involving patients in the planning and development of health care.
Results: Of 42 papers identified, 31 (74%) were case studies. Papers often described changes to services that were attributed to involving patients, including attempts to make services more accessible and producing information leaflets for patients. Changes in the attitudes of organisations to involving patients and positive responses from patients who took part in initiatives were also reported.
Conclusions: Evidence supports the notion that involving patients has contributed to changes in the provision of services across a range of different settings. An evidence base for the effects on use of services, quality of care, satisfaction, or health of patients does not exist.

What is already known on this topic Involving patients in planning and delivering health services is recommended as a means of improving the quality of services Methods for engaging with patients have been considered in depth, but the effects of involving patients are less clear What this study adds Few studies have explored the effects of involving patients Involving patients has contributed to changes in service provision, but the effects of these on quality of care have not been reported

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