Neither patients nor frontline staff, such as GPs and primary care nurses, have had a strong influence on most patient and public engagement strategies, a survey has found. The Picker Institute, a research charity that promotes patient centred health care, which carried out the survey, says that its findings amount to the beginnings of a cultural change. It warns, however, that the change has so far penetrated only trusts’ own management.

More than eight in 10 primary care trusts say that they have made considerable changes in the past two years in the way that they organise patient and public engagement in commissioning.

The English government launched …