Surely if people have asked for consumer input you’ll be welcomed to the table. your views listened to and reflected on, questioned about possible solutions to issues, valued and treated as if you have desirable expertise and knowledge? However as the old song says: ‘it aint necessarily so”. Listening to the experiences of a range of consumers involved in a variety of ways with services, government departments, hospitals, reference and advisory groups, there’s a level of dissatisfaction and cynicism that I didn’t expect. There’s a huge push for health services in particular to engage with consumers, to work towards ‘consumer-centred’ care. New uses of the term ‘co-creation’, ‘co-design’ and partnership are bandied about. Annual Reports proudly present the numbers of consumers or patients who were ‘consulted’, ‘informed’ or who ‘provided input’. However, numbers are only part of the picture, just as patient throughput doesn’t tell you about the quality of care. There are a number of models of consumer engagement, showing a ‘Maslow-like’ hierarchy of piecemeal to integrated genuine consumer engagement and these can be used to assess an organisation’s stage or level of engagement. It would be brave if organisations were to ask consumers if they believed that their input had created change in the way the organisation operates, measures it’s achievements or grows patient satisfaction. I suspect that the organisations willing to do this are already at the top of the consumer engagement hierarchy. How can we encourage organisations to give more than tick the box (for accreditation, quality improvement, governance) attention to the views of patients or consumers?