Rob Baggott - Academia.edu (original) (raw)

Papers by Rob Baggott

Journal of Advanced Nursing, 2012

To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence... more To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence of non-communicable disease between the two ethnic groups and to identify predictors for differences between groups. Tobacco use, poor diet and physical inactivity are major lifestyle risk factors for chronic cardiovascular diseases, certain cancers, diabetes and chronic lung diseases. There are higher risk and incidence of these diseases in some ethnic groups, for example Asians have higher incidence of diabetes. Cross sectional survey. Cross sectional survey of Asians of Indian descent and white British adults conducted between October-December 2009. Main outcome variables were lifestyle behaviours and BMI. Self-reported disease diagnosis was also collected. In a regression analysis, predictors of outcome variables were demographic variables and beliefs/attitudes/knowledge towards lifestyle behaviours. Body mass index, tobacco use and non-communicable disease (except diabetes) were lower in Indians. Indians reported lower physical activity levels and greater salt use than Whites. Tobacco use was higher in Whites, but knowledge, attitudes and beliefs were similar between Whites and Indians. Health risk behaviour and morbidity are different between the two ethnic groups. Gender, age, educational level, beliefs, attitudes and knowledge do not explain these differences. Health promotion that aims to improve knowledge will probably not work and innovative methods are needed to improve health in high risk groups.

Health Education Journal, 1985

TYPOLOGIES of health education' ~2,3 recognise that there are different levels at which heal... more TYPOLOGIES of health education' ~2,3 recognise that there are different levels at which health educators might intervene to promote health and prevent illness. These range from activities at the micro-level, such as education directed at individual health-related beha-viours, ...

Social science & medicine (1982), 2014

This article explores the policy role of health consumer and patients' organisations (HCPOs),... more This article explores the policy role of health consumer and patients' organisations (HCPOs), an important subset of the UK voluntary health sector. Based on research findings from two surveys, the article examines the activities, resources and contacts of HCPOs. It also assesses their impact on health policy and reform. There is some evidence that HCPOs can influence policy and reform. However, much depends on the alliances they build with other policy actors (including other HCPOs), their resources and leadership. HCPOs seem to have more impact on the detail of policy than on the direction of travel. In addition, there are potentially adverse consequences for HCPOs that do engage with the policy process, which may partly explain why some are wary of such involvement. For example, it is possible that HCPOs can be manipulated by government and other powerful policy actors such as health professionals and the drugs industry.

Democratizing Health, 2011

Sociology of Health and Illness, 2004

This paper argues that a health consumer movement has developed in the United Kingdom over the la... more This paper argues that a health consumer movement has developed in the United Kingdom over the last decade. Drawing on two empirical studies of groups that promote and/or represent the interests of patients, users and carers, it argues that groups formed by people with personal experience of a condition are now more widespread. Feelings of pain and loss can lead to the identification of others in a similar position, and to the formation of groups and action in the political sphere. Research shows that groups share a common discourse and follow similar participative practices, and there is extensive networking. Informal and formal alliances have formed to pursue joint action and indicate a wider health consumer movement. As governments have also increased the opportunities for participation, this has the potential for patients and carers to shape services in ways more responsive to their needs.

Social Science & Medicine, 2011

Previous studies of groups representing patients, users and carers in the UK indicate that their ... more Previous studies of groups representing patients, users and carers in the UK indicate that their principal focus is on health care and treatment services. In recent years, UK government policy has emphasised prevention and health promotion as part of its wider public health agenda. This paper investigates how this might have affected health consumer and patients' organisations (HCPOs) by presenting findings from an online survey of 312 UK groups undertaken in the summer of 2010. The sample was identified using the publicly available membership lists of a number of large alliance organisations. The survey achieved a 39% response rate. The findings suggest that the main focus of lobbying and campaigning remains on health care rather than public health issues. However, a significant minority of groups stated they prioritised public health campaigning and lobbying. Possible explanations for engagement with the public health agenda include: the presence of public health on the government's agenda, the influence of other, more powerful interests in the health policy process, and growing awareness among groups of health promotion, prevention and environmental causes of illness. The paper argues that although HCPOs may be more active in the public health policy arena, more research is needed - notably with regard to their relationship with devolved governments, EU institutions and the current UK government's public health and voluntary sector agenda. The reasons why some groups engage more than others with the public health agenda also merit closer investigation. Moreover, not enough is currently known about the influence of HCPOs on the public health agenda and policies in this field.

Policy & Politics, 1986

ABSTRACT Studies of quasi-government have tended to focus on public sector 'quangos&#... more ABSTRACT Studies of quasi-government have tended to focus on public sector 'quangos' and their implications for accountability and democracy. In contrast, this article focuses on a rather neglected aspect of quasi-government: the role of semi-private bodies and how they emerge and develop. By focusing on the emergence, development and persistence of the self-regulatory system of advertising control, a number of important insights for quasi-government, politics and the policy formation process are provided.

Policy & Politics, 2004

ABSTRACT Health consumer groups – voluntary organisations representing patients, users and carers... more ABSTRACT Health consumer groups – voluntary organisations representing patients, users and carers – have become increasingly active in the national policy process in recent years. Groups have constructed alliances with each other, and with other interests in the health policy arena. They have developed extensive contacts within the political system and have generated social and political resources valued by government and other stakeholders. Groups have contributed to policy development, particularly where this has matched government agendas. It is suggested that group characteristics, resources, tactics and contacts have had an impact on their influence. These findings are considered in the context of Alford's structural model of healthcare politics. Spanish Los grupos del consumidor de la salud – organizaciones voluntarias que representan a los pacientes, usuarios y cuidadores – se han convertido cada vez más activas en el proceso político nacional en años recientes. Los grupos han formando alianzas entre ellos, y con otros intereses en la arena política sanitaria. Estas organizaciones han desarrollado amplios contactos dentro del sistema político y ha generado recursos sociales y políticos valorados por el gobierno y otros participantes. Los grupos han contribuido al desarrollo político, especialmente donde este desarrollo se ha ajustado a las agendas del gobierno. Se ha sugerido que las características, recursos, tácticas y contactos del grupo han tenido un impacto en su influencia. Estos descubrimientos se consideran en el contexto del modelo estructural de Alford de las políticas de asistencia sanitaria. French Les groupements de consommateurs de santé publique (des organisations bénévoles qui représentent les patients, les utilisateurs et les soignants) sont devenus de plus en plus actifs dans le processus de politique nationale ces dernières années. Des groupes se sont unis et ont formé des liens avec d'autres intérêts dans le contexte de politique sanitaire. Ils ont développé de nombreux contacts à l'intérieur du système politique et ont créé des ressources sociales et politiques appréciées par le gouvernement et d'autres parties prenantes. Les groupes ont joué un rôle dans le développement de politiques, particulièrement lorsqu'elles correspondaient à l'agenda du gouvernement. L'article suggère que les caractéristiques des groupes, leurs ressources, leurs contacts et leurs tactiques ont marqué leur influence. Ces conclusions sont considérées dans le contexte du modèle structurel de politique sanitaire d'Alford.

Journal of Hospital Infection, 2013

The national surgical site infection (SSI) surveillance service in England collates and publishes... more The national surgical site infection (SSI) surveillance service in England collates and publishes SSI rates that are used for benchmarking and to identify the prevalence of SSIs. However, research studies using high-quality SSI surveillance report rates that are much higher than those published by the national surveillance service. This variance questions the validity of data collected through the national service. To audit SSI definitions and data collection methods used by hospital trusts in England. All 156 hospital trusts in England were sent questionnaires that focused on aspects of SSI definitions and data collection methods. Completed questionnaires were received from 106 hospital trusts. There were considerable differences in data collection methods and data quality that caused wide variation in reported SSI rates. For example, the SSI rate for knee replacement surgery was 4.1% for trusts that used high-quality postdischarge surveillance (PDS) and 1.5% for trusts that used low-quality PDS. Contrary to national protocols and definitions, 10% of trusts did not provide data on superficial infections, 15% of trusts did not use the recommended SSI definition, and 8% of trusts used inpatient data alone. Thirty trusts did not submit a complete set of their data to the national surveillance service. Unsubmitted data included non-mandatory data, PDS data and continuous data. The national surveillance service underestimates the prevalence of SSIs and is not appropriate for benchmarking. Hospitals that conduct high-quality SSI surveillance will be penalized within the current surveillance service.

Journal of Advanced Nursing, 2012

To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence... more To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence of non-communicable disease between the two ethnic groups and to identify predictors for differences between groups. Tobacco use, poor diet and physical inactivity are major lifestyle risk factors for chronic cardiovascular diseases, certain cancers, diabetes and chronic lung diseases. There are higher risk and incidence of these diseases in some ethnic groups, for example Asians have higher incidence of diabetes. Cross sectional survey. Cross sectional survey of Asians of Indian descent and white British adults conducted between October-December 2009. Main outcome variables were lifestyle behaviours and BMI. Self-reported disease diagnosis was also collected. In a regression analysis, predictors of outcome variables were demographic variables and beliefs/attitudes/knowledge towards lifestyle behaviours. Body mass index, tobacco use and non-communicable disease (except diabetes) were lower in Indians. Indians reported lower physical activity levels and greater salt use than Whites. Tobacco use was higher in Whites, but knowledge, attitudes and beliefs were similar between Whites and Indians. Health risk behaviour and morbidity are different between the two ethnic groups. Gender, age, educational level, beliefs, attitudes and knowledge do not explain these differences. Health promotion that aims to improve knowledge will probably not work and innovative methods are needed to improve health in high risk groups.

Health Expectations, 2014

Health consumer and patients&... more Health consumer and patients' organizations (HCPOs) seek to influence policy. But how are they affected by developments in the policy context and political environment? The article draws on original research into HCPOs in the UK by the authors, including a major survey undertaken in 1999 and interviews with HCPOs and policymakers between 2000 and 2003 as well as a further survey in 2010. It also draws on a review of key government policies on health and the voluntary sector since 1997. Developments in the political environment and policy context have created both opportunities and threats for HCPOs as they seek to influence policy. These include policies to promote choice and competition in public services; support for a greater role for the voluntary sector and civil society in health and welfare (including the current government's 'Big Society' idea); NHS reorganization; changes to the system of patient and public involvement; and austerity measures. Devolution of powers within the UK with regard to health policy and the rising profile of the EU in health matters have also had implications for HCPOs. This analysis raises key issues for future research in the UK and elsewhere, such as how will HCPOs be able to maintain independence in an increasingly competitive environment? And how will they fare in an era of retrenchment? There are also challenges for HCPOs in relation to maintaining relationships in a new institutional setting characterized by multilevel governance.

Health Expectations, 2004

Introduction Whilst recent research has focused on consumer involvement at local level in the UK,... more Introduction Whilst recent research has focused on consumer involvement at local level in the UK, there have been few studies of the representation of user, carer and patientsÕ interests nationally. This paper concentrates on the role of health consumer groups in representing the collective interests of patients, users and carers in the national policy process.

Constructions of Health and Illness: European Perspectives, 2004

In his presidential address to the 1998 American Political Science Association, Kent Jennings arg... more In his presidential address to the 1998 American Political Science Association, Kent Jennings argued that human actions as a result of pain and loss experiences may move from individual to collective action. As a consequence, there is a shift from interaction in the private sphere to the sphere of the political (Jennings, 1999). He considers that the process through which this occurs should be studied more systematically by political scientists. The territory is also of interest to sociologists of health and illness. In this paper, the aim is to ...

Health Expectations, 2008

Despite the rise of health consumer and patients' organizations (HCPOs) i... more Despite the rise of health consumer and patients' organizations (HCPOs) in modern health-care systems, studies are few and far between. In particular there is a lack of comparative research across Europe and at the pan-European level. In an effort to address this gap, an expert workshop was held in Vienna in February 2006. This involved 22 delegates from 10 European Countries and was funded by the European Science Foundation (ESF). The workshop reviewed the development of HCPOs in Europe and their role in the policy process in order to establish a platform for further research in this field. It found evidence of an increase in HCPOs across European countries, increased engagement with policy makers and political institutions, and the creation of alliance organizations bringing together HCPOs across the sector. However, variations between countries were observed, relating to different political, cultural and health system contexts. There was no consensus on whether the rise of HCPOs constituted a new social movement. An increase in HCPO activity at the pan-European level was noted, reflecting the increased interest of EU institutions in health policy. At both domestic and European levels, concerns about the representativeness and legitimacy of HCPOs were raised as well as questions about their independence (notably with regard to the drugs industry). HCPOs face a number of obstacles including: lack of capacity and resources, fragmentation and the power of more established interests within the health-care system. The workshop concluded that further research is needed in this field, in the form of a comparative study of HCPOs in European countries and an analysis of their activities at the pan-European level.

Journal of Advanced Nursing, 2012

To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence... more To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence of non-communicable disease between the two ethnic groups and to identify predictors for differences between groups. Tobacco use, poor diet and physical inactivity are major lifestyle risk factors for chronic cardiovascular diseases, certain cancers, diabetes and chronic lung diseases. There are higher risk and incidence of these diseases in some ethnic groups, for example Asians have higher incidence of diabetes. Cross sectional survey. Cross sectional survey of Asians of Indian descent and white British adults conducted between October-December 2009. Main outcome variables were lifestyle behaviours and BMI. Self-reported disease diagnosis was also collected. In a regression analysis, predictors of outcome variables were demographic variables and beliefs/attitudes/knowledge towards lifestyle behaviours. Body mass index, tobacco use and non-communicable disease (except diabetes) were lower in Indians. Indians reported lower physical activity levels and greater salt use than Whites. Tobacco use was higher in Whites, but knowledge, attitudes and beliefs were similar between Whites and Indians. Health risk behaviour and morbidity are different between the two ethnic groups. Gender, age, educational level, beliefs, attitudes and knowledge do not explain these differences. Health promotion that aims to improve knowledge will probably not work and innovative methods are needed to improve health in high risk groups.

Health Education Journal, 1985

TYPOLOGIES of health education' ~2,3 recognise that there are different levels at which heal... more TYPOLOGIES of health education' ~2,3 recognise that there are different levels at which health educators might intervene to promote health and prevent illness. These range from activities at the micro-level, such as education directed at individual health-related beha-viours, ...

Social science & medicine (1982), 2014

This article explores the policy role of health consumer and patients' organisations (HCPOs),... more This article explores the policy role of health consumer and patients' organisations (HCPOs), an important subset of the UK voluntary health sector. Based on research findings from two surveys, the article examines the activities, resources and contacts of HCPOs. It also assesses their impact on health policy and reform. There is some evidence that HCPOs can influence policy and reform. However, much depends on the alliances they build with other policy actors (including other HCPOs), their resources and leadership. HCPOs seem to have more impact on the detail of policy than on the direction of travel. In addition, there are potentially adverse consequences for HCPOs that do engage with the policy process, which may partly explain why some are wary of such involvement. For example, it is possible that HCPOs can be manipulated by government and other powerful policy actors such as health professionals and the drugs industry.

Democratizing Health, 2011

Sociology of Health and Illness, 2004

This paper argues that a health consumer movement has developed in the United Kingdom over the la... more This paper argues that a health consumer movement has developed in the United Kingdom over the last decade. Drawing on two empirical studies of groups that promote and/or represent the interests of patients, users and carers, it argues that groups formed by people with personal experience of a condition are now more widespread. Feelings of pain and loss can lead to the identification of others in a similar position, and to the formation of groups and action in the political sphere. Research shows that groups share a common discourse and follow similar participative practices, and there is extensive networking. Informal and formal alliances have formed to pursue joint action and indicate a wider health consumer movement. As governments have also increased the opportunities for participation, this has the potential for patients and carers to shape services in ways more responsive to their needs.

Social Science & Medicine, 2011

Previous studies of groups representing patients, users and carers in the UK indicate that their ... more Previous studies of groups representing patients, users and carers in the UK indicate that their principal focus is on health care and treatment services. In recent years, UK government policy has emphasised prevention and health promotion as part of its wider public health agenda. This paper investigates how this might have affected health consumer and patients' organisations (HCPOs) by presenting findings from an online survey of 312 UK groups undertaken in the summer of 2010. The sample was identified using the publicly available membership lists of a number of large alliance organisations. The survey achieved a 39% response rate. The findings suggest that the main focus of lobbying and campaigning remains on health care rather than public health issues. However, a significant minority of groups stated they prioritised public health campaigning and lobbying. Possible explanations for engagement with the public health agenda include: the presence of public health on the government's agenda, the influence of other, more powerful interests in the health policy process, and growing awareness among groups of health promotion, prevention and environmental causes of illness. The paper argues that although HCPOs may be more active in the public health policy arena, more research is needed - notably with regard to their relationship with devolved governments, EU institutions and the current UK government's public health and voluntary sector agenda. The reasons why some groups engage more than others with the public health agenda also merit closer investigation. Moreover, not enough is currently known about the influence of HCPOs on the public health agenda and policies in this field.

Policy & Politics, 1986

ABSTRACT Studies of quasi-government have tended to focus on public sector 'quangos&#... more ABSTRACT Studies of quasi-government have tended to focus on public sector 'quangos' and their implications for accountability and democracy. In contrast, this article focuses on a rather neglected aspect of quasi-government: the role of semi-private bodies and how they emerge and develop. By focusing on the emergence, development and persistence of the self-regulatory system of advertising control, a number of important insights for quasi-government, politics and the policy formation process are provided.

Policy & Politics, 2004

ABSTRACT Health consumer groups – voluntary organisations representing patients, users and carers... more ABSTRACT Health consumer groups – voluntary organisations representing patients, users and carers – have become increasingly active in the national policy process in recent years. Groups have constructed alliances with each other, and with other interests in the health policy arena. They have developed extensive contacts within the political system and have generated social and political resources valued by government and other stakeholders. Groups have contributed to policy development, particularly where this has matched government agendas. It is suggested that group characteristics, resources, tactics and contacts have had an impact on their influence. These findings are considered in the context of Alford's structural model of healthcare politics. Spanish Los grupos del consumidor de la salud – organizaciones voluntarias que representan a los pacientes, usuarios y cuidadores – se han convertido cada vez más activas en el proceso político nacional en años recientes. Los grupos han formando alianzas entre ellos, y con otros intereses en la arena política sanitaria. Estas organizaciones han desarrollado amplios contactos dentro del sistema político y ha generado recursos sociales y políticos valorados por el gobierno y otros participantes. Los grupos han contribuido al desarrollo político, especialmente donde este desarrollo se ha ajustado a las agendas del gobierno. Se ha sugerido que las características, recursos, tácticas y contactos del grupo han tenido un impacto en su influencia. Estos descubrimientos se consideran en el contexto del modelo estructural de Alford de las políticas de asistencia sanitaria. French Les groupements de consommateurs de santé publique (des organisations bénévoles qui représentent les patients, les utilisateurs et les soignants) sont devenus de plus en plus actifs dans le processus de politique nationale ces dernières années. Des groupes se sont unis et ont formé des liens avec d'autres intérêts dans le contexte de politique sanitaire. Ils ont développé de nombreux contacts à l'intérieur du système politique et ont créé des ressources sociales et politiques appréciées par le gouvernement et d'autres parties prenantes. Les groupes ont joué un rôle dans le développement de politiques, particulièrement lorsqu'elles correspondaient à l'agenda du gouvernement. L'article suggère que les caractéristiques des groupes, leurs ressources, leurs contacts et leurs tactiques ont marqué leur influence. Ces conclusions sont considérées dans le contexte du modèle structurel de politique sanitaire d'Alford.

Journal of Hospital Infection, 2013

The national surgical site infection (SSI) surveillance service in England collates and publishes... more The national surgical site infection (SSI) surveillance service in England collates and publishes SSI rates that are used for benchmarking and to identify the prevalence of SSIs. However, research studies using high-quality SSI surveillance report rates that are much higher than those published by the national surveillance service. This variance questions the validity of data collected through the national service. To audit SSI definitions and data collection methods used by hospital trusts in England. All 156 hospital trusts in England were sent questionnaires that focused on aspects of SSI definitions and data collection methods. Completed questionnaires were received from 106 hospital trusts. There were considerable differences in data collection methods and data quality that caused wide variation in reported SSI rates. For example, the SSI rate for knee replacement surgery was 4.1% for trusts that used high-quality postdischarge surveillance (PDS) and 1.5% for trusts that used low-quality PDS. Contrary to national protocols and definitions, 10% of trusts did not provide data on superficial infections, 15% of trusts did not use the recommended SSI definition, and 8% of trusts used inpatient data alone. Thirty trusts did not submit a complete set of their data to the national surveillance service. Unsubmitted data included non-mandatory data, PDS data and continuous data. The national surveillance service underestimates the prevalence of SSIs and is not appropriate for benchmarking. Hospitals that conduct high-quality SSI surveillance will be penalized within the current surveillance service.

Journal of Advanced Nursing, 2012

To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence... more To compare physical activity levels, body mass index, habitual diet, tobacco use and prevalence of non-communicable disease between the two ethnic groups and to identify predictors for differences between groups. Tobacco use, poor diet and physical inactivity are major lifestyle risk factors for chronic cardiovascular diseases, certain cancers, diabetes and chronic lung diseases. There are higher risk and incidence of these diseases in some ethnic groups, for example Asians have higher incidence of diabetes. Cross sectional survey. Cross sectional survey of Asians of Indian descent and white British adults conducted between October-December 2009. Main outcome variables were lifestyle behaviours and BMI. Self-reported disease diagnosis was also collected. In a regression analysis, predictors of outcome variables were demographic variables and beliefs/attitudes/knowledge towards lifestyle behaviours. Body mass index, tobacco use and non-communicable disease (except diabetes) were lower in Indians. Indians reported lower physical activity levels and greater salt use than Whites. Tobacco use was higher in Whites, but knowledge, attitudes and beliefs were similar between Whites and Indians. Health risk behaviour and morbidity are different between the two ethnic groups. Gender, age, educational level, beliefs, attitudes and knowledge do not explain these differences. Health promotion that aims to improve knowledge will probably not work and innovative methods are needed to improve health in high risk groups.

Health Expectations, 2014

Health consumer and patients&... more Health consumer and patients' organizations (HCPOs) seek to influence policy. But how are they affected by developments in the policy context and political environment? The article draws on original research into HCPOs in the UK by the authors, including a major survey undertaken in 1999 and interviews with HCPOs and policymakers between 2000 and 2003 as well as a further survey in 2010. It also draws on a review of key government policies on health and the voluntary sector since 1997. Developments in the political environment and policy context have created both opportunities and threats for HCPOs as they seek to influence policy. These include policies to promote choice and competition in public services; support for a greater role for the voluntary sector and civil society in health and welfare (including the current government's 'Big Society' idea); NHS reorganization; changes to the system of patient and public involvement; and austerity measures. Devolution of powers within the UK with regard to health policy and the rising profile of the EU in health matters have also had implications for HCPOs. This analysis raises key issues for future research in the UK and elsewhere, such as how will HCPOs be able to maintain independence in an increasingly competitive environment? And how will they fare in an era of retrenchment? There are also challenges for HCPOs in relation to maintaining relationships in a new institutional setting characterized by multilevel governance.

Health Expectations, 2004

Introduction Whilst recent research has focused on consumer involvement at local level in the UK,... more Introduction Whilst recent research has focused on consumer involvement at local level in the UK, there have been few studies of the representation of user, carer and patientsÕ interests nationally. This paper concentrates on the role of health consumer groups in representing the collective interests of patients, users and carers in the national policy process.

Constructions of Health and Illness: European Perspectives, 2004

In his presidential address to the 1998 American Political Science Association, Kent Jennings arg... more In his presidential address to the 1998 American Political Science Association, Kent Jennings argued that human actions as a result of pain and loss experiences may move from individual to collective action. As a consequence, there is a shift from interaction in the private sphere to the sphere of the political (Jennings, 1999). He considers that the process through which this occurs should be studied more systematically by political scientists. The territory is also of interest to sociologists of health and illness. In this paper, the aim is to ...

Health Expectations, 2008

Despite the rise of health consumer and patients' organizations (HCPOs) i... more Despite the rise of health consumer and patients' organizations (HCPOs) in modern health-care systems, studies are few and far between. In particular there is a lack of comparative research across Europe and at the pan-European level. In an effort to address this gap, an expert workshop was held in Vienna in February 2006. This involved 22 delegates from 10 European Countries and was funded by the European Science Foundation (ESF). The workshop reviewed the development of HCPOs in Europe and their role in the policy process in order to establish a platform for further research in this field. It found evidence of an increase in HCPOs across European countries, increased engagement with policy makers and political institutions, and the creation of alliance organizations bringing together HCPOs across the sector. However, variations between countries were observed, relating to different political, cultural and health system contexts. There was no consensus on whether the rise of HCPOs constituted a new social movement. An increase in HCPO activity at the pan-European level was noted, reflecting the increased interest of EU institutions in health policy. At both domestic and European levels, concerns about the representativeness and legitimacy of HCPOs were raised as well as questions about their independence (notably with regard to the drugs industry). HCPOs face a number of obstacles including: lack of capacity and resources, fragmentation and the power of more established interests within the health-care system. The workshop concluded that further research is needed in this field, in the form of a comparative study of HCPOs in European countries and an analysis of their activities at the pan-European level.