A Dialogue of Equals - Pacesetters

29th June 2008

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This guidance offers a framework for effective community engagement, particularly with communities and groups who are seldom heard or who are described by some as being ‘hard to reach’.  It was published in 2008 for Department of Health Pacesetters programme which developed, implemented, monitored and evaluated ideas aiming to change the way the NHS dealt with equality and diversity.

Although originally written for Pacesetters, the guidance may be readily used by any NHS organisation. The guidance aims to create a common understanding of the intrinsic role that community engagement can play within any health or service improvement process.

What is engagement?

Engagement is the involvement of the public, either as individuals or as a community, in policy and service decisions which affect them. In practice this involvement can take a number of different forms. The three main stages of engagement are:

Information gathering

The collection of information and data about public attitudes and requirements through surveys, etc. There is no ongoing dialogue between the public and the organisation seeking the information. The public usually participate in this as individuals.


Members of the public and the organisation work together for a defined period to discuss a particular policy or service issue. The methods used can range from focus groups to citizens’ juries. People are brought together as representatives of the demographic profile of a particular community.


Members of the public and the organisation work together, on an ongoing basis, on a range of policy or service issues. These tend to focus on the community rather than on individuals. Community forums are an example.

A key difference between the different approaches to engagement outlined above is the extent of the dialogue that takes place. The word ‘dialogue’ refers to the exchange  of views, ideas and concerns between different groups, for example between a local community organisation and a service-commissioning agency such as a local Clinical Commissioning Group.

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