Consumer participation is starting to become accepted in most areas of health
care, including clinical governance and research. However, when it comes to consumer involvement in the work of organisations like the Cochrane Collaboration, there are positives and pitfalls which in many ways are uniquely linked to the nature and operations of the Collaboration. Depending on whether this is accepted as a discussion workshop or an oral presentation, I will discuss the various different challenges that have faced myself and other consumers in participating fully in the Cochrane Collaboration. The workshop or paper will then look at a diagnostic analysis using the work of Jeremy Grimshaw and Martin Eccles that was presented at the Australian National Institue of Clinical Studies workshop on Implementing Evidence Based Medicine on how to bring about successful change.

The set of questions set out at that workshop were designed to allow health services to undertake a systematic evaluation of the barriers to change and then to have an appropriate action plan to address these barriers. The simplified set of questions we use are:

(a) Why are we doing this? (b) What does this involve? (c) Who are the players and what do they know or think? (d) What is the impact of the setting, organisational structure and culture? (e) What do you know?

We have started to use this set of questions in our local clinical health improvement committtee, where I am a consumer representative, to look at the barriers to change. This paper or workshop will look at the issue of encouraging and capturing consumer input in the Collaboration, analysing the barriers and looking at targeted strategies to address the issues.

If it is accepted as a discussion workshop, the intention would be to ask people to use this framework to identify what the barriers their CRG or entity faces in involving consumers, and to outline a range of possible options or tools which might be used to help with this. The paper would simply outline how it could be used.