of the new system we have identified will make this process challenging for Healthwatch and health and social care providers and commissioners. Our analysis shows that local Healthwatch are negotiating with multiple stakeholders and competing for legitimacy within governance arrangements that comprise markets, hierarchies and networks. In this complex system of polycentric governance and in a crowded PPI environment, they must try to establish themselves as the organisation for patients and ‘go-to’ the public. include groups who deserve a voice, Healthwatch’s ‘constituents’ ‘seldom-heard’ as well as more empowered individuals who seek information about their healthcare choices. Further research might focus on how these tensions manifest in practice and how local Healthwatch are negotiating positions of influence and trust. References 1. Hudson B. Public and patient engagement in commissioning in the English NHS: An idea whose time has come? 2014;17(1):1-16. Public Management Review. 2. Taylor J, Tritter JQ. 'Local involvement networks: Learning from the early adopter programme final report'. Coventry: Warwick University, 2007. 3. Martin G. The third sector, user involvement and public-service reform: A case study in the co-governance of health-service provision. 2011;89(3):909–932. Public Administration. 4. Dent M, Pahor M. Patient involvement in europe–a comparative framework. Journal of 2015;29(5):546-555. Health Organization and Management. 5. Martin GP. Representativeness, legitimacy and power in public involvement in management. 2008;67(11):1757-1765. Social Science & Medicine. 6. Newman J, Clarke J. London: Sage, 2009. Publics, politics and power. 7. Peckham S. Accountability in the UK healthcare system: An overview. Healthcare Policy. 2014; 10(special issue):154-162.
of the new system we have identified will make this process challenging for Healthwatch and health and social care providers and commissioners. Our analysis shows that local Healthwatch are negotiating with multiple stakeholders and competing for legitimacy within governance arrangements that comprise markets, hierarchies and networks. In this complex system of polycentric governance and in a crowded PPI environment, they must try to establish themselves as the ‘go-to’ organisation for patients and the public. Healthwatch’s ‘constituents’ include ‘seldom-heard’ groups who deserve a voice, as well as more empowered individuals who seek information about their healthcare choices. Further research might focus on how these tensions manifest in practice and how local Healthwatch are negotiating positions of influence and trust. References 1. Hudson B. Public and patient engagement in commissioning in the English NHS: An idea whose time has come? Public Management Review. 2014;17(1):1-16. 2. Taylor J, Tritter JQ. 'Local involvement networks: Learning from the early adopter programme final report'. Coventry: Warwick University, 2007. 3. Martin G. The third sector, user involvement and public-service reform: A case study in the co-governance of health-service provision. Public Administration. 2011;89(3):909–932. 4. Dent M, Pahor M. Patient involvement in europe–a comparative framework. Journal of Health Organization and Management. 2015;29(5):546-555. 5. Martin GP. Representativeness, legitimacy and power in public involvement in management. Social Science & Medicine. 2008;67(11):1757-1765. 6. Newman J, Clarke J. Publics, politics and power. London: Sage, 2009. 7. Peckham S. Accountability in the UK healthcare system: An overview. Healthcare Policy. 2014; 10(special issue):154-162.