There is substantial evidence that strategies to strengthen patient engagement are effective, argue Angela Coulter and Jo Ellins. However, any strategy to reduce health inequalities must promote health literacy. Policymakers increasingly believe that encouraging patients to play a more active role in their healthcare could improve quality, efficiency, and health outcomes. Critics, however, have dismissed patient engagement and patient-centered care as political correctness with no scientific basis. Patient-focused quality interventions aim to engage patients in their own or their family's clinical care. These interventions can improve patients' knowledge, experience, use of health services, health behavior, and health status. Health literacy is fundamental to patient engagement. People with low health literacy have poorer health status, higher rates of hospital admission, are less likely to adhere to prescribed treatments, and experience more drug and treatment errors. Well-designed written information can improve health knowledge and recall, especially if personalized. Decision aids have been tested in several randomized controlled trials and have shown to improve patients' knowledge and understanding of their condition and treatment options. These aids can be cost-effective, especially when combined with face-to face counseling. Educational interventions that increase patient participation in treatment decisions have also been shown to be effective. Coaching and question prompts for patients and training in communication skills for health professionals can improve patients' knowledge and information recall. Self-care and self-management in chronic diseases are important. Educational and self-help programmes that are actively supported by clinicians improve health outcomes for patients with depression, eating disorders, asthma, diabetes, and hypertension. Interactive computer-based support systems also have positive effects on a range of outcomes. Interventions can improve patients' knowledge and experience, use of health services, health behavior, and health status. Patients can help select treatments, manage long-term conditions, and increase the safety of drug use and infection control. Shared decision making and self-management are mutually supportive approaches that should be given equal importance and implemented consistently. Health information materials, decision aids, self-management action plans, and other technologies of patient engagement are most effective when they supplement or augment, rather than replace, interactions between patients and professionals. Health professionals must be given the opportunity to develop their competencies in patient-centered care, particularly their communication skills. Clinicians must also be given the resources needed to work collaboratively with their patients.There is substantial evidence that strategies to strengthen patient engagement are effective, argue Angela Coulter and Jo Ellins. However, any strategy to reduce health inequalities must promote health literacy. Policymakers increasingly believe that encouraging patients to play a more active role in their healthcare could improve quality, efficiency, and health outcomes. Critics, however, have dismissed patient engagement and patient-centered care as political correctness with no scientific basis. Patient-focused quality interventions aim to engage patients in their own or their family's clinical care. These interventions can improve patients' knowledge, experience, use of health services, health behavior, and health status. Health literacy is fundamental to patient engagement. People with low health literacy have poorer health status, higher rates of hospital admission, are less likely to adhere to prescribed treatments, and experience more drug and treatment errors. Well-designed written information can improve health knowledge and recall, especially if personalized. Decision aids have been tested in several randomized controlled trials and have shown to improve patients' knowledge and understanding of their condition and treatment options. These aids can be cost-effective, especially when combined with face-to face counseling. Educational interventions that increase patient participation in treatment decisions have also been shown to be effective. Coaching and question prompts for patients and training in communication skills for health professionals can improve patients' knowledge and information recall. Self-care and self-management in chronic diseases are important. Educational and self-help programmes that are actively supported by clinicians improve health outcomes for patients with depression, eating disorders, asthma, diabetes, and hypertension. Interactive computer-based support systems also have positive effects on a range of outcomes. Interventions can improve patients' knowledge and experience, use of health services, health behavior, and health status. Patients can help select treatments, manage long-term conditions, and increase the safety of drug use and infection control. Shared decision making and self-management are mutually supportive approaches that should be given equal importance and implemented consistently. Health information materials, decision aids, self-management action plans, and other technologies of patient engagement are most effective when they supplement or augment, rather than replace, interactions between patients and professionals. Health professionals must be given the opportunity to develop their competencies in patient-centered care, particularly their communication skills. Clinicians must also be given the resources needed to work collaboratively with their patients.