Patient and user involvement is central to current government thinking on the NHS. More comprehensive approaches to organised community participation and community development have received less support and examples of effective and genuine participation in key areas such as primary care decision-making are rare. The initiative described in this paper was established in Newcastle upon Tyne in 1995 to promote community participation in decision-making about local health services. It has particular relevance to current concerns about addressing social exclusion and tackling health inequalities since it operates in an area of social disadvantage with a significant black and ethnic minority population (6 percent). This case study is based on an independent evaluation which used multiple research methods, including interviews, questionnaire surveys and direct observation, to assess the project's practice and impact. Describes a community development approach to public participation. An emphasis on inclusive practices has facilitated meaningful involvement of minority groups such as ethnic minority residents and those with disabilities who tend to be marginalised in public debate. Argues that the project has made a significant impact on the ways in which local health services are planned and delivered