In the past few years, rapid and significant changes have taken place in the social, political and policy environment in which health professionals and patients interact. This paper reports on the Patient Involvement Project, a King's Fund study that assessed changing relationships between health professionals and patients/clients in a changing health environment. Part One of the report constitutes a policy analysis that sets out the context for changing relationships. Part Two reports on an empirical study designed to contribute towards a fuller understanding of changing relationships and patient involvement in health care.