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The aim of this paper is to draw together suggestions for future research from the papers and from the discussion that took place at the workshop.

The suggestions are summarised under four broad themes.

At an international workshop on trust organised by the UK MRC Health Services Research Collaboration there was broad agreement that trust was still a salient issue in diverse health care contexts. The workshop proceedings identified a number of important questions for empirical research and several key conceptual, theoretical and methodological questions relating to trust that need to be addressed in support of or alongside this. The collection of papers in this volume starts to address some of these questions.

Considers trust relations in health care from patient, clinical, organisational and policy perspectives.

The idea that patients should be informed about the benefits and risks of treatment options and involved in decisions about their care is, to many people, appealing and sensible. However, it has important implications. This paper briefly considers two motivations for involving patients in clinical decisions and explores some of the issues raised by these. It then makes some practical suggestions for those wanting to provide information to support patient involvement. The paper emphasizes that although the provision of more good‐quality information to patients is widely accepted to be a priority, it is not always a straightforward matter and warrants critical consideration. Substantial resources may be needed if it is to be done well.

The Informed Choice Initiative aims to make available to both professionals and users a range of leaflets about topics related to pregnancy and childbirth which are based upon the best available scientific evidence. For each topic covered there are two leaflets — one for health care professionals and one for patients. They are intended to facilitate women's involvement in decisions about their health care and help promote clinical effectiveness. The initiative is the result of a collaboration between the Midwives Information and Resource Service and the NHS Centre for Reviews and Dissemination. The article describes the rigorous development process of the leaflets and discusses some of the issues raised by initiatives such as Informed Choice.

This paper considers some implications of recent developments relating to patient safety for understandings of trust in health care contexts.

Conceptual analysis focusing on patients' trust in health care providers and health care providers' trust in patients.

Growing awareness of the scale of the problem of iatrogenic harm has prompted concerns that patients' trust in health care providers may be threatened and/or become inappropriate or dysfunctional. In principle, however, patients' trust may be both well placed and compatible with current understandings of safety problems and efforts to address these. Contemporary understandings of patient safety suggest that, to be deemed trustworthy, health care providers should make vigorous efforts to improve patient safety, be honest about safety issues, enable patients to contribute effectively to their own safety, and provide appropriate care and support after safety incidents. Patients who trust health care providers need not be ignorant of patient safety problems and may be vigilant in the course of their care. Iatrogenic harms do not necessarily reflect breeches of trust (not all such harms are yet preventable), and patients who are harmed might in some circumstances appropriately forgive and resume trusting. Health care providers may feel vulnerable to patients in several respects. From their perspective, trustworthy patients will act competently to optimise the outcomes of their health care efforts and to preserve health care providers' good reputations where those are justified. Providers' trust in patients may strengthen patients' trust in them and facilitate safety improvement work.

Shows how, in principle, trust can be compatible with current understandings of patient safety issues and may enhance efforts to improve patient safety.

Over the past decade, there has been growing international interest in shaping local organisational cultures in primary healthcare. However, the contextual relevance of extant culture assessment instruments to the primary care context has been questioned. The aim of this paper is to derive a new contextually appropriate understanding of the key dimensions of primary care medical practice organisational culture and their inter-relationship through a synthesis of published qualitative research.

A systematic search of six electronic databases followed by a synthesis using techniques of meta-ethnography involving translation and re-interpretation.

A total of 16 papers were included in the meta-ethnography from the UK, the USA, Canada, Australia and New Zealand that fell into two related groups: those focused on practice organisational characteristics and narratives of practice individuality; and those focused on sub-practice variation across professional, managerial and administrative lines. It was found that primary care organisational culture was characterised by four key dimensions, i.e. responsiveness, team hierarchy, care philosophy and communication. These dimensions are multi-level and inter-professional in nature, spanning both practice and sub-practice levels.

The research contributes to organisational culture theory development. The four new cultural dimensions provide a synthesized conceptual framework for researchers to evaluate and understand primary care cultural and sub-cultural levels.

The synthesised cultural dimensions present a framework for practitioners to understand and change organisational culture in primary care teams.

The research uses an innovative research methodology to synthesise the existing qualitative research and is one of the first to develop systematically a qualitative conceptual framing of primary care organisational culture.

The last ten years have shown a significant upward trend of engagement in public management reflecting a significant increase in interest in the topic. The purpose of this paper is to investigate the benefits and factors affecting the construct of civic engagement that thus far are missing in the current literature through the analysis of studies published in the main journals of management.

Through a systematic literature review, the current research tries to advance the progress in the understanding of the civic engagement construct analyzing a sample of 96 papers published in the main journals on the subject areas of “communication,” “marketing” and “public sector management.”

The literature was codified and characterized as follows: level of analysis, variables that affect civic engagement; benefits of civic engagement; and theoretic and methodological approach. This research explores the construct through an analysis of the literature found in the main scientific journals to intercept its various profiles and facets alongside the mechanisms that precede and follow its manifestation.

Public organizations can no longer do without engaging citizens in decision-making processes. Public managers can use these findings to establish a connection with their citizens and influence their publics through commitment and managerial actions that guarantee direct democracy.

This is the first research that aims to study the phenomenon in the public sphere from a multidisciplinary perspective that is as yet incomplete. An integrated vision can highlight current and future developments and eventual opportunities for further research.