Engaging people in their own health and care has never been more important. The underlying concept of Patient and Public Engagement (PPE) encourages patients and the public to better understand their role as active participants in their own health and care, which has been reinforced recently by the Minister for Health and Social Services. After the pandemic we face the twin challenges of longer waiting lists and ever-increasing demand for services alongside austerity. We need to make use of the insights of good PPE to support service improvement and redesign activities, as well as helping people to manage their own health and well-being. There are some good examples of engagement, but we do not see these consistently applied across Wales. The challenge of delivering true co-production and high-quality engagement across health and care to maximise the opportunities to improve patient experience, requires urgent attention.