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Biomedical research policy in many countries has adopted the principle of active involvement in research. However, how different approaches to involvement such as patient and public involvement/engagement (PPIE), qualitative research, participatory research, co-design and co-production sit alongside each other, is contentious and unclear. There has also been a subtle shift in the discourse, with the language of co-design and co-production used more widely in debates about involvement. This shift has surfaced once again debates about what counts as meaningful involvement. In this paper we seek to contribute to this debate by exploring boundaries and overlaps between them. We suggest that they share some underpinning philosophies and all are prone to be challenged on the grounds of tokenism despite avowed good intentions. We argue that these different approaches are not necessarily as distinct as is often advocated and question whether there is merit in this family of marginalised approaches working more collaboratively to give patient voices greater traction. At the same time, we recognise that this creates challenges and tensions.

The relationship between research, policy and practice remains a contested area. This article explores pressures for researchers to make their work more useful and relevant to policy and practice, and for practitioners to undertake research. Whilst there are clearly areas of mutual interest and benefit, we argue that the research, policy and practice communities also have distinct traditions, skills and obligations which should be recognised and valued rather than artificially suppressed. Narrow conceptions of research utility constrain the debate about what each community has to offer and how best to communicate with each other across borders.

Health systems internationally have developed policies to support evidence‐based health care (EBHC) for over a decade. As this article shows, the time is ripe to review current policy frameworks in an evidence‐based manner. We summarize key themes deriving from qualitative research on the UK EBHC implementation and draw out implications for policy renewal. Our diagnosis is different from current UK NHS (National Health Service) policy since we stress local capacity building rather than top‐down frameworks, standardized tools and guidelines. As other jurisdictions demonstrate alternative EBHC policy frameworks, more international comparison and mutual learning is needed.