Of all fields of health research, basic science, biomedical, and clinical research arguably have the poorest records of meaningful engagement with consumers and communities. If your goal is to address an issue of biochemistry, immunology, or pathophysiology, what value could consumer input possibly have? If you are conducting clinical trials designed to identify an effect based on statistical rigour, what useful insight could community members provide in relation to study design? Surely, consumers won’t understand the science, so why would you involve them? Views such as these that have given rise to a long history of research that is paternalistic, fails to address the priorities of communities, disempowers consumers, and, ultimately, does little to improve health outcomes. In the worst instances, these views have led to distress and trauma in participants, and the stigmatisation of those who decline to participate. Meaningful engagement with consumers and communities is not only an ethical requirement, but a necessary process in producing research that can inform effective and translatable clinical measures. However, many biomedical and clinical research lack the expertise necessary to undertake this work. Geraint will describe his own experiences in developing frameworks for community consultation and challenges of having to fundamentally reassess how research is designed, interpreted, and appraised.