Although the success of innovation relies on civic engagement and involvement in a vast array of interests, it is a long way from being clear what the best way to interest and entangle people is. Commencing with the community approach, a number of structural elements was identi ed, components able to make participation a growth driver for innovation and connected to two fundamental axes: the former is related to participation as a structured system, whereas the latter is linked to the rules that oversee the deliberative process. Through this key interpretation, the practices adopted by European countries in the healthcare sector have been analyzed and led to the identi cation of two main types of methods: those requiring the introduction of a stable participation and those relying on temporary processes. The analysis showed that each practice is adequate just for one of the two fundamental axes therefore completely inadequate for the other. The only exception is the Catalan Consejo de Salud.