The Consumers Health Forum (CHF) of Australia released a white paper in November 2018 ‘Shifting Gears, Consumers transforming health’. It describes the risk of a chasm between policy intent to create consumer-centred care and the principles being put into practice. It builds on the 2017 Productivity Commission appraisal of the health system and calls for fundamental changes and the involvement of consumers as drivers for these changes. While the CHF report overall has a focus on developing consumer leaders, the UK Healthcare Improvement Studies Institute has produced three reports in 2018 on ‘citizen science’: Citizen science: crowdsourcing for systematic reviews, Citizen science: crowdsourcing for research and Citizen science: generating ideas and exploring consensus. In some examples, citizens are simply used to provide cheaper or free labour to supplement the work of scientists and their computers. However, all reports provide detailed descriptions of on-line resources and the third report provides practical ideas for how explore consumer ideas and even achieve consensus – at scale – using on-line tools. In 2019 NSWRHP will be both building consumers into research processes (including research project selection) and exploring the use of on-line tools to reach out broadly into communities.