It has been heralded a "quiet revolution". But the volume will be notched up a little today with the formal launch of a network of more than 570 patient and public forums across England.

Rosie Winterton, whose ministerial brief embraces the forums, describes their prospects as "quite inspiring". But she is anxious to play down expectations of any dramatic early impact and is warning that results will vary widely.

"Because it's a whole new agenda, there is going to be a bit of hesitancy," Winterton says. "Some people are going to say:'Oh, it's not what we expected', but then the whole idea is that we are shifting the balance of power in general to a local level, and therefore we have to accept within that there will be some differences of approach."

The forums, set up by the Commission for Patient and Public Involvement in Health, were established for each NHS and primary care trust. Their role is to represent local people on health and healthcare, scrutinise the quality of care and "be a force for fairness and change".

Despite forecasts that the commission would struggle to get so many forums up and running, it has achieved the minimum target of recruiting seven members into each of the new bodies. Recruitment will continue, though, with the aim of appointing 15-20 members to each.

Sharon Grant, who chairs the commission, says the forums will spend the next two or three months determining their priorities and drawing up action plans. "We've got a lot to do to raise awareness of their role, certainly at the local level, and to explore how they Þt with other people working on the ground, both in local government and the voluntary sector."

Echoing the minister's caution, Grant adds: "We are talking about a real cultural change here, and it will take time to realise the potential of the role and to get to grips with the areas they want to concentrate on."

Having said that, Grant forecasts that the forums will surprise people in the long-term. She points out that the remit of the bodies extends beyond the NHS and gives them the scope to engage other agencies, such as local authorities. She fully expects the forums to convene meetings on housing estates, for instance.

"Our vision is to encourage the forums, once they get into their stride, to become involved in broader discussions that relate to public health and we expect them to be looking, for example, at issues around obesity," Grant says. "They could look at what's being done in terms of availability of sports facilities, in terms of the quality and choice of school meals and in terms of nutrition generally. It's about pushing health up people's agendas."

With 4,000 forum members already signed up, and potentially 6,000 more to come, the commission is running an enormous operation. It has nine regional ofÞces, as well as a headquarters in Birmingham, and has additional responsibility for overseeing development of the new NHS complaints system.

It is no secret the commission considers its £35m budget to be inadequate and is pressing for a review. Winterton is unimpressed, however, and it seems that the forums will have to prove their worth before the ministers will dig deeper.

As Grant says: "It has taken a huge amount of effort to get the infrastructure on the ground and we still need to bed that down, but we do want to be starting to show in the Þrst year that there are some tangible outcomes."

For more on patient and public involvement forums: www.maketimeforhealth.org