TABLE 3.

Summary table of noteworthy findings

Loyalty to whom?

HEPs stressed that they were not advocates for individual consumers; they are advocates for improvement in the systems. On the other hand, health consumers emphasized that HEPs' primary responsibility was to advocate for individual consumers.

Tension could arise as HEPs are responsible for choosing a selected group of individuals to serve as health consumer representatives to represent the collective voices of all health consumers in the process of consumer engagement. It is important to ensure that the ‘selected’ voices can represent the collective in improving the systems.

HEPs ought to believe that system‐level change is possible and be committed to follow through on how the voices of health consumers are incorporated into the systems.

The roles of HEPs could be embedded into health service organizations differently. Some of them could have other responsibilities such as handling patient complaints. This could affect the roles of HEPs in fulfilling their responsibility as advocates for improving the system.

Empathy vs compassion?

Some health consumers conveyed that HEPs should have ‘lived experiences’ like the patients themselves so that they could empathize with them. But HEPs highlighted that they needed compassion and boundaries because they were not trained in counselling.

There is a need to re‐examine the attribute of empathy in health‐care professionals and distinguish it from compassion.

Can HEPs be trained?

The job descriptions for HEP roles do not often have predefined required and desired qualifications and capabilities.

Some of the capabilities identified in this study including the relational, communication and personal capabilities may come with the person and cannot be acquired by training; an example is one's commitment and persistence to navigate through the bureaucratic systems.

Some professional qualities such as health literacy, process literacy and policy literacy can be acquired through training.