Summary Participation has been encouraged for many years in health development work, as a means to involve populations in improving the appropriateness and quality of their local health services. This article is an attempt to highlight a new approach to participation which moves away from a purely community focused activity and seeks to engage a broader partnership between health service providers, managers and users for a more accountable and sustainable end product. It takes inspiration from the Client Oriented Provider Efficient process (COPE) which has been proved an effective tool to improve the quality of reproductive health services. Mixing some of its core components with Participatory Learning and Action (PLA) methods we have developed a new model of participatory planning and training. Preliminary results show that including all stakeholders in the process can work as long as the exercises are accessible to all. This accessibility is achieved through a range of visualisation methods. As with any tool for Human Resource Development the crucial issue continues to be the need for effective follow up which can maintain levels of enthusiasm and quality in resource?poor settings.