Health care customers are demanding a more active role in the provision and development of health care services, a position supported by government health care policy in Australia. However, many health care organisations lack an understanding of the capabilities required to respond to this increased participation from customers. This study applies dynamic capability theory through a lens of co-creation to identify organisational capabilities that support customer participation in health care service innovations. A qualitative approach using convergent interviews with health care CEOs and senior managers was undertaken. As a result, four categories of organisational capabilities were identified: customer activation, organisational activation, interaction capabilities, and learning agility. Despite acknowledging the need for these capabilities, most health care organisations perceived they had not developed the required skills and resources. This study provides an insight into the organisational capabilities managers seek to improve their customer participation in health care service innovation.