Patient and Public Engagement and Involvement

For more information about the theme and the Exchange Network contact Rachel Matthews, Programme Lead for Patient and Public Engagement and Involvement on 020 331 53047 or email

We have an established track record in promoting and supporting the involvement of patients and the public in improvement and research activities. In March 2015, the NIHR published a strategic review of involvement ‘Going the Extra Mile – Improving the nation’s health and wellbeingthrough public involvement in research1 with advisory support from our programme. 

Figure 1: The aim of NIHR CLAHRC Northwest London

In line with the primary aim of CLAHRC Northwest London (Figure 1), the purpose for our Patient and Public Engagement and Involvement (PPEI) is to empower and enable patients, families and carers to play an active role in shaping improvement and research. Improvement interventions that take account of the difficulties experienced by people as they use health services are more likely to meet their needs and preferences. 


How to get involved

We welcome people from all backgrounds who are interested in improving healthcare. There are opportunities in our programme and with our teams and through the Improvement Leader Fellowship which is open to patients and carers. As a first step you may want to consider joining our Exchange Network.

The Exchange Network

By working with patient advisers and leaders, we know that people want to meet and learn from each other in less formal ways that take account of existing experiences and skills. The Exchange Network is evolving into a facilitated, informal, flexible group of people committed to the involvement of patients and families, who want to make a difference, learn and lead together. We meet four times a year and provide support and advice between meetings.

Our strategy

We work with improvement teams to help them find effective ways to actively engage and involve patients. There are many benefits to involving people including improving experience, knowledge and cost effectiveness2. We notice that patient and public engagement and involvement can be problematic because teams may be unfamiliar in working with patients outside of a clinical consultation or are unsure how to approach the activity in order to get the best results. Over the last six years we have worked with many teams and from this experience we are evolving different ways to approach involvement. We are testing the action-effect method as way to describe our strategic aim, interventions and associated measures.


Examples of our current research

Implementation of PPI frameworks for meaningful patient and public involvement practice and evaluation

Patient and public involvement (PPI) needs to be managed to achieve its potential3. Frameworks and guidance are available to support well planned, meaningful PPI. Their existence however, does not equate to their use in practice. There is little evidence explaining the necessary processes which help people understand how to use the frameworks and guidance. It is not known whether they lead to meaningful PPI practice or outcomes and this is the basis of our research investigation.

The 4Pi: National Involvement Standards4 is an evidence-based framework created by the National Survivor User Network. Originally designed to guide user involvement for improving mental health services, our early tests indicate it can be used with improvement teams more generally. This study will investigate the facilitators and barriers of using 4Pi: National Involvement Standards to involve patients and families in improvement initiatives. It aims to further understanding into the relationship between use and influence on PPI processes and outcomes.

Could 4Pi help you?

Get in touch if you’re interested in using 4Pi to plan your PPI.

Our research partners

We have an established research partnership with the London School of Hygiene and Tropical Medicine, working in partnership with Cicely Marston, Angela Filipe and Alicia Renedo.


1.        NIHR. Going the Extra Mile: Improving the Nation’s Health and Wellbeing through Public Involvement in Research.; 2015. Mile2.pdf.

2.        Coulter A. Engaging Patients in Healthcare. Open University Press; 2011.

3.        Armstrong N, Herbert G, Aveling E-L, Dixon-Woods M, Martin G. Optimizing patient involvement in quality improvement. Heal Expect. 2013:1-12. doi:10.1111/hex.12039.

4.        Faulkner A, Crepaz-Keay D, Kalathil J, et al. 4Pi: National Involvement Standards. London, UK; 2015.

5.        Renedo A, Marston CA, Spyridonidis D, Barlow J. Patient and public involvement in healthcare quality improvement: how organisations can help patients and professionals to collaborate. Public Manag Rev. 2014:1-25.