Bridie Angela Evans is lead for Public and Patient Involvement in PRIME Centre Wales, the research centre for primary and emergency care research in Wales, and at the Swansea Trials Unit in Wales. She is a health services researcher based at Swansea University and collaborates, alongside academics, lay members and health practitioners, in studies concerning service delivery in primary and prehospital settings. For her PhD, she developed and implemented a model for involving patients and public members in health services research.



Background: Health services research is expected to involve service users as active partners in the research process, but few examples report how this has been achieved in practice in trials. We implemented a model to involve service users in a multi-centred randomised controlled trial in pre-hospital emergency care. Methods: In our model, we planned to involve service users at all stages in the trial through decision-making forums at three levels: 1) strategic; 2) site (e.g. Wales; London; East Midlands); 3) local. We linked with charities and community groups to recruit people with experience of our study population. We collected notes of meetings alongside other documentary evidence such as attendance records and study documentation to track how we implemented our model. Results: We involved service users at strategic, site and local level. We also added additional strategic level forums (Task and Finish Groups and Writing Days) where we included service users. Service user involvement varied in frequency and type across meetings, research stages and locations but stabilized and increased as the trial progressed. Conclusion: Involving service users in the SAFER 2 trial showed how it is feasible and achievable for patients, careers and potential patients sharing the demographic characteristics of our study population to collaborate in a multi-centre trial at the level which suited their health, location, skills and expertise. A standard model of involvement can be tailored by adopting a flexible approach to take account of the context and complexities of a multi-site trial.