Involving patients and the public in healthcare operational research—The challenges and opportunities

Interest is growing internationally in the potential benefits of patient and public involvement (PPI) in research. In the United Kingdom (UK) health and social care services are now committed to involving patients and service users in the planning, development and evaluation of their services. Many funders require PPI as a prerequisite for funding. What does healthcare operational research miss by not involving patients and the public in the development, refinement and implementation of models? We believe PPI is important for healthcare OR for model design and validation, and ethical and economic reasons. It also has a distinct contribution that goes beyond the incorporation of behavioural parameters into models. Case studies in neonatal care and a fractured neck of femur pathway highlight PPI’s contribution to model design and validation, but a recent conference session also identified a number of obstacles. We suggest a provisional model for the implementation of PPI in healthcare OR that emphasises a facilitative approach. We acknowledge this is a significant challenge, but argue that it must be met for ethical and economic reasons that are ultimately rooted in modellers’ construction of valid models. Crucially, it has the potential to enhance our ability to bring about change which can benefit health services and, most importantly, the patients they serve.