January 13, 2025

By Amy Connelly – Patient and Public Involvement and Engagement (PPIE) Coordinator for Tay Health Tech

Introduction

Patient and Public Involvement and Engagement (PPIE) is essential for advancing healthcare research, particularly when it directly impacts the public. PPIE involves activities that invite participants to learn about a project, share their experiences, and suggest meaningful changes. These contributions are shared with researchers, shaping the next stages of the project and leading to co-designed outcomes.

Tay Health Tech is a collaborative initiative dedicated to transforming community healthcare in Tayside by bringing advanced medical technologies closer to those who need them most. Our goal is to improve prognostics, treatment planning, and patient outcomes. By shifting healthcare from hospital-based to community-centred care, the project aims to reduce inpatient demand and enable remote monitoring. Importantly, this approach addresses health inequalities by making cutting-edge healthcare more accessible to underserved communities.

This article outlines my approach to PPIE within the Tay Health Tech project, a place-based impact accelerator (PBIAA) funded by the Engineering and Physical Sciences Research Council (EPSRC). I demonstrate how integrating PPIE from the outset ensures that the research remains patient-centred and impactful.

Workshop Design

Chronic illnesses such as lung cancer, COPD, and diabetes are particularly prevalent in these areas, making engagement with patients who regularly access healthcare crucial. These individuals typically visit hospitals three or more times a year and maintain ongoing communication with healthcare providers, offering valuable insights into the system’s strengths and areas for improvement. The workshops began with a top-level overview and gave participants the opportunity to share personal experiences. They could either document their thoughts in writing or share them aloud with the group. This ensured everyone had a chance to contribute and understood the purpose behind sharing their insights.

This was the project’s first direct interaction with patients, and the findings from these workshops defined the four Grand Challenges – key issues identified by participants that the project will address. These challenges inform a call for proposals, inviting researchers from the project partners to apply for funding to develop solutions targeting the specific issues raised in the workshops.

Our goal is to introduce medical technologies that improve the lives of patients and healthcare workers by making healthcare technology accessible and effective. The most valuable ideas come from those who will ultimately use these devices, as they are best positioned to identify gaps in care that innovative technologies could fill.

Recruitment

To recruit the public for our workshops, we collaborated with the Scottish Health Research Register (SHARE). SHARE connects researchers with patients who have expressed an interest in participating in research by granting access to their health details. This streamlined approach made it easier to identify and recruit participants whose healthcare experiences aligned with the themes of our workshops. The table below outlines the workshop location details, the defined participants, and the themes they are aligned with.

Table 1: Workshop Participation

Location	Participants	Health Condition	Theme
Coupar Angus	Retired, rural, more affluent	Any	Digital health/ remote monitoring
Arbroath	All adults, lowest 30% SIMD	Any	Digital health/ remote monitoring
Perth	All adults	Chronic Conditions	Bringing hospital to local clinics
Dundee	All adults	Substance Use	Access to healthcare
Online	Health and Social Care Staff	N/A	Open

We provided SHARE with detailed information about each workshop, including the objectives, themes, locations, conditions, and age groups, to help them identify suitable participants. For example, for the Dundee workshop focused on substance use, SHARE was able to contact individuals from the region whose experiences matched the criteria for the discussion. This targeted recruitment strategy ensured that we gathered insights from individuals most affected by the issues being addressed.

Ethics, Data protection and Consent

Before the workshops could take place, it was essential to secure ethical approval and establish a data protection and data-sharing agreement between SHARE and Heriot-Watt University, which would manage access to personal data. Obtaining ethical approval was a crucial step to ensure that participants’ information was protected and that their contributions could be retained and used responsibly.

We have a duty of care to create a safe environment where participants feel comfortable sharing their experiences openly. To support this, comprehensive documentation was prepared, including consent forms and participant information sheets. These documents ensured that participants were fully informed about the workshop objectives, what to expect on the day, and how their information would be used and stored. Clear communication of these processes is vital for building trust and encouraging meaningful engagement.

Workshop Method

The workshops were carefully designed to ensure that every participant had the opportunity to contribute, preventing any single voice from dominating the discussion. To achieve this, the 1-2-4 and More method was used – a structured technique commonly employed in focus group settings to encourage participation, generate ideas, and build consensus. This approach fosters inclusivity and ensures that all contributions are valued.

We invited Rodney Mountain, a head and neck surgeon at NHS Tayside with experience in healthcare education, technical skills training, and “Design” lead research related to healthcare products and service design, to facilitate the workshops. Rodney played a key role in the success of the workshops, as he was able to connect with the participants, helping them feel safe and open about their views and experiences.

Each of the five workshops revolved around two key questions:

• What are the issues surrounding NHS healthcare in Tayside?
• What do you think the solutions are?

To provide context and inspire participants, an introduction to medical technology was included at the beginning of each session. This helped establish a shared understanding and encouraged participants to reflect on how technology might address the challenges they identified.

The attendance goal for each workshop was 40 participants, with the highest attendance reaching 36. Workshops were conducted in a cabaret-style room setup, with six groups of six participants each. The session began with individual reflection, where participants were asked to consider the questions and note their thoughts on post-it notes. This step encouraged independent thinking, allowing individuals to draw from their personal experiences before group discussions began.

The next stage involved pairing up with another participant to share ideas. This step facilitated a deeper exchange of perspectives, helping participants identify commonalities and differences in their experiences. It also created a sense of community and mutual understanding, helping participants feel less isolated in their challenges.

Following this, the small groups at each table came together to refine and expand upon their ideas, identifying common themes or potential solutions. Finally, each table shared their conclusions with the full room, integrating insights into a collective discussion.

This step-by-step method proved highly effective in promoting inclusivity, collaboration, and diverse thinking. By allowing contributions to build progressively, participants gained confidence, enriched the conversations, and generated a range of valuable ideas to inform the project’s next steps.

Recording, Transcribing, and Analysing

During the workshops, scribes documented the main points as participants shared their ideas. This real-time notetaking complemented the post-it notes contributed by participants, adding valuable context to the data collection process.

After the workshops, the notes were transcribed and systematically organised into categories to facilitate analysis. Codes were identified and defined, allowing recurring themes to emerge from the data. Excel was used to analyse the frequency of these themes, providing a quantitative perspective to support the qualitative insights.

The identified themes played a crucial role in shaping the Grand Challenges for the project. By basing these challenges on the evidence gathered from the workshops, the process ensured that community-driven decisions would inform the project’s direction, aligning with the needs and experiences of those most affected.

The Next Steps

Following the workshops, participants were invited to complete a survey and indicate whether they were interested in continuing their involvement with the project. This feedback will inform the development of a Citizens Assembly, which is currently being established.

The Citizens Assembly will serve as a platform for ongoing engagement, offering long-term guidance and support for the project after the call for proposals is finalised. By maintaining this collaborative approach, the assembly ensures that the community’s perspectives remain central to the project’s progress.

As PPIE is fundamental to Tay Health Tech, it will continue to play a vital role in the project’s future stages. The initiative remains committed to integrating PPIE throughout its activities and advocating for the voices of the Tayside community.