The 'Public' in Public Involvement: A Call to Centre Frontline Staff Voices in Health Workforce Research

Public involvement, or patient and public involvement and engagement (PPIE), is widely embedded in health and care research and is valued for its moral, ethical, and methodological contributions. However, its application in workforce research raises important questions about the voices that might be missing from the 'public' when research's primary object of inquiry is healthcare staff, organisations, and systems, rather than patients and service users. This viewpoint explores tensions arising from the extension of standardised public involvement requirements, which were originally developed for research where patients and service users are the primary target of focus, into workforce-focused studies. We argue that while patient and public perspectives remain crucial, the lived experience and voices of frontline staff are often under-recognised in existing involvement frameworks, including those used in NIHR domestic programmes, as they are not fully accommodated within either public involvement or stakeholder engagement activities. We therefore call for greater clarity, flexibility, and, where appropriate, expansion in how public involvement is conceptualised and operationalised in workforce research, to better centre the voices of frontline staff. Rather than offering definitive solutions, we invite debate and future research on how public involvement can be made more meaningful, proportionate, and fit-for-purpose in health and care workforce research. PATIENT OR PUBLIC CONTRIBUTION: This viewpoint article is written by researchers in the health and care workforce, PPIE, and community engagement, and a public contributor with interest and experience of involvement in health and care workforce research. We drew on our respective perspectives and experience to shape the framing and arguments presented in this viewpoint.