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Patient and public involvement (PPI) in research has become expected practice by funders and Research Ethics Committees (RECs).1–3 Working with public contributors from the outset in designing and undertaking patient-related research aims to ensure that the focus is relevant to, and grounded in, their lived experiences.4 Despite sustained UK research policy advocating the importance of PPI,3 public contributions are often absent or minimal in reports of primary care research.5 In this patient perspectives edition of the BJGP, only two papers report on public contributions to the design and execution of the research.6,7 When PPI input is described, research reports are rarely specific about the input of public contributors along the way; how their concerns, reviews, suggestions, and objections have actually shaped or changed the course of the research.1,4,8 PPI work often remains a ‘black box’. This editorial makes the case that meaningful PPI makes a positive contribution, but the nature and content of PPI work need to be transparent and appropriate. PPI collaboration in research is time consuming and more problematic for both public contributors and researchers than best-practice guidelines suggest.4,9 The reasons why general practice research is not designed and undertaken with public contributors are numerous, including insufficient resources and a desire to avoid complicating a project.2,8 We draw on our experience as three researchers and one PPI group member to highlight some of the key challenges and practicalities involved.

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Dphil student: Ben Bowers