Epistemic Exclusion and Patient Safety Participation Evaluation (EPSPE): conceptualising a knowledge framework for involvement, learning and change with harmed patients and families from diverse backgrounds.

Keeping patients safe [patient safety] is essential to our National Health Service, but there are many examples of patients being harmed. Evidence indicates minority ethnic groups and people with mental health challenges or learning disabilities are more likely to experience healthcare harm. There is much interest amongst researchers and healthcare professionals about improving patient safety, but methods to do this have often not been developed with groups more likely to be harmed. The proposed research will: 1. Review evidence on a) patient safety and different population groups, b) how to involve people from different groups to improve safety, c) develop a local equity, diversity, and inclusion, Patient Safety Incident Strategy for reporting into the NHS England ‘learn from patient safety events service’. 2. Conduct 30 interviews with groups experiencing healthcare harm to understand why they think this happens. 3. Conduct 20 interviews with health professionals to get their thoughts on achieving more equitable approaches to patient safety. 4. Synthesise the evidence to develop and test a conceptual framework that can be used to improve decision-making in patient safety to reduce patient safety incidents across diverse population groups and understanding of harmed patients’ experiences and how they can be better involved.