Patient and public involvement (PPI) is an expectation when conducting a health technology assessment (HTA), but there is little guidance for those wishing to embed PPI when developing an HTA proposal. We wanted to ensure PPI was central in preparing a proposal for an HTA potentially of any intervention for pelvic organ prolapse (POP) in women.

We conducted an open process to recruit two PPI co-applicants who, after induction to the project, were jointly responsible for governance of PPI in partnership with the PPI Lead throughout project planning. We facilitated an online workshop with the PPI co-applicants and other women with a lived experience of POP to: develop our question and scope; decide interventions and outcomes for the evidence synthesis; discuss the care pathway for the economic evaluation component; and plan dissemination. The PPI co-applicants were encouraged to comment on the full proposal, while workshop attendees were invited to comment on the plain language summary. Our work adhered to United Kingdom (UK) Standards for Public Involvement. We obtained funding to facilitate PPI within the proposal and reimburse those with lived experience for their time.

Involving the co-applicants and workshop participants strengthened the HTA proposal by: solidifying the rationale based on lived experience; adding interventions to our evidence synthesis not previously considered; and highlighting dissemination outlets that appealed to the public. Comments on the full proposal and plain language summary ensured the proposal was accessible. However, we were unable to discuss everything we originally planned even though researcher time spent on embedding PPI into the proposal was substantial.

Including PPI can be valuable for developing HTA proposals. However, research is required to explore the appropriate level of involvement at the HTA proposal stage, particularly given the large amount of researcher time and additional resource needed to incorporate meaningful PPI.