This paper draws on a London-based exploratory action research study into the factors affecting the engagement in UK National Health Service (NHS) clinical trials of African patients and the wider African communities. The paper argues for the use of participatory qualitative methodologies in relation to centralizing the voices of those who are mostly easily marginalized by mainstream UK health and social care policies. The paper describes how the co-researchers in this study (professional/lay members from within the affected communities and academic researchers) shaped the study methodology. The challenges and responsibilities of the co-researchers within this process of mutual engagement are further described in relation to identifying the perspectives of all co-researchers within a methodology that strives to mutually engage diverse communities of NHS clinicians, academic researchers and service users. Drawing on the findings from the data analysis, the paper will discuss emergent issues that are of particular relevance for New Labour’s policies on social exclusion, cultural competence and NHS service user involvement