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Highlights•The barriers and facilitators to trial participation from the patient perspectives are captured in the themes of ambiguity of context and benefit, lacking awareness of opportunity, wary of added burden, skepticism, fear and mistrust, building confidence, and social gains and belonging to the community. •Trials were perceived as an opportunity for some patients to access free and high-quality healthcare •Patients feared discrimination and inequities in accessing healthcare, particularly among patients from vulnerable ethnic minority groups, discouraged participation in trials.