Patient Paticipation Groups (PPGs) or Patient Forums

From April 2016, it’s been a contractual requirement for all GP practices in England to set up a patient participation group (PPG) and to make this group fairly representative of the practice population. In 2016 about 75% of practices are thought to have a PPG, but they will vary widely in their effectiveness.

Generally speaking, the members of a PPGs will include volunteer patients, the practice manager and one or more of the practice’s GPs who will meet on a regular basis to discuss the services on offer and how improvements can be made for the benefit of patients and the practice. There is no set way in which PPGs have to work – what they aim to do and how they go about this will depend on local need and circumstances. A PPG might, for example,

  • support the practice through raising understanding of patients’ needs,
  • identify ways of improving how surgeries are run,
  • lobby to improve local health services,
  • monitor how changes to the NHS are impacting on patients, and
  • ensuring patients are aware of their rights (see our section ‘Ways of ensuring your rights’ under the ‘Resources’ tab).

Joining a PPG may also help patients to see how the local Clinical Commissioning Group (CCG) is  responding to NHS policies. PPGs can also potentially put their views to their local CCG and so to influence healthcare choices in their area.

Joining a Patient Participation Group.
Ask your GP or Practice Manager if there is a group at your surgery and how to join. In most cases membership is open to all registered patients and staff in the practice.

If there is no patient group at your surgery, or if there is one but you get the impression that it’s not firing on all cylinders, find out what you can do from the sources of information listed below. Because patient involvement is, in theory anyway, an important element of recent NHS “reforms” you should be pushing at an open door.

Sources of information about patient groups

  • Under the 2012 Health and Social Care Act, CCGs have a legal obligation to include a statement in their policy document about how and to whom they will listen in order to be aware of, and respond to patients’ needs. As an example, one CCG’s draft strategy states:

“The CCG believe it is our duty to create a culture where local people are armed with the knowledge and power to participate in and influence our work. Recognising this we have a “Patient and Public Engagement Strategy.”

So check to see what your local Clinical Commissioning Group has to say about its plans to listen to patients and involve them in its decision making. You can find information on the Internet using the name of your local CCG and ‘patient involvement’ as key search words, or ask your CCG administrator to send you relevant documents.

  • The National Association for Patient Participation ( is a membership organisation providing information to surgeries and their patients about how to run effective PPGs. NAPP also provides guidance for CCGs about how to make best use of PPGs in their area on the basis that: “engaging with PPGs gives the CCG essential insight into its constituent practices, which are the gateways into healthcare for most local people.” Some of this information is openly available on NAPP’s website, but some, including their PPG Getting Started Guide, is restricted to members – so its worth urging your practice to join.(£50 for the first year, £30 in subsequent years.)
  • Information about existing patient groups in practices all over the country is freely available on the internet. Try looking under Patient Participation Groups and you will be able to find examples of terms of working, constitutions, agenda etc.

How PPGs work.

There is no universal system. Patient groups develop in different ways, largely depending on how enthusiastic GPs are about engaging with patients. If the practice management see value in having an active PPG they will invest resources, space and staff time, and in return get a reliable volunteer team that makes things better for staff and patients alike. To get results, the PPG needs to be taken seriously and to have clear lines of communication within and beyond the Practice. Unsurprisingly, where practice managers are lukewarm, or if none of the GPs get actively involved, PPGs tend to fail.

All patients and staff need to know about the PPG and be encouraged to join. Guidance from NAPP suggests an annual meeting at which patients and staff elect a chairperson and a Committee to undertake the core work of the PPG, drawing in other members as necessary. The expectation is that this core group should represent the different interests within the practice population.

Finally, given the changes to health care provision that we are currently seeing following the Health and Social Care Act (2012) and in response to NHS England’s Five Year Forward View and Sustainability and Transformation Plans, here are some of the sorts of  questions that PPGs can research and discuss with their GP Practices:

  • Does this practice have a doctor or other staff member representative on the local CCG? If not, what is the system for this Practice to exchange relevant information with the CCG?
  • How will patients be told about changes in NHS services and how the practice will be affected?
  • So far, has this Practice had any restrictions put on the services or medications doctors can prescribe?
  • So far, are there any significant delays or restrictions on referrals to consultants or for hospital treatment? And in future how will patients be kept informed about delays or cuts in services.

Further information

NHS England’s document on ‘Transforming participation in health and care” –

updated June 2016

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