National Association for Patient Participation
Danny is the current chairman of the National Association for Patient Participation (NAPP) and has been an active trustee since 2001 upon retirement from fulltime employment. Danny’s career was spent in the hospitality industry as a chef and latterly as an educator. Married to Barbara, a retired practice manager, Danny enjoys canal navigation, crossword puzzles and the addictive Sudoku
Current intelligence would suggest that there are approximately 2,000 active PPGs in the UK. The advent of change to GP contracts and the emergence of the Quality and Outcomes Framework (QOF) have resulted in a sharp increase in practice interest in starting up and sustaining such groups. However, the majority of practices do not currently have a PPG, and this article is designed to give you a flavour of how they operate, with a view to taking the first steps in starting up a PPG.
What PPGs are not
Before giving a brief outline of what PPGs do, how they are formed and the benefits that they may bring to the practice, it seems sensible to dispel a few myths attached to such groups:
- They are not complaints forums. All practices will have a structured complaints procedure embedded within their protocol portfolio.
- They do not function only in rural practices. A survey conducted by the National Association for Patient Participation (NAPP) discovered that there was a fairly even balance among innercity, rural and urban PPGs.(1)
- They do not follow a predetermined agenda. PPGs are independent and informally accountable to all the patients of the practice and take a balanced view of needs.
- It is not a time-consuming activity for the practice. Most groups are self-organising. The majority undertake activities that assist the practice.
What PPGs are
The comparison between parent/teacher associations and PPGs is valid. PPGs provide practical support for the practice and act as a conduit to enhance service delivery, provide patient information and promote health education. Because PPGs are autonomous, they are all varied to suit local and community needs in consultation with the practice. PPGs cannot function without the support of the practice and, normally, a partner (to advise on clinical matters) and the practice manager (to ensure patient confidentiality, data protection and provide valuable contributions to the proceedings) would attend group meetings.
What PPGs do
- Meet on a regular basis.
- Formulate their own agenda.
- Set short- and long-term objectives.
- Assist the practice on agreed aims.
- Manage, organise and facilitate events.
- Act as a conduit between the practice and patients.
- Contribute to improvement in services.
In the achievement of the above criteria PPGs will, depending on local needs and practice aims, become involved in a range of diverse activities (see Box 1 below).
How to start a PPG
Ensure that the practice is fully committed to the concept and obtain as much information on the mechanics of forming and sustaining a group as possible. It is a good idea to contact your PCO patient and public participation officer. All PCTs in England, LHBs in Wales, LHCCs/CHPs in Scotland and HSSBs in Northern Ireland will have one, although their titles will differ from one area to another (see Resources).
Recruiting patients can be achieved by:
- Direct invitation.
- Using individuals serving on established groups.
- Advertising through the practice newsletter, noticeboards, etc.
- Inviting patients to a general meeting, presenting the facts of PPGs and undertaking an election process.
The above list is not definitive, and you may wish to involve elements of all four. Obviously there are advantages and disadvantages with any recruitment process, and the selection of patients to serve on a PPG may appear to be undemocratic. However, it is suggested that this is the best and most pragmatic approach to ensuring that a group is formed and functioning. When the constitution is designed, a group will need to ensure accountability and give patients the opportunity to either support or challenge decisions made on their behalf. Ideally, a group will consist of between six and 12 members: too few and the work falls to a limited number; too many and the focus of meetings can be obscured.
Once you’ve got a group of patients together, call your first meeting. Ensure that all members fully understand the parameters of a PPG. Over the next few initial meetings (once a month is the norm), the group will need to do the
- Set short- and long-term objectives (in consultation with the practice).
- Devise a suitable title for the group (eg, “Friends” or “The Family Practice Support Group”).
- Elect officers (most groups will need a chair, secretary and treasurer).
- Devise a constitution.
- Decide whether they need a newsletter or they will either contribute to or manage existing practice publications. This is an effective method for informing the wider patient population about your PPG and using it as a vehicle for patient involvement.
- Discuss funding issues.
The formation and running of a group is an activity that relies upon volunteers from your patient list. How successful a PPG becomes depends on the enthusiasm and capabilities of individuals serving on the group and the support emanating from the practice. It will take time for a new group to fully flourish and be a valuable asset to the work of the practice. Some PPGs have been active for more than 30 years.
The issue of funding will be unique to each practice. In some areas, a PCO will assist with startup funds. Some practices will view it is a worthwhile investment. There are instances whereby patients make an annual voluntary contribution or, alternatively, make an annual subscription to become members of the group. Many groups are also active fundraisers; others have elected not to get involved in this area. Costs will be determined by the activities of the group (ie, the more proactive, the higher the costs). It will be up to the practice, in consort with the group, to determine their approach to this element.
NAPP has more than 250 PPGs affiliated to the organisation, and PCTs are also discovering the benefits of belonging to such a body. Upon affiliation, at a current cost of £25 per annum, a practice will be sent The Handbook of Patient Participation, together with a certificate of affiliation.
The handbook is an invaluable toolkit, packed with all you need to know about PPGs: starting up, maintenance, continuity and the development of ideas for your own group.
I hope you have found this information helpful and that you will realise the potential benefits for the practice and your patients in starting a patient participation group.
- Battye R. Activity survey 2003. In:The handbook of patient participation. NAPP; 2004. Sect. 4.1-4.8
To find out more about patient participation groups, or to enquire about affiliation to NAPP, you will find the following contact points useful:
The Hon Secretary NAPP
10 Rosegarth Avenue
T/F 0114 2874035