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Building better participation: patients as partners in healthcare

Since April 2016, it is a contractual obligation for all GP practices in England to have a patient participation group (PPG). Dr Patricia Wilkie, president and chairman of the National Association for Patient Participation (N.A.P.P.), discusses how to build better working relations on the frontline.

The NHS and general practice are generally revered institutions providing treatment free at the point of delivery, but paid for out of general taxation. And yet patients and the public know relatively little about the organisation of general practice, the implications of guidelines, protocols, targets, and referral management schemes on how GPs consult and work, how practices are funded, the price of different elements of healthcare, and the standards of care patients can expect. 

The (WHO) Alma Ata Declaration of 1978 recommended that people have a duty and a right to participate individually and collectively in the planning and implementation of their healthcare. In the same year visionary and exceptional GPs from the West Country established N.A.P.P to promote patient involvement in decision-making in the NHS and in their own care through the development of PPGs. Almost 30 years later, the NHS Forward View endorsed these views in the statement that “patients must be able to influence healthcare as a key partner”. And as of 1 April 2016, it is a contractual obligation for all GP practices in England to have a PPG. 

Updated guide

In 2016 N.A.P.P. launched an updated guide, ‘Building Better Participation (BBP)’, to help PPGs and their practices work well together. The BBP guide, supported by NHS England, is not compulsory but was designed to be dipped into to meet and reflect the very great diversity of practices and PPGs, and can help a practice work more effectively with the PPG. 

BBP describes clearly how to get a PPG in place, the ground rules for working, the various methods for communicating and involving all patients and how the practice will support the PPG. 

It also explains how PPGs and their practices can work well together. PPGs are groups of active volunteers working with the practice in a mutually agreed and documented relationship built on trust and respect. Most meet face-to-face preferably with the practice manager and/or a GP. Some also have virtual groups that work best when they are in addition to a face-to-face group. 

BBP demonstrates how PPGs can help the practice. Patients have more to offer doctors than their illnesses. PPGs have intelligence of the wider community including patients who do not attend the practice often. They can also help inform this community about how to make the most appropriate use of health services; about current regulations and requirements for practices; about the current services and future ideas for the practice; and about the costs of services. 

Helping to implement change 

The PPG supports the practice and helps implement change. They also help patients take more responsibility for their own health. BBP also highlights how the PPG can influence beyond the GP practice by understanding how to work with the practice in relation to regulators and other inspection bodies. This is particularly relevant as Care Quality Commission inspectors now like to meet the PPG. 

The PPG can also contribute to the revalidation of the practice doctors and nurses when asked. 

BBP shows how PPGs can engage with relevant local, regional and national networks feeding useful information to the practice and the wider patient population, and with the practice have shared understanding of the local health and social care system and how they might contribute to it.  

Good GP practices tend to have good PPGs, which is one way of demonstrating their patient focus. Using BBP can help practices set up and establish a good PPG which makes a difference to the practice and patients, is visible to all and which achieves results helping to meet the needs of the patient community. It is surely essential reading!

FOR MORE INFORMATION

The updated ‘Building Better Participation’ guide can be accessed at:

W: www.napp.org.uk/bbp