Patient Participation Group

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• Date: 17 September 2026
• Time: 11am
• Venue: St Mary's Church
• Chair: Dylan Reynolds

Attendees

• Patient representatives from the four neighbourhood practices
• Practice representatives
• Health Inequalities Lead
• Neighbourhood representatives and facilitators
• Together Better engagement care coordinators
• Community Health Champions
• Primary Care Network representatives
• Other community and patient representatives
• 18 people attended

Patient survey and patient feedback

The group discussed the annual requirement for practices to gather feedback from patients. Previous surveys had mainly focused on access, including how patients preferred to contact and access their GP practice.

It was agreed that traditional surveys can sometimes be too restrictive because they direct patients towards predetermined issues. The group therefore considered using a more conversational and open-ended format.

Two suggested questions were:

1. The thing I like most about my GP practice is...
2. My experience at the practice could be improved if...

A third possible question was:

3. How would you prefer the practice to communicate with you or collect your feedback?

Participants felt these questions would allow patients to identify the issues that matter most to them, rather than requiring them to select from a predetermined list.

It was acknowledged that analysing open-ended comments had previously been time-consuming. However, technology could now be used to group responses into common themes, while maintaining patient confidentiality.

Agreed principles for the survey

The survey should:

• Be short, friendly and easy to complete.
• Include no more than two or three main questions.
• Avoid looking like a lengthy or formal questionnaire.
• Provide an opportunity for open comments.
• Allow patients to respond anonymously.
• Be available in different formats.
• Be accessible to people with language, literacy or digital barriers.
• Include face-to-face support wherever possible.
• Be offered to a broad and representative range of patients.
• Clearly explain how the feedback will be used.

Methods for collecting feedback

There was strong support for gathering feedback face-to-face. Participants felt patients may be more willing to speak openly to another person than complete a formal questionnaire.

Suggested methods included:

• Patient Participation Group volunteers approaching patients in waiting areas.
• Reception staff offering the survey to patients while they wait.
• Volunteers recording responses for patients who would prefer to speak rather than write.
• Paper copies in reception and waiting areas.
• Text-message links for patients who prefer digital communication.
• Focus groups involving selected patient groups.
• Community-based conversations and neighbourhood events.
• Offering translated or interpreted support where required.

It was noted that patients often arrive early for appointments, making the waiting area a good place to invite feedback.

The group felt that volunteers should explain that they are patients themselves and that the purpose is to improve services. This may make the process feel more personal and less like a routine administrative exercise.

Survey fatigue

Participants raised concerns about the large number of surveys patients receive from healthcare organisations and other services.

Patients may ignore surveys when:

• They receive too many requests.
• The questionnaire is too long.
• The questions are repetitive.
• The survey appears overly formal.
• They do not understand how their feedback will be used.
• They do not believe their feedback will result in change.

It was agreed that the proposed survey should be brief, purposeful and more conversational. Where possible, the practices should report back to patients using a "You said, we did" format.

Inclusion and representation

The group discussed the difficulty of obtaining feedback from a representative cross-section of the patient population.

Traditional PPG membership may not fully represent:

• Younger people.
• Working-age patients.
• Patients who do not speak English as their first language.
• Digitally excluded patients.
• People with disabilities.
• Patients with long-term conditions.
• Socially isolated patients.
• Patients from minority ethnic and faith communities.
• Patients who are less confident engaging with healthcare services.
• People experiencing deprivation.
• Patients registered with a practice outside the neighbourhood in which they live. 

Allerton Road Surgery

A particular concern was raised regarding the significant number of Haredi patients registered at Allerton Road Surgery. It was explained that text-message surveys and digital invitations may not reach a substantial proportion of this community.

For this reason, face-to-face engagement at reception and support from trusted community representatives were considered particularly important.

Language barriers were also identified as an issue across the neighbourhood. Surveys should therefore use plain English and, where possible, be translated into the main community languages.

Focus groups

The group discussed focus groups as an alternative or additional way of collecting detailed feedback.

A focus group could:

• Include patients from different demographic groups.
• Explore patients' experiences in more depth.
• Provide refreshments and a welcoming environment.
• Use an experienced facilitator or moderator.
• Be recorded or documented with the participants' consent.
• Identify issues that may not be captured through written surveys.

It was recognised that focus groups would require planning, suitable funding, accessible venues and facilitation support.

Communication and coordination of care

Communication was identified as a significant theme.

One patient described experiencing difficulty obtaining support before an MRI scan because of claustrophobia. The hospital advised the patient to contact the GP practice, while the practice advised the patient to contact radiology. This left the patient feeling anxious and unsure where to obtain support.

The discussion highlighted a need for:

• Clearer communication between hospitals and GP practices.
• Better pre-appointment information for patients.
• Clear responsibilities between different services.
• Recording relevant support needs and reasonable adjustments.
• Information about whom patients should contact if they need additional support.
• Timely hospital letters and clinical reports.
• Clearer information about the purpose of referrals and hospital appointments.

Patients with multiple conditions or those moving repeatedly between primary and secondary care may have different experiences from patients attending for a single, isolated issue. The group agreed that feedback should be sought specifically from patients who have experienced care across several services over an extended period.

Health inequalities work

Rob introduced himself as a GP at Cedar Practice and the Health Inequalities Lead for the four practices in the neighbourhood.

He explained that health inequalities are broad and can include differences relating to:

• Access to healthcare.
• Health outcomes.
• Ethnicity or race.
• Spoken language.
• Disability.
• Socioeconomic deprivation.
• Social isolation.
• Understanding of NHS information.
• Sex, gender or sexuality.
• Long-term conditions.
• Geographic and practice boundaries.

The purpose of the work is to identify groups experiencing poorer access or outcomes, understand the reasons for the differences, and develop practical solutions.

Patient involvement in the leadership group

The neighbourhood Leadership Group currently does not have direct patient representation.

Rob advised that discussions were taking place with Homerton regarding a consistent process for involving patients across City and Hackney neighbourhoods.

Patient representatives could:

• Attend Leadership Group meetings.
• Raise concerns identified within their communities.
• Bring lived experience into decision-making.
• Challenge existing arrangements constructively.
• Help shape projects and priorities.
• Support communication between the Leadership Group and local communities.

Attendees interested in participating were invited to leave their email addresses so they could be contacted when further information becomes available.

Community Health Champions and accessible information

The group recommended that the Health Inequalities Lead link with the Community Health Champions Network.

Community Health Champions may provide:

• Knowledge of local communities.
• Connections with people who do not routinely engage with GP practices.
• Support with community engagement.
• Insight into barriers experienced by different groups.
• Help sharing accessible health information.

A need was also identified for simple, easy-read versions of NHS information. Some existing information was considered too complicated for patients and community representatives to use effectively.

Neighbourhood structure and community services

Participants said that the number of local organisations, programmes and services could be confusing. There may also be duplication where organisations are not fully aware of each other's work.

The group felt the neighbourhood should:

• Map available services.
• Clarify the roles of different organisations.
• Improve signposting.
• Reduce duplication.
• Strengthen communication between services.
• Make information easy for patients and staff to find.
• Build on existing community resources before developing new services.

It was recognised that, in many cases, resources may be better used to connect patients with effective existing services rather than creating new projects.

Neighbourhood forums and action groups

The Neighbourhood Facilitator explained that neighbourhood forums are open to people who live or work in Hackney.

The forums focus on different health priorities and feed information into relevant action groups and the Leadership Group.

Current priorities include:

• Young people’s access to services, including support for mental health.
• Support for people with long-term health conditions.
• Social isolation.
• Access to health and community services.

The next neighbourhood forum was expected to take place around November or December, with further information to be circulated.

It was suggested that neighbourhood forums could provide a suitable setting for focus groups and patient feedback sessions.

Young people and schools

The group discussed increasing levels of anxiety among young people and the significant pressures experienced by school staff.

Participants asked whether stronger links could be developed between neighbourhood health services and local schools. It was acknowledged that engagement varies between schools and that school workloads can make participation difficult.

The neighbourhood team has established links with some local schools, but further work is needed to build consistent relationships.

Long-term conditions and social isolation

Work relating to long-term conditions has identified that some patients manage the clinical aspects of their conditions but remain socially isolated.

The neighbourhood is therefore considering how patients can be connected with:

• Community activities.
• Peer support.
• Exercise programmes.
• Social groups.
• Volunteering opportunities.
• Other non-clinical support.

The group recognised that health outcomes are influenced not only by clinical treatment but also by social and environmental factors.

Together Better services

The Together Better engagement care coordinators described the activities available to patients across the neighbourhood.

Services include:

• Exercise classes.
• Coffee mornings.
• Social activities.
• Book clubs.
• Creative writing.
• Digital inclusion support.
• Help with the NHS App and technology.
• Acupuncture as part of a pilot programme.
• Volunteering opportunities.

Many activities are led by patients who initially attended as participants and later chose to volunteer or share their skills. Qualified professionals lead activities where specialist credentials are required.

GPs and other healthcare professionals may refer patients who are socially isolated, need support with their mental wellbeing, or would benefit from increased physical or social activity.

Neighbourhood and practice boundaries

Concerns were raised about patients who live in one neighbourhood but are registered with a GP practice in another.

This may create difficulties regarding:

• Access to neighbourhood services.
• Eligibility for home visits.
• Continuity of care.
• Understanding which services are available.
• Participation in local engagement activities.

The specific circumstances of the Haredi community were highlighted, as family and community considerations may influence which practice a person registers with.

The group asked for greater clarity about how neighbourhood arrangements recognise cross-boundary patients and whether previous commitments regarding this issue have been implemented.

Palliative and end-of-life care project

Rob advised that he and the PCN paramedic, James, are working on a project relating to palliative care and conversations about end-of-life wishes.

Due to the potentially sensitive and distressing nature of the subject, this was offered as an optional discussion at the end of the meeting.

Patient input will be sought to support the development of clear and appropriate information for the local community.

Local transport

The group briefly discussed proposals affecting the 254 bus route and potential changes to the frequency of the 253 service.

It was noted that public transport is relevant to health inequalities because changes to local routes can affect patients' ability to attend appointments and access community services.