Patient Participation Group Policy

Introduction

Policy statement

Since 1 April 2015, it has been a contractual requirement for all organisations to have a Patient Participation Group (PPG). The requirements of the organisation to have a PPG are shown at Part 5.2 of the contract and under para 5.2.1 the purposes are to:

• Obtain the views of patients who have attended the organisation about the services delivered.
• Enable the organisation to obtain feedback from its registered patients about those services.

PPGs have a key role to play as they help to ensure that patients and carers can influence their local services.  Furthermore, it is vital that every patient and carer is aware that a PPG exists at Spa Medical Centre, the purpose of the group and how they can get involved.

Principles

Spa Medical Centre has a responsibility to respond to service user demand and will conform to the following principles:

• Good public and patient participation enable the design and delivery of services and programmes that are grounded in reality and better reflect people's needs.
• Meaningful public and patient participation builds trust, creates a partnership approach, leads to improved planning and the early identification and addressing of potential problems.
• Participation activities should be embedded in the organisation programme, including timescales and milestones for delivery, with sufficient time to plan and deliver robust participation approaches.
• Understand who will be involved.
• Those who experience the greatest disadvantages and exclusion often experience the poorest health outcomes; it is vital to work proactively with these patient groups.
• Encourage inclusive participation by making use of multiple and diverse approaches, learning from previous activities.
• Make use of existing networks to build on community strengths and avoid unnecessary duplication of effort.
• Good engagement seeks and acts on people's views and ideas but also feeds back how things have changed as a result of participation.

KLOE

The Care Quality Commission would expect any primary care organisation to have a policy to support this organisation's Patient Participation Group (PPG).

Therefore, at Spa Medical Centre, this policy is classified as 'Expected' and should be used as evidence of compliance against CQC Key Lines of Enquiry (KLOE). Specifically, for Patient Participation, Spa Medical Centre will need to answer the CQC Key Question on "Well-Led". 

The following is the CQC definition of Well-led:

"By well-led, we mean that the leadership, management and governance of the organisation assures the delivery of high-quality and person-centred care, supports learning and innovation, and promotes an open and fair culture".

CQC KLOE W7

How are people who use the service, the public and staff engaged and involved?

W7.1

Are people's views and experiences gathered and acted on to shape and improve the services and culture? Does this include people in a range of equality groups?

W7.2

Are people who use services, those close to them and their representatives actively engaged and involved in decision-making to shape services and culture? Does this include people in a range of equality groups?

W7.5

Is there transparency and openness with all stakeholders about performance?

Status

The organisation aims to design and implement policies and procedures that meet the diverse needs of our service and workforce, ensuring that none are placed at a disadvantage over others, in accordance with the Equality Act 2010. Consideration has been given to the impact this policy might have with regard to the individual protected characteristics of those to whom it applies.

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment.

Training and support

This document and any procedures contained within it are non-contractual and may be modified or withdrawn at any time. For the avoidance of doubt, it does not form part of your contract of employment.

Scope

Who it applies to

This document applies to all employees, partners and directors of the organisation. Other individuals performing functions in relation to the organisation, such as agency workers, locum clinical staff, PCN personnel and contractors, are encouraged to use it.

Why and how it applies to them

Patient participation is a contractual requirement. It is the most appropriate way to maintain robust communication and interaction with a representative sample of the patient population. 

All staff must understand that the PPG exists, who the organisation lead for the PPG is and how to direct patients to relevant PPG sources of information.

Patient Participation Group overview

The role of the PPG

Spa Medical Centre has a PPG currently consisting of 12 members who meet on a quarterly basis. The role of the PPG includes:

• Being a critical friend to the organisation
• Advising the organisation on patient perspective and providing an insight into the responsiveness and quality of services
• Encouraging patients to take greater responsibility for their own and their family's health.
• Carrying out research into the views of those who use the organisation.
• Organising health promotion events and improving health literacy
• Regular communication with the patient population

The structure of the PPG

Whilst there are no contractual requirements regarding the structure of a PPG, for effectiveness at Spa Medical Centre there is to be a PPG which will include:

• Chairperson/Vice Chairperson (if appointed)
• Secretary
• Treasurer (if required)
• Any additional posts may be created at the AGM if proposals are made.

The committee will not exceed 20 members who may be part of face-to-face or virtual groups. Should a member cease to be registered at the organisation, then they will cease to be a member of Spa Medical Centre PPG.

Job descriptions for these posts are shown at Annex A.

PPG membership

PPGs should consist of a representative sample of the organisation population and representatives must:

• Be registered as either a patient or carer of a patient at the organisation.
• Remain objective, contributing to group discussions appropriately with the patient at the forefront of their mind.
• Work in a collaborative manner with all group members
• Listen to the views of group members.
• Adhere to the terms of reference for PPG members.
• Commit to upholding the following seven key Nolan principles of public life:
  • Selflessness
  • Integrity
  • Objectivity
  • Accountability
  • Openness
  • Honesty
  • Leadership

Membership is not restricted to those patients or carers who can attend face-to-face meetings. Members can contribute to discussions remotely if arranged in advance.

Role of PPG members

Spa Medical Centre will encourage PPG members to:

• Liaise with patients and carers, discussing concerns and comments pertinent to organisation services.
• Champion the PPG, actively engaging with the patient population and local community.
• Attend and contribute to meetings, sending apologies in advance to the secretary in cases of known absence.
• Remain polite and objective throughout meetings, listening to and respecting other members.
• Be constructive and balanced when contributing to PPG meetings.
• Represent the patient population effectively, expressing the views of the population in an objective manner.
• Undertake any training and development opportunities that may arise for the benefit of the PPG.

The Patients Association in conjunction with NHS (E) have produced a Confidentiality Policy and Declaration Agreement (Annex C) for PPG members that is to be used at Spa Medical Centre.

All PPG members are to sign the declaration on page four of the policy and return it to the Practice Manager.

PPG meetings

PPG meetings take place quarterly. Prior to the meeting, the chairperson will email members the agenda for the meeting. 

The standing agenda should follow a similar format to the example below and include the following:

 PPG terms of reference

Terms of reference for Spa Medical Centre PPG can be found at Annex D to this policy.

PPG checklist

The Patients Association has produced a template for a PPG checklist which can be used to review the current structure and effectiveness of the PPG before formulating an action plan to improve the effectiveness of the PPG, if necessary.

PPG toolkit

London-wide LMCs, in conjunction with the Patients Association, have produced a toolkit which may be used to review and set the future framework for the PPG at Spa Medical Centre.

Additional resources

Useful guidance on PPGs can be sought from The Patients Association or Healthwatch.

Summary

Patient Participation Groups are an invaluable forum for patients and carers to influence their local services, ensuring Spa Medical Centre meets the needs and wishes of the patient population.  

Furthermore, through constructive feedback, Spa Medical Centre will be able to make improvement to services, ensure compliance with CQC regulations but, ultimately, will build a strong relationship with the patient population.

Annex A – Job descriptions for key members of the PPG

All key members of the PPG are required to be a registered patient of the organisation, and all must fulfil their role as detailed at Section 3.4.

The following key members will have roles duties and responsibilities as indicated.

Chairperson/Vice Chairperson (if appointed)

Appointment/role

1. The chairperson shall be elected by the PPG members to serve for a period of 24 months from the [date of meeting] as the first item on the agenda and may stand for re-election. 
2. The chairperson shall stand down after a period of 2 consecutive years and may not be elected for a further period of 12 months.
3. If the chairperson wishes to terminate their role before their elected time is concluded they are to inform the Practice Manager in writing (an email will suffice).
4. Any election shall take place by a show of hands from those present at the meeting. 
5. Nominations for the post of chairperson must be supported by a proposer and a seconder at the meeting. 
6. In the absence of the chairperson, one of the other PPG members will be invited to chair the meeting.
7. The role of the chairperson is to ensure that PPG meetings are conducted in accordance with its terms of reference. 

Duties and responsibilities

Duties and responsibilities may include but not be limited to: 

• Setting the agenda in conjunction with the organisation manager
• Welcoming new members and making introductions
• Introducing speakers
• Ensuring that the timing of the agenda is maintained
• Ensuring that each member has an opportunity to speak and to control the meeting
• Ensuring that contributions shall be non-political and non-sectarian at all times respecting diversity and exemplifying the PPG's commitment to the principles contained within the Equality Act 2010
• Ensuring that the ruling of the chairperson is final on matters relating to orderly conduct

Qualities

The qualities which a good chairperson should have are:

• Previous experience in the role of chairperson
• Leadership skills
• Assertiveness
• Be respected and active in the community. 
• Good at networking
• Diplomacy, tact and consideration for others

Secretary

Appointment/role 

1. The secretary shall be elected by the PPG members to serve for a period of 12months from the date of meeting as the first item on the agenda and may stand for re-election.
2. The secretary shall stand down after a period of 3 consecutive years and may not be elected for a further period of 12 months.
3. If the secretary wishes to terminate their role before their elected time is concluded they are to inform the PPG chairperson copying in the organisation manager in writing (an email will suffice).
4. Any election shall take place by a show of hands from those present at the meeting. In the event of a tie, the chairperson will have the deciding vote.
5. Nominations for the post of secretary must be supported by a proposer and a seconder at the meeting.
6. In the absence of the secretary, one of the other PPG members will be invited to act as secretary to the meeting.
7. The role of the secretary is to assist the chairperson in ensuring that PPG meetings are conducted in accordance with its terms of reference.

Duties and responsibilities

Duties and responsibilities may include but not be limited to:

• Deputising for the chairperson at meetings in the event of them being unable to attend or resigning, until a replacement can be elected.
• Upholding the PPG's terms of reference
• Working with the PPG chairperson and relevant practice/organisation staff to ensure relevant PPG documentation is circulated to PPG members in a timely and appropriate fashion prior to any PPG meeting in accordance with the PPG's terms of reference.
• Working with the PPG chairperson and relevant practice/organisation staff to review all PPG documentation (for example, meeting minutes and reports) to ensure that this is accurate and appropriately reflects the work of the PPG and that these are, where appropriate, displayed prominently on a notice board in the organisation and on the organisation's website.
• With the assistance of the practice/organisation manager, providing an email address whereby patients can contact the secretary to raise matters of importance. When patients contact the secretary, he/she will subsequently discuss this with the PPG chairperson, and they will collectively agree the appropriate course of action.
• Providing a brief induction to all new PPG group members (for example, an explanation of how the PPG works and ensuring the new member signs the relevant paperwork)

Qualities

The qualities which a good secretary should have are:    

• Previous experience in the role of secretary is desirable.
• Well-organised
• Good at note-taking.
• Punctual
• Ability to write clearly and concisely with a good command of the English language.
• Good IT skills are desirable.

Annex B - application to join the PPG

Apply to join the PPG

Annex C - Patient Participation Groups Confidentiality Policy and Declaration Agreement for Volunteers

Introduction

This policy shall apply to all volunteer members of the Patient Participation Group (PPG).

Volunteers shall normally be considered to be those individuals who are not bound to the practice by contract of employment or any other form of contract. Practice staff who have, at any moment in time, responsibility for the conduct and discipline of volunteers within the bounds of the practice shall be required to comply with this policy in relation to ensuring confidentiality awareness in any situation which may arise.

Confidentiality

1. All information held at the practice about patients is deemed confidential whether held electronically or in hard copy.
2. All information about the practice, including financial and staff records, is also deemed confidential whether held electronically or in hard copy.
3. Volunteers should not have direct access to confidential information held by the practice. This includes any information concerning an identifiable patient (or a patient who could potentially be identified on the basis of the confidential information). Access to any such information is only permissible with the written authorisation of the patient concerned or their authorised representative.
4. If during the course of his or her activities within the surgery a volunteer overhears or otherwise comes by confidential information, the facts will, as soon as is reasonably practicable, be referred to the Practice Manager or other authorised person within the practice and that information will not be disclosed to any other person.
5. If a situation arises where a patient contacts the PPG member directly, the code of conduct and confidentiality agreement must be adhered to.

Definitions

For the purpose of this policy the definitions of the following key words shall apply:

• Confidential:  something that is intended to be kept secret, classified, restricted or suppressed; something that is personal, private and trusted.
• Safeguarding: protecting the safety and welfare of vulnerable individuals such as children and young people and those with a learning or mental or intellectual impairment.

Policy - induction of volunteers

• At the point of being accepted as a prospective volunteer, an authorised member of practice staff shall brief the volunteer on the contents of this Confidentiality Policy and of its paramount importance to the business of the practice, staff and patients alike.
• Prior to commencing any authorised activity or duties within the practice, an authorised member of practice staff shall also ensure that the volunteer has read and understood the document titled 'Guidelines for Volunteers - Confidentiality' (below) and is aware of their safeguarding obligations.
• The authorised member of the practice shall then ensure that the volunteer is committed to complying with this policy and also with the Confidentiality Guidelines and is advised of the disciplinary consequence of failing to do so. Breaking the Data Protection Act could have legal implications and would mean that the volunteer could no longer continue in that role.
• A volunteer and PPG member who satisfies the preceding elements of this policy shall then be invited to sign a declaration in the presence of the authorised member of practice staff.

Responsibilities

• Any safeguarding issue must be reported immediately to the Practice Manager.
• All information relating to practice staff and patients shall be considered confidential at all times. This information may be spoken, documented, or electronically stored, transmitted or displayed on any kind of electronic device.
• All information relating to a patient's identity, presence at and/or reason for visiting the practice, even within the physical boundaries of the practice (including any area occupied by an associated activity, for example, a pharmacy) is equally confidential. This extends to the identity of anyone accompanying the patient at the time of said visit.
• Any unauthorised disclosure is a breach of confidentiality and may be regarded as an absolute disqualification from volunteer status.

Guidelines for volunteers - confidentiality

1. Discuss your activities with an authorised member of practice staff on a "need to know" basis.
2. Such discussions should be discreet and in private.
3. Oral reporting of your activities should be conducted in private (for example, with the Group Chair/Practice Lead) or, when it is a part of discussion at public meetings, you should have due regard for discretion and confidentiality.
4. When requesting information from a patient in the Patient Waiting Room, such conversation should be conducted as quietly and discreetly as possible with voices directed away from others who might hear.
5. Where it is easier for the patient to fill in a questionnaire or form, they should be invited to do so, but vigilance is then required to ensure that their feedback is not seen by others or lost.
6. Questionnaires, or other forms, completed in the Patient Waiting Room or elsewhere and containing personal details shall be confidential and shall remain in the custody of the volunteer until handed over to the designated member of staff for that activity.
7. When using a phone or other electronic device, make sure that any other conversations within the practice cannot be accidentally transmitted at the same time.
8. During authorised use of computer systems, always ensure that all access codes and passwords are safeguarded.
9. When responsible for a Personal Computer (PC) terminal or Visual Display Unit (VDU) screen, always ensure that the screen is only visible to you, the user. Where necessary, isolate the PC terminal or VDU screen by shutting and locking any access doors. Always log off before leaving the PC/VDU unattended.
10. Always ensure that paper waste containing confidential information is completely cleared away and disposed of safely by shredding on site.
11. Always ensure that any computer accessories you need are owned and screened by the practice prior to use. Privately owned devices must not be used.
12. Do not use practice equipment for own use.

Volunteers shall not:

• Behave contrary to the preceding guidelines/ best practice.
• Disclose confidential information to any unauthorised persons.
• Copy confidential information for any unauthorised use or reason.
• Remove confidential information from the practice premises.
• Take custody of confidential information when not authorised to do so.

Annex D - Terms of reference

Spa Medical Centre Patient Participation Group Terms of Reference

Group structure

Spa Medical Centre PPG will consist of no more than 20 members, drawn from the patient population at Spa Medical Centre. Any member who leaves the organisation ceases to be a member of the group immediately.

The group will comprise of officers and patients of the organisation, with the following committee positions:

• Chairperson 
• Secretary

Other positions may be added as deemed appropriate at the Annual General Meeting (AGM).

Meeting frequency and attendance

Spa Medical Centre PPG will meet on a quarterly basis; meetings must have in attendance at least four members if they are deemed to be quorate. To maintain momentum within the PPG, any members who fail to attend 3 meetings consecutively will be asked if they wish to continue to actively participate in the group. If not, they will be asked to resign.

Committee members will prior main PPG meeting for planning purposes.  

Members are requested to adhere to the following etiquette:

• Submit apologies for non-attendance prior to the meeting.
• Attend meetings punctually.
• Be prepared to discuss items on the agenda for which they are the lead.
• Respect the views of others.
• Acknowledge the vote of the majority and, should the vote be tied, that the chairperson may exercise the casting vote (optional)

Face to face and virtual PPG

Spa Medical Centre will operate a face to face and virtual PPG via WhatsApp. Both are intrinsically linked and members of either group will adhere to these terms of reference. Furthermore, the members of both groups will be expected to sign a Confidentiality Policy and Declaration Agreement.

Aims of the PPG

The aim of the Spa Medical Centre PPG is to establish and embed an effective relationship between the organisation team and the patient population, communicating patient experience, concerns, suggestions, comments and compliments in an objective manner.

The PPG will work collaboratively with the organisation, on behalf of the patient population, ensuring the services of the organisation meet the needs and wishes of the patient group.

The organisation agrees to work collaboratively with the PPG on behalf of the patient population ensuring they listen to feedback, concerns, suggestions, comments and compliments in an objective manner, taking the necessary action to improve services where applicable.

PPG members will act as the information conduit between the organisation and the organisation population and the wider community, ensuring that all parties are aware of any issues or initiatives which are, or are likely, to affect patients.

Specific activities

The PPG will obtain feedback from the patient population about the services delivered by Spa Medical Centre. Members will review the feedback, informing organisation staff accordingly, identifying areas for improvement. This information will then be relayed to the patient population.

The PPG will promote the organisation at every opportunity, helping the community to understand the range of services available. In addition, members will promote online services, encouraging patients to register for such services.

The PPG will maintain a prominent presence online and in the organisation waiting room, displaying pertinent information. Additionally, the PPG will meet with the patient population opportunistically, gathering information for feedback as well as promoting the services of the organisation.

The PPG will be involved in all areas of organisation development, relaying patient feedback and/or concerns, promoting organisation and CCG led health initiatives wherever possible.

The PPG will liaise effectively with organisation staff, sharing information regarding issues which may affect both patients and staff, whilst relaying issues identified by staff, in order to improve service provision or raise patient awareness.

Committee responsibilities

In addition to the above, the chairperson is responsible for:

• Ensuring meetings are held on a regular basis.
• Facilitating the AGM
• Ensuring all committee and group members adhere to the terms of reference.

The vice chairperson is responsible for:

• Supporting the chairperson throughout his or her tenure
• Deputising for the chairperson in periods of absence
• Ensuring committee members are aware of their roles and responsibilities.

The secretary is responsible for:

• Producing the agenda at least one week prior to the quarterly meetings
• Taking and issuing the minutes of the quarterly meetings
• Retaining a record of all decisions made at meetings.
• Retaining all PPG meeting administration effectively and securely