How this PCN is revitalising patient groups

When Feltham and Bedfont PCN in London recognised there had been a dip in patient involvement with patient participation groups (PPG), it took action. Orika Riley, senior PCN manager, explains how the network went about rejuvenating the groups and how patients have responded.

Patient engagement has become more important than ever, with increasing contracts and directives channeled through PCNs. At Feltham and Bedfont PCN, we saw patient feedback and involvement as crucial if we were to shape the delivery of services in a way that best meets the needs of our local population in north west London.

And there are significant needs in our PCN patient population of over 80,000. As well as having higher levels of deprivation than our neighbours, we have some of the highest numbers of asylum seekers and refugees in the country, with three large asylum seeker hotels. Many of our patients have English as an additional language (both from asylum seeker and non-asylum seeker populations). And we have high numbers of residents working long hours in transport and logistics due to our close proximity to Heathrow.

The 13 practices in the PCN experienced a significant decline in engagement with their Patient Participation Groups (PPGs) following the COVID-19 pandemic. So in 2023, we decided to revitalise these groups. As well as helping us shape our delivery, we saw it as an opportunity to increase patient awareness of the PCN and the various services it offers.

The initiative is run by me as PCN manager and, before her retirement, Angela Mckenzie, who was senior delivery manager – primary care at the North West London ICB.  

Aims

The project’s primary goal was to foster stronger engagement with patients and increase their awareness of the PCN and the range of services it provides.

By enhancing communication and building more direct relationships with the patient community, we sought to inform individuals about available healthcare options and encourage them to make use of these services more effectively.

Additionally, the project aimed to empower patients with a better understanding of the PCN’s role in their healthcare journey, ensuring they feel supported and confident in accessing the care they need at the right time. This, in turn, was intended to improve overall patient satisfaction and health outcomes by creating a more informed and proactive patient population.

Methods

The first step was to reach out to all patients within our PCN to identify those interested in participating in patient engagement activities. In addition, we conducted surveys to determine the most effective ways to engage with them.

We used a range of methods including:

• Text messages to patients
• Posters
• Information on the website
• Posters on waiting room screens
• Promotion from practice managers

Following this, invitations were sent out for the inaugural PCN PPG meeting. To simplify the registration process, patients were given an Eventbrite link, allowing them to easily book their spot for the meeting.

The first meeting took place at Feltham Assembly Hall – a local community hall. We chose this venue because it is local and central to most of our practices and is used for other community services. For example, it was used for the COVID vaccination clinics, so we felt patients would be familiar with it.

The project is funded by the PCN and involves ongoing costs. Each PPG meeting incurs an approximate expense of £200, covering venue rental and refreshments. This figure does not include the additional costs associated with staff time required to organise and manage the meetings.

Outcomes

Our first PPG meeting was held on 8 June 2023 and 150 patients registered via Eventbrite to attend. However, only around 45 patients turned up. Since then, attendance numbers at our quarterly meetings have fluctuated.

We have held four PPG meetings to date. Maintaining patient attendance and engagement in the PCN PPG meetings has continued to be the biggest challenge we face. 

However, there have been benefits too.

The greatest benefit is that patients feel heard. The meetings provide a valuable opportunity for patients to share their feedback and suggestions, which helps us improve our service delivery. Patient input at the meetings has led to the implementation of several changes. 

For example, in September 2023, there was patient feedback on reception staff asking why patients were calling for an appointment without providing an explanation of why they needed this information. As a result, all practices agreed to send at least one member of their reception team on training to include active signposting, telephone triage and dealing with difficult customers.

And in March 2024, patients suggested we send a text message about PCN services, so we sent an SMS to all registered patients with the link to the PCN website, which showcases the PCN staff roles and enhanced access we deliver.

In October of last year, patients asked whether we could update the practice telephone messages. This has prompted a review of the telephony script at PCN level to be implemented by March 2025.

Collaborative approach

The PPG meetings provide an opportunity to educate patients about the PCN and the range of services available to them. Although anecdotal, we’ve already seen positive results with patients directly requesting PCN services instead of automatically seeking an appointment with a GP.

This collaborative approach has allowed us to work more closely with patients, fostering a stronger partnership. By addressing patient concerns and incorporating their insights, we have improved how we interact with our community and tailor our services to better meet their needs.  

One of the most significant changes has been a greater understanding and compassion for both practice staff and patients. The first PCN PPG meetings had quite a lot of conflict, with patients airing their anger and frustration. Meetings now are about information sharing and collaborative thinking.

Over the course of the meetings, patients’ understanding has evolved. They seem to have come on a journey of acceptance that primary care cannot remain as it was 10 years ago when everyone could see the same GP every time.

Future

We plan to continue with our PCN PPG initiative and we are exploring different strategies to increase participation, such as holding meetings on Microsoft Teams for those who are unable to attend in person. Another idea is showcasing specific PCN services, e.g. social prescribers or first contact physiotherapists talking about their roles. We have created a smaller focus group to come up with other ideas on how we can encourage attendance.

We hope to introduce a PCN newsletter as a new way to engage with patients and keep them updated on changes and developments. The newsletter will be crafted by a dedicated group of our PCN PPG members, providing a platform for direct communication and fostering a stronger connection with our patient community. This is a work in progress.

Ultimately, the aim is to cultivate a more engaged patient population that will help optimise the delivery of healthcare services in our area.