Setting Up and Running PPG

News - 7 April 2026

Patient Participation Groups (PPGs) are groups of patients who work with their GP practice to help improve services. NHS Nottingham and Nottinghamshire Integrated Care Board (ICB) describes a PPG as a group of people who volunteer to work with their GP practice so it works as well as it can for patients and staff. Patient Participation Groups (PPGs) - NHS Nottingham and Nottinghamshire ICB

Is a PPG a legal requirement for GP surgeries?
Yes, for NHS GP practices in England, having and working with a PPG is a contractual requirement. The current standard GMS contract says the contractor must establish and maintain a PPG, review its membership each financial year so it is representative, engage with it in an appropriate and accessible way, review feedback with the group, and make reasonable efforts to implement agreed improvements. The same requirement also appears in the current standard PMS agreement and APMS contract. NHS England’s 2025 patient guidance also says a practice will have a group of patients who can offer feedback and that the practice website should explain how to join. NHS England » You and your general practice – English

A useful bit of context is that the duty is contractual, but the rules do not tell a practice exactly how to run the group. The requirement is to have a PPG, make it representative, engage accessibly, review feedback, and try to act on agreed improvements. It does not set a fixed number of meetings, a fixed constitution, or one single model for every surgery. 

What should a PPG do?
A good PPG should focus on service improvement, not on managing individual complaints or discussing personal clinical cases. The contracts frame PPGs around getting patient views on services and agreeing improvements. Separately, NHS England says formal concerns can be raised with the practice manager, the ICB, or local Healthwatch. CQC has also made clear in a March 2026 example that where a practice had no PPG and no other way of getting patient feedback, that was a weakness in engagement and patient involvement. Inadequate example: Engagement and patient involvement - Care Quality Commission

How to recruit well
The most important point is not just to recruit quickly, but to recruit so the group reflects the practice population. The contract says practices must make reasonable efforts each year to review membership, so the PPG is representative. NHS Nottingham and Nottinghamshire’s PPG resource pack also says not everyone can attend meetings and that some surgeries use an online or virtual PPG to widen involvement. Sometimes a mixed model is used: a small core group that meets, plus a wider virtual group who can respond by email, text, post, or short surveys. That fits the contract requirement for accessible engagement and reflects local advice that virtual PPGs can help people who work, care for others, or cannot attend in person.


Use more than one route to recruit. Nottingham and Nottinghamshire ICB’s engagement toolkit (PPG-Resource-Pack-Updated-20th-January-2023-FINAL-2.pdf) says not to take a one size fits all approach. It recommends different routes and methods, including easy read, online and printed documents, letters, leaflets, text messages, email, social media, websites, hard copy surveys, community and voluntary services, places of worship and local events. 

Make joining simple and visible. NHS England says the practice website should explain how to join the PPG. Local examples show what this can look like. 

How to run the PPG well
Keep the purpose simple. A PPG works best when it is a constructive group that helps test ideas, improves communication and checks whether changes are working for patients. The BMA describes PPGs as a crucial ally and resource for practices. Patient Participation Groups (PPGs) - Safe working in general practice - BMA. 

There is no fixed meeting frequency in the contract, so agree something realistic.

Use basic but clear governance. Good practice is to have named staff support, a short terms of reference, minutes, an action log and public updates. Local Nottinghamshire examples show this in action: 

These are good local examples to learn from, even though each practice will adapt the detail to its own population. 

Accessibility matters from the start. So, offer paper and digital ways to join, use plain English, think about easy read where needed, use accessible venues, offer hybrid or virtual options, ask about communication needs, and avoid relying on online only engagement.

How to sustain a PPG
The best way to keep a PPG going is to show that it makes a difference. Practices should give feedback on what changed as a result of patient input. Wollaton Park Medical Centre provides a useful local example, showing how survey and PPG feedback led to changes such as website improvements, telephony changes and revised reception rotas. Patient Participation Group - Wollaton Park Medical Centre

The wider picture

Locally, it makes sense to build a PPG that is linked not only to the individual practice, but also aware of the wider health and care system. Nottingham and Nottinghamshire current local picture has four place-based partnerships: Nottingham City with 8 Primary Care Networks, South Nottinghamshire with 6, Mid Nottinghamshire with 6, and Bassetlaw with 3. 


In South Nottinghamshire, a useful example of working beyond one surgery is RAPID, the Rushcliffe Assembly of PPGs to Innovate and Develop, which brings together PPG chairs and PCN managers to promote wider patient and public involvement across Rushcliffe. 


In Nottingham West, the Primary Care Network covers the Broxtowe neighbourhoods of Beeston, Eastwood and Stapleford, includes 12 GP practices, and sits within the South Nottinghamshire Place Based Partnership. This means Nottingham West PPG can help shape issues at practice level, while also feeding into wider conversations about access, communication, inequalities and joined up care across the area. 

Healthwatch Nottingham and Nottinghamshire is another important route for raising broader patient experience themes beyond a single practice, as its role is to gather and amplify people’s experiences and use them to influence improvement across health and social care.

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NHS and social care staff are doing everything they can to keep us well during these challenging times, but there might be things that can be improved for you and your loved ones, both in the area you live in and across the country.

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