Coverage and quality of patient participation groups: a mixed-methods analysis of Care Quality Commission reports

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Abstract
Background: Patient participation in health systems is increasing globally. English general practices have been required to establish patient participation groups (PPGs) since 2015. However, little is known about current PPG coverage and distribution. Aim: To explore the relationship between PPG coverage and quality with general practice deprivation deciles, geographical location, and Care Quality Commission (CQC) ratings. Design and setting: Mixed-methods documentary analysis of quantitative and qualitative data was carried out from general practice CQC reports in Yorkshire and Humber, England. Method: Data were extracted from CQC reports for practices in the most and least deprived areas across three integrated care systems (ICSs). Quantitative data examined PPG coverage by practice deprivation decile, location, and CQC rating. Qualitative thematic analysis assessed PPG quality. Results: Of 122 practices, 99 (81.1%) had a PPG, 16 (13.1%) lacked one, and seven (5.7%) had a partial PPG. Practices in the most deprived areas were significantly less likely to have a PPG than those in the least deprived areas ( P = 0.006). While there were minor differences in PPG coverage between ICS locations, no significant variation was observed based on CQC ratings. PPG activities included workforce adjustments and training, infrastructure, communications, accessibility and appointments, health promotion and education, and fundraising. Conclusion: Practices in the most deprived areas were significantly less likely to have a PPG ( P = 0.006), and their PPGs engaged in different activities compared with those in the least deprived areas. This may exacerbate inequalities as PPGs are one mechanism to support patient participation and improve general practice quality and experience.

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