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Thousands of new patient groups set up as a result of DES

Exclusive: Practices across the country have established thousands of new patient reference groups since last year, as GPs defy expectations to achieve positive results on the patient participation DES.

Figures obtained by Pulse from 28 PCTs, covering 1,960 practices, show 87% of surgeries received payment for setting up a patient reference group – one of the key requirements for the new DES which was introduced as part of the 2011/12 contract settlement.

The poll found 80% of practices opted to take part in the voluntary DES, despite concerns it would create extra workload for practices.

Some 82% of practices agreed which issues were priorities with patient groups and discussed the views of patients through a practice survey, while 80% agreed changes in the delivery of services in light of a patient group's input.

PCTs also disclosed 79% of practices developed an action plan in conjunction with their patient group that took into account issues arising from the survey, one of the other components of the enhanced service.

A spokesperson from NHS Oxfordshire, where 92% of practices that took part achieved full payment, said the high results reflected a positive level of public engagement: ‘The high level of achievement across the county reassures the PCT patient views are being taken into account when delivering primary care services. We are now into the second year and would like to see practices build on the hard work already put in by many GPs and their staff.'

Dr Gillian Rice, a GP in Bristol, said the DES encouraged patient to make suggestions that led to improvements in the practice.

She said: ‘The DES prompted us to make the members of our patient reference group and patient participation groups more representative. We worked harder to incorporate members of different ages and different ethnicities.'

‘It did work well- I can give you examples of time when we've scrapped schemes because they were unpopular with the patient reference group.'

But Stephanie Varah, chief executive of the National Association for Patient Participation (NAPP) said some practices had taken a ‘tokenistic' approach to the DES but still received payment from the PCT.

She said: ‘Feedback from patients has indicated that some practices have taken a limited or tokenistic approach to participation opting to only communicate with patients via email which can exclude those without a computer rather than using a range of methods to reach the widest possible population.'

She added: ‘Other feedback describes practices using standard surveys rather than involving patients in the co-design. Both of these approaches do not meet the stipulated DES requirements and do not lead to meaningful two way engagement, but have been accepted by the PCT as appropriate methods.'

Dr Adrian Midgley, a GP in Exeter ‘It's an example of how the NHS is giving into the temptation to create new paperwork and look busy. We'll need to look back on this scheme in five years and really think was it effective? Or was it just amusing?'

‘It wouldn't be surprising if some practices did take a tokenistic approach. If you offer £5000 to set up a group and do a bit of paperwork then of course they'll do it.'

Dr Brian Balmer, chief executive of Essex LMCs, said the DES had been a burden on smaller practices: ‘It's been more difficult for small practices because of the way that the funding is allocated. It's a lot of paperwork.


DES component

Percentage of practices that received payment

Establish a patient reference group comprising only of registered patients and use best endeavours to ensure it is representative


Agree with the patient reference groupwhich issues are a priority, and include these in a local practice survey.


Collate patient views through a local practice survey and inform the patient reference groupof the findings.


Provide the patient reference groupwith the opportunity to comment and discuss findings of the local practice survey. Reach agreement with the patient reference groupof changes in provision and manner of delivery of services. Where the patient reference groupdoes not agree significant changes, agree these with the PCT.


Agree with the patient reference groupan action plan setting out the priorities and proposals arising from the local practice survey. Seek patient reference groupagreement to implement changes, and where necessary inform the PCT.


Source: Figures obtained by Pulse from 28 PCTs