Ashdown Forest Health Centre

Patient Reference Group (PRG)

Under new initiatives issued by the Department of Health, practices have been asked to form Patient Reference Groups to ensure that patients are involved in decisions about the range and quality of services provided and, over time, commissioned by their practice.

There are a number of key steps which will be developed over a two year period.

1. Develop a Patient Reference Group (PRG), this must be made up of patients from a cross section of the practice population, with a mix of age groups, ethnicity and sex.

2. Agree areas of priority with the PRG.

3. Collate patient views through the use of an agreed survey

4. Allow the PRG to discuss survey findings and agree required changes

5. Agree action plan with the PRG and seek PRG agreement to implementing changes

6. Publicise actions taken.

We are keen as a practice to initiate this with enthusiasm and energy and want to ensure that the views of patients are fed into the practice. To do this we are compiling a contact list of email addresses so that we can contact you by email now and again to ask you a question or two.

If you would like to be involved either as a member of the PRG group or as a recipient of emails regarding our progress please complete the form below. (If you do not have email, your telephone number will be sufficient)

Name: Email: Postcode:   Telephone number: Mobile number: Are you? Male Female   Age Group: Under 16 years 55-64 years   17-24 years 65-74 years   25-34 years 75-84 years   35-44 years over 84 years   45-54 years     Ethnic Origin: British Group White & Asian Chinese Irish White & Black African Other ethnic group Other Black background White & Black Caribbean     Other mixed background         African Bangladeshi I do not wish to disclose Caribbean Indian   Other Black background Pakistani     Other Asian background   How would you describe how often you come to the Practice? Regularly Occasionally Very rarely Are you registered as having a disability? Yes No Are you a carer or have involvement with looking after somebody with a disability? Yes No (If Yes, is the patient registered with this Surgery?) Yes No Are you interested in joining the PRG Group? Yes No Are you happy to receive email updates/Questions? Yes No