Patient Participation Group

Dear Patient,

We would like to know how we can improve our service to you and how you perceive our surgery and staff.

To help us with this, we are setting up a virtual patient representation group so that you can have your say. We will ask the members of this representative group some questions from time to time, such as what you think about our opening times or the quality of the care or service you received. We will contact you via email and keep our surveys succinct so it shouldn’t take too much of your time.

We aim to gather around a hundred patients from as broad a spectrum as possible to get a truly representative sample. We need young people, workers, retirees, people with long term conditions and people from non-British ethnic groups.

If you are happy for us to contact you occasionally by email please click the link below to open the sign-up form and complete all the fields.

Please download the sign up form as a pdf document, print it out, complete it and return it to the practice.

Download the pdf version of our sign up form


We will be in touch shortly after we receive your form. Please note that no medical information or questions will be responded to. Many thanks for your assistance

The practice continues to provide tailor made service to our patients based on there needs and demands. In house survey helps us improve our services and all other areas of concern raised by Patients and service users.

We are publishing this years surveys results and analysis done by an independent provider.

We have discussed results of surveys with members of our active Patient Engagement/Reference Group.

If you would like to be involved and contribute in our PEG  please complete the form attached above and hand it in at the reception for the attention of the Patient Engagement Lead Miss Rizwana Shaheen.

Our Patient Engagement Group’s Chair is Mr Shazad Hussain and vice chair is Mr Fazlul Haq.

Thank You.


The information you supply us will be used lawfully, in accordance with the Data Protection Act 1998. The Data Protection Act 1998 gives you the right to know what information is held about you and sets out rules to make sure that this information is handled properly.

Terms of reference and ground rules


Ground rules