Patient Participation Group

Our Patient Participation Group is a group of patients registered with our practice coming together on a regular basis. In our meetings we look at how we can positively influence the development of the surgery and local health services.

The main focus of the group are the health interests of our patients, along with the development and progress of the practice as a whole.

The group is very interested in feedback, suggestions, comments that you may have about the surgery and we would like to know how we can improve our service to you and how you perceive our surgery and staff. This can be done by joining our Virtual Patient Representation Group. We are in the process of creating a Virtual Patient Reference Group which does not involve face to face meetings.

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 brief so it shouldn’t take too much of your time.

We aim to gather number of 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 complete the sign-up form below:

Your Details

Your name

Date of BirthPlease provide in the format dd/mm/yyyy, for example 18/01/1970

Are you able to provide your NHS or Patient Number?This will allow us to locate you quickly on our Patient Database.

NHS Number

E-mail Address

Postcode

Gender

Which of the following ethnic backgrounds do you most closely identify with?

How would you describe how often you come to the practice?

Privacy Protection

Information submitted through secure forms is used only for the purposes of processing your request. We may be in touch with you in relation to the information submitted.

All Information submitted through secure forms is secured with a private key and is accessed over a secure connection by nominated staff. We have a strict confidentiality policy.

This information is not shared with any third party organisations.

This information is retained for up to 28 days.

I consent to my information being used for the purposes described above and wish to submit this online form to Birchills Health Centre • 23 - 37 Old Birchills, Birchills, Walsall, WS2 8QH.

Learn more about our Privacy Policy and Terms of Use. Should you have any concerns about sending your personal details using the web, please use one of the alternative methods offered by our organisation.

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