This article brings together research carried out by the National Association for Patient Participation from 2005 to 2009. Its aim was to capture the views of GP surgeries that have patient participation groups (PPGs) as well as those who do not. It also studied the views of PPGs affiliated to the National Association for Patient Participation (NAPP) about their role, their organisation and the support that they require to maximise their success. With the exception of the online, UK-wide members' survey, the research was carried out through postal surveys sent to more than 4000 English practices in three separate studies. The main results relate to the prevalence of PPGs, their geographical location, their activities, the attitudes of practices towards PPGs (especially those that do not have one) and the future needs of PPGs. PPGs are seen to play an important role in providing the practice with the patient perspective but they are active in several other areas, including health promotion, information provision, influencing commissioning, supporting other patients and fundraising (for their own needs as well as those of the practice). Three central challenges are highlighted, relating to (a) the most successful strategies to promote more PPGs; (b) the importance of support from primary care trusts (or their equivalent organisations); and (c) ways in which PPGs can increase their ability to represent the wider patient perspective. A future research agenda is also proposed that would evaluate the costs and benefits of PPGs across their broad range of activities.