Publication - Statistics
Health and care experience survey 2017 to 2018: technical report
Information on the technical aspects of the survey, including development, implementation, analysis and reporting.
3. Survey Design
Survey Development
The survey questionnaire was fundamentally redeveloped during Summer 2013, details of which are available in the 2013/14 survey’s technical report www.gov.scot/Publications/2015/03/8892/0.
Minimal changes were made to the 2015/16 survey to ensure comparability and allow reporting of trends over time.
The questionnaire was reviewed again in 2017 to ensure continued relevance of survey questions, to reflect changes to primary care services in particular, and to reduce the overall length of the questionnaire.
The survey materials were also reviewed in 2017 to improve engagement with respondents and to ensure compliance with General Data Protection Regulations. This included improving the information provided to survey recipients in the covering letter and also introducing a privacy notice for the survey which is available at www.gov.scot/HACEPrivacyNotice.
Survey Materials
The initial survey pack included a letter and an information leaflet in a range of languages. Respondents had the option to complete the survey online or via a telephone helpline in a wide range of languages/text phone. The helpline was also available to handle questions or complaints about the survey.
A follow up survey pack was sent to people who had not responded to this initial letter after a couple of weeks. This pack included a reminder letter, an information leaflet and a paper copy of the questionnaire. This is the first time that a reminder letter has been issued since the 2009/10 survey. The reminder was introduced in order to boost response rates, particularly amongst groups of the population that we know are less likely to respond at first contact.
Copies of all of the survey materials and the privacy notice can be found at www.gov.scot/GPSurvey.
Changes to 2017/18 Questionnaire
Table 1: New questions for the 2017/18 survey
| Quest. No. | Topic | Question Text | Reason |
|---|---|---|---|
| 8a | GP Practice | How would you rate the quality of information provided by the receptionist? | Previous questions asked about helpfulness of reception staff, but feedback indicated that this potentially encompasses a wide range of factors. This new question focuses on one particular aspect. |
| 9 | GP Practice | The last time you received treatment or advice at your GP practice in the last 12 months, what did you receive treatment or advice for? | Introduced to understand the context of treatment/advice. |
| 10 | GP Practice | Who provided most of that treatment or advice? | Introduced to allow people to describe treatment received by any healthcare professional – previous surveys had focused particularly on care by doctors and nurses. |
| 11d | GP Practice | I was given the opportunity to involve the people that matter to me. | Included to reflect the five key person-centred "must do with me" areas[2] |
| 11e | GP Practice | I understood the information I was given | Included to reflect the five key person-centred "must do with me" areas[2] |
| 11f | GP Practice | I was in control of my treatment/care | Included to reflect the five key person-centred "must do with me" areas[2] |
| 11g | GP Practice | I knew the healthcare professional well | Included to gauge continuity of care in terms of building a relationship with healthcare professionals at the GP Practice |
| 11h | GP Practice | My treatment/care was well coordinated | Included to gauge continuity of care in terms of coordination of care within the GP Practice. |
| 12 | GP Practice | How would you describe the effect of that treatment or advice | Added to find out the individuals’ view of the treatment outcome, on both symptoms and functioning – to replace Section 4 in previous survey on ‘Health and care effectiveness’. |
| 15 | Referrals | Thinking about the last time you were referred by your GP practice, what type of health professional were you referred to? | Added to better understand the patient journey and the context of the experiences described. |
| 17 | Referrals | Overall, the last time you were referred, how would you rate the care you experienced at the service you were referred to? | Added to understand the quality of care received, in addition to the co-ordination of that care. |
| 19 | Out of Hours | Before contacting this service, which one of the following statements applied: | Added to understand reasons for contacting Our of Hours services. |
| 20 | Out of Hours | What did you receive treatment or advice from this service for? | Introduced to understand the context of treatment/advice. |
| 21b | Out of Hours | I was given enough time | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 21c | Out of Hours | I was treated with compassion and understanding. | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 21d | Out of Hours | I was given the opportunity to involve the people that matter to me. | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 21e | Out of Hours | I understood the information I was given | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 21f | Out of Hours | I was in control of my treatment/care | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 21g | Out of Hours | My treatment/care was well coordinated | Introduced to mirror the person-centred care questions in the GP Practice section. |
| 31 | Carers | Who do you care for? | Added to provide context to caring experiences. (There was interest in understanding what the person needed care for, but this can be derived from the carers census.) |
Table 2: Questions that were changed in the 2017/18 survey
| 2015/16 Q. No. | 2017/18 Q. No. | Topic | Question Text | Reason |
|---|---|---|---|---|
| 1 | 1 | GP Practice | When did you last contact the GP practice named on the enclosed letter? | Response options made more detailed to better understand when last visit took place. |
| 3 | 3 | GP Practice | How easy is it for you to contact your GP practice in the way that you want? | Changed from a focus on ability to contact by phone, to a more person-centred question. |
| 9b | 8c | GP Practice | The arrangements for getting to see another medical professional in your GP practice? | Widened from the previous survey question, which asked specifically about nurses. |
| 15/16 | 11 | GP Practice | Thinking about that healthcare professional, how much do you agree or disagree with the following statements? | Widened from the previous survey question, which asked specifically about doctors and nurses. |
| 10 | 14 | Referrals | Have you been referred to any other NHS health professional in the last 12 months? | Question has been changed to focus on referrals to NHS services and incorporate those who self-referred. |
| 11 | 16 | Referrals | Thinking about the last time you were referred, how would you rate the coordination of your treatment/care? | Question refined to focus on co-ordination of care, which is the main area of interest. |
| 28 | 18 | Out of Hours | Which service did you end up being treated or advised by? | New response option added to include routing for those who haven’t used OOHs. |
| 46 | 33 | About You | What best describes your gender? | Question updated to allow respondents to describe their gender identity. |
| 53 | 37 | About You | What best describes your work status? | Response options updated to incorporate those who are self-employed. |
| 48 | 39 | About You | In general, how would you rate your health? | Response options expanded to enable a more fine grained analysis. |
| 52 | 41 | About You | How would you rate your quality of life as a whole? | Question and response options simplified and made more consistent. |
Table 3: Questions that were removed for the 2017/18 survey
| 2015/16 Q. No. | Topic | Question Text | Reason |
|---|---|---|---|
| 4 | GP Practice | The last time you phoned the GP practice, how helpful was the person who answered? | Responses to this question in previous surveys have been very positive, therefore little value in retaining the question. |
| 8 | GP Practice | When you arrange to see a doctor at your GP surgery can you usually see the doctor you prefer? | The ability of people to see their preferred doctor is likely to be affected by the workforce of each individual practice. In general, there is an emphasis on a person’s care being provided by the whole clinical team. Superseded by (new) Q11g which relates to all healthcare professionals. |
| 12 | GP Practice | In the reception area, can other patients overhear what you say to the staff? | Little use has been made of this question. |
| 13 | GP Practice | How helpful do you find the receptionists at your GP practice? | Responses to this question in previous surveys have been very positive, therefore little value in retaining the question. Superseded by (new) Q8a. |
| 14 | GP Practice | How do you feel about how long you usually have to wait to be seen after you arrive at your GP practice? | Little use has been made of this question. |
| 15c | GP Practice | I felt that the doctor had all the information needed to treat me | It is not clear that individuals would know if this was the case. |
| 15d | GP Practice | The doctor took account of the things that matter to me | Responses to this question in previous surveys have shown no change and have been very positive. This question was removed in favour of questions on other person-centred questions. |
| 15e | GP Practice | The doctor talked in a way that helped me understand my condition and treatment | Responses to this question in previous surveys have shown very little change and have been very positive. This question was removed and replaced with a broader question on understanding information given (Q11e in the 2017/18 survey). |
| 15f | GP Practice | I felt confident in the doctor's ability to treat me | Responses to this question in previous surveys have shown no change and have been very positive. This question was removed in favour of questions on other person-centred questions. |
| 16c | GP Practice | I felt that the nurse had all the information needed to treat me | It is not clear that individuals would know if this was the case. |
| 16d | GP Practice | The nurse took account of the things that matter to me | Responses to this question in previous surveys have shown no change and have been very positive. This question was removed in favour of questions on other person-centred questions. |
| 16e | GP Practice | The nurse talked in a way that helped me understand my condition and treatment | Responses to this question in previous surveys have shown very little change and have been very positive. This question was therefore removed and replaced with a broader question on understanding information given (Q11e in the 2017/18 survey). |
| 16f | GP Practice | I felt confident in the nurse's ability to treat me | Responses to this question in previous surveys have shown very little change and have been very positive. This question was removed in favour of questions on other person-centred questions. |
| 17 | GP Practice | Are you involved as much as you want to be in decisions about your care and treatment? | Responses to this question in previous surveys have shown no change. This question was removed and replaced with a broader question on being in control of treatment / care (Q11f in the 2017/18 survey). |
| 18 | GP Practice | In the last twelve months have you had any blood tests, x-rays or any other tests arranged by your GP practice? | Little use has been made of this question. |
| 19a-d | GP Practice | Thinking about the last time you had a blood test, x-ray or any other test arranged by your GP practice, how much do you agree or disagree with each of the following | Little use has been made of these questions. |
| 20 | GP Practice | Have you been prescribed medicines at your GP practice in the last 12 months? | Little use has been made of this question. |
| 21a-f | GP Practice | Thinking about the last time you were prescribed medicines, how much do you agree or disagree with each of the following: | Little use has been made of these questions. |
| 22 | GP Practice | In the past year, do you believe a mistake was made in your treatment or care by your GP practice (including for example in test results, medicines prescribed, diagnosis)? | There are other sources for information about mistakes and complaints |
| 23 | GP Practice | Were you satisfied with how it was dealt with overall? | There are other sources for information about mistakes and complaints |
| 24a | GP Practice | I am treated with respect | Responses to this question are highly correlated with those to the question "I am treated with compassion and understanding" |
| 26 | Out of Hours | In the last 12 months, have you tried to get medical help, treatment or advice, for yourself or someone you were looking after, when your GP Practice was closed (out of hours)? | Relevant routing (for those who haven’t used the service) has been added to the first Out of Hours question so this question was no longer necessary. |
| 27 | Out of Hours | Thinking about the last time you tried to get help out of hours, which NHS service did you speak to or go to first? | Little use has been made of this question. |
| 29 | Out of Hours | Who ended up providing most of your treatment or care? | Little use has been made of this question. |
| 30a-g | Out of Hours | Thinking of the service that you ended up being treated or seen by, how much would you agree or disagree with the following about your experience? | These questions were dropped in favour of the person-centred focused questions which were introduced to the Out of Hours section to mirror those used in the GP Practice section. |
| 36d | Social Care | I was treated with respect | Responses to this question are highly correlated with those to the question "I am treated with compassion and understanding" |
| 38 | GP Practice | In the last 12 months, have you received NHS treatment or advice because of something that was affecting your ability to live your normal life? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 39 | GP Practice | Thinking about the last time this happened, how would you describe the effect of the treatment on your ability to live your normal life? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 40 | GP Practice | In the last 12 months, have you received NHS treatment or advice because of something that was causing you pain or discomfort? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 41 | GP Practice | Thinking about the last time this happened, how would you describe the effect of the treatment on your pain or discomfort? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 42 | GP Practice | In the last 12 months, have you received NHS treatment or advice because of something that was making you feel depressed or anxious? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 43 | GP Practice | Thinking about the last time this happened, how would you describe the effect of the treatment on how you felt? | Results from this section are not widely used. Decided to replace with other questions about the individuals' view of the outcome of treatment (new Q12) |
| 47 | About You | What was your age on your last birthday? | Age of respondent now being taken from administrative records (see Section 8 for more information). |
| 50 | About You | Are your day-to-day activities limited because of a health problem or disability which has lasted, or is expected to last, at least 12 months? (Include problems related to old age). | Other questions already cover respondents' health and long term conditions |
| 57 | About You | What best describes the accommodation you live in? | This had previously been included to understand the circumstances in which people live. However, limited use has been made of this information. |
| 58 | About You | Do you give your permission for NHS Scotland Statisticians to add your survey results to other information about your health and care for the purposes of analysing this survey? | These questions were removed as part of the information governance review of this survey. Information about how data will be used was provided to respondents in a privacy notice. |
| 59 | About You | Do you give your permission for NHS Scotland Statisticians to add your survey results to other information about your health and care for the purposes of other future research? | These questions were removed as part of the information governance review of this survey. Information about how data will be used was provided to respondents in a privacy notice. |
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