Health and Care Experience Survey 2021 to 2022: technical report

5. Fieldwork

The Scottish Government contracted Quality Health Ltd to administer the survey. Quality Health Ltd has in-depth experience of NHS surveys, and has provided support for other care experience survey work both in Scotland and elsewhere in the UK. Public Health Scotland provided support for the administration of the survey along with Scottish Government analytical staff.

Mail-out

The fieldwork began on 3^rd November 2021. In total, 537,924 letters and information sheets were posted out in batches between 3^rd and 4^th November 2021. These initial letters asked respondents to complete the survey online, but also included a helpline number. 1,069 of those initially sampled were identified as deceased or no longer eligible for the survey via checks with NHS CR and Atos Origin Alliance between the sample being drawn and prior to the first day of mail-out.

Reminder letters including a paper version of the questionnaire, were sent out from the 17^th November until the 26^th November 2021.

Survey Helpline Calls

During the fieldwork a telephone helpline answered queries from people surveyed. In total, 2,071 telephone enquiry calls were answered by the telephone and language line. This was a substantial decrease on the number received in 2019/20 (which was 3,390), which is likely due to improvements in the survey materials which made the URL of the online survey easier to read. Calls fell into the broad categories shown in Table 5. The number of helpline calls regarding telephone completions is greater than the number of telephone completions received (Table 12) as respondents are able to start a telephone completion, take a break and then call back later to complete the questionnaire, resulting in more than one call to the helpline for some telephone completions.

People who were recently deceased

The people included in the 2021/22 survey were sampled from an extract taken from the CHI database provided to Public Health Scotland on 6^th October 2021. The sampling, questionnaire printing and mail-out process extended from this date through to the final mailing date of the 26^th November 2019. This meant that some people would have died between the extract date and mail out dates.

As with all Care Experience surveys, every possible effort was made by Quality Health Ltd, Public Health Scotland and the Scottish Government to avoid questionnaires being sent to family members of people who had died. Therefore, in the same way to previous surveys, a list of people included in the initial sample was sent to NHS Central Register (NHS CR^[3]) and linked to the National Records of Scotland deaths database register to identify people who had recently died and remove them from the sample.

The list of people sampled for the survey was shared with Atos Origin Alliance (who host the CHI database).

This approach provided a check on a daily basis for people who had died and notifications to be sent to Public Health Scotland throughout the mail-out period. Public Health Scotland subsequently passed this information on to Quality Health Ltd, who removed survey packs as required prior to mail out. Having access to information about recent deaths greatly reduced the number of questionnaires being sent to addresses of people who had died. We are grateful to NHS CR and Atos Origin Alliance for their help and support during this stage of the project.

A total of 645 people were identified as deceased by NHS CR and Atos checks and removed from the sample prior to and on the initial mail-out day of the survey on the 3^rd November 2021. These individuals were not sent survey packs. In addition, 424 people were identified through these checks as no longer eligible for the survey. NHS CR and Atos Origin Alliance identified a further 32 people as deceased on the second mail-out day (4^th November 2021). Public Health Scotland subsequently passed this information on to Quality Health Ltd, who removed remaining survey packs as required prior to mail out.

NHS CR and Atos Origin Alliance checks identified 516 people as deceased during the reminder mail out period (up to the 26^th November 2021). Public Health Scotland passed this information to Quality Health Ltd, who ensured these people were not sent survey packs. These figures include a small number of cases where the death status of individuals could not be confirmed or patients were no longer eligible for the survey.

In 39 cases a questionnaire was sent to someone who had died and the person's family had contacted Quality Health. Note that this includes a small number of instances where deaths were picked up via the death checking process after the mail-out of these letters and notification by relatives.

Any death which occurs in Scotland must be registered within eight days of the date of death. This means that there can be a delay between the actual date of death and the date that it is registered and updated on the CHI and National Records of Scotland databases. This delay, combined with the volume of the mail out process, made it extremely difficult to prevent all questionnaires being sent to addresses of people who had died. However, as outlined above, efforts were made to avoid this as much as possible.