Health and Care Experience Survey 2023/24 Technical Report

Fieldwork

The Scottish Government contracted IQVIA to administer the survey following an open procurement process. IQVIA 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 statisticians.

Mail-out

The fieldwork began on 23 October 2023. This is a similar time of the year, compared with the beginning of the fieldwork for the 2021/22 survey (3rd November 2021).

Out of 528,376 individuals initially sampled, 1,618 were identified as deceased or no longer eligible for the survey via checks with NHS Central Register (NHSCR) and PHS Community Health Index Linkage and Indexing (CHILI) service between the sample being drawn and prior to the first day of mail-out. Checks were run daily prior to each mailout day (please see the section on people who were recently deceased below for more information).

In total, we sent letters and information sheets to 526,758 people during the first mailout phase (537,924 in 2021/22). These were posted out in batches between 23 and 25 October 2023. These initial letters asked respondents to complete the survey online and also included a helpline number.

Reminder letters including a paper version of the questionnaire, were sent out from the 8 November until the 17 November 2023 to those who had not responded to the survey.

Survey Helpline Calls

During the fieldwork a telephone helpline answered queries from people surveyed. In total, 1,646 helpline requests were answered by the telephone and language line.

There were also 3 requests answered by email.

This is a small decrease from the previous round of the survey (2,071 out of the 537,924), which is likely due to improvements in the survey materials.

Over half of the helpline requests received (58%) were about general enquiries or requests for help to complete the survey (545 and 406 respectively). Compared with helpline calls received in the last round of the survey, there was an increase in the number of calls for declining to take part (31% vs 21%). The number of calls to say that a survey recipient had died decreased from 37 in 2021/22 to 32 in 2023/24.

Due to differences in the way that helpline calls were categorised compared to the previous round, care should be taken when comparing the number of General Enquiries and calls for help to complete the survey with previous rounds of the survey.

The number of helpline requests for the 2032/24 survey and for its previous round (2021/22) is broken down by main reason of the request in Table 2 below.

Number of calls to the survey helpline has fallen compared to the previous survey.

People who were recently deceased

In any survey, there is a risk to sample and send survey material to people who have recently passed away. This can cause distress to the family members of the person who has passed away and every effort is made to minimise the risk of this occurring.

We sample people for this survey from the CHI database, which is a source generally up to date with regard to death events. Nevertheless, 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.

In order to address this gap, we ask a specialised team at NRS to run several death checks of the people sampled, one after we have drafted the sample, and daily checks prior to each mail out.

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 IQVIA, 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.

The people included in the 2023/24 survey were sampled from an extract taken from the CHI database provided to Public Health Scotland analysts on 25th September 2023. The sampling, questionnaire printing and mail-out process extended from this date through to the final mailing date of the 17 November 2023. 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 IQVIA, 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 (NHSCR) 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 the Community Health Index Linkage and Indexing (CHILI) team in PHS (who host the CHI database) for further death checks.

A total of 512 people were identified as deceased by NHSCR and CHILI checks and removed from the sample prior to and on the initial mail-out day of the survey on the 23rd October 2023. These individuals were not sent survey packs. In addition, 1,106 people were identified through these checks as no longer eligible for the survey.

NHSCR and CHILI identified a further 47 people as deceased and 43 people as no longer eligible across the second and third mail-out days (24th & 25th October 2023) which completed the initial mail out phase. Public Health Scotland subsequently passed this information on to IQVIA, who removed remaining survey packs as required prior to mail out.

NHSCR and CHILI checks identified 457 people as deceased and 73 people as no longer eligible during the reminder mail out period (8th November 2023 up to the 17th November 2023). Public Health Scotland passed this information to IQVIA, who ensured these people were not sent survey packs.

In 37 cases a questionnaire was sent to someone who had died and the person's family had contacted IQVIA. 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.